This blog post draws on data and research discussed in our new entry on Causes of Death.
The world has changed considerably over the last few centuries — this is what Our World in Data shows. One thing however has remained constant through this transition: we all have to die sometime. However, the causes of death are changing as living standards improve, healthcare advances, and lifestyles change.
In this blog we attempt to answer the question 'what do people die from?', first by looking at the data on global causes of death followed by a selection of country-level examples. The leading causes of death across the world still vary significantly — we have therefore picked a selection of countries which highlight this heterogeneity.
First, let's start with the question: 'what does the world die from?'
In 2016, around 55 million people died – nearly half of these were aged 70 years or older; 27% aged 50-69; 15% aged 15-49; only 1% aged 5-14; and around 10% were children under the age of 5. In the chart below we see a breakdown of global deaths by cause, ordered from highest to lowest. This is shown in absolute numbers, and each cause as a share of total deaths. Note that this list is not exhaustive: deaths from less common causes are not shown. You can also the causes of death for any country by clicking on the chart to get to the interactive version of this chart and then chosing 'Change country'.
The leading global killer in 2016 were cardiovascular diseases (CVD), which refer to a range of diseases that affect the heart and blood vessels: These include hypertension (high blood pressure); coronary heart disease (heart attack); cerebrovascular disease (stroke); heart failure; and other heart diseases. Cardiovascular diseases killed 17.6 million people – around one-third of all deaths.
Rounding off the top four were respiratory and diabetes-related diseases. Collectively, these are known as non-communicable diseases (NCDs): together they accounted for more than 39 million deaths (more than 70 percent) in 2016.
There are a number of causes with high death tolls which if not entirely preventable can be (and have been in many countries) dramatically reduced. More than 1.7 million newborns still died due to complications at birth. The very low neonatal death rates in high-income countries and significant progress across the world in recent decades is testament to the fact that we know how to reduce such tragedies significantly. Similarly, diarrheal diseases — which claimed 1.7 million people in 2016 and is one of the leading causes of death in children under 5 years old — are also preventable and treatable through improved water, sanitation, hygiene, and simple 'oral rehydration salt' (ORS) packets. Malaria has been successfully eliminated in some regions, and should with time be possible to eradicate; nonetheless, the IHME's Global Burden of Disease (GBD) study estimates that more than 700,000 still died from malaria in 2016.
Road incidents fall within the top ten causes of death, claiming 1.3 million in 2016.
Surprising to some is that the number who die from suicide is more than double that of homicide at a global level. In fact, the number of deaths from suicides is higher than the number of deaths from all forms of violence – including homicide, terrorism, conflict, and executions – globally and across many countries across the world. You can see this relationship here. As Yuval Noah Harari notes in his TED Dialogue: "Statistically you are your own worst enemy. At least, of all the people in the world, you are most likely to be killed by yourself".
At the bottom of the list we see deaths from natural disasters and terrorist attacks. Whilst the relative risk from such events is typically low, we must take care when using annual statistics in this case. Death rates related to disease, illness and other health factors tend to change relatively slowly over time. Natural disaster and terrorism-related deaths are different: they can vary substantially from one year to the next. This can make the annual comparison of deaths between health-related factors and volatile events more challenging and assessing the relative risk of these events can require a longer-term overview of high and low-mortality years. We cover discussion and analysis on this topic in a blog post here.
What do people in the United States die from? In the chart below we see its breakdown of deaths in 2016.
Compared with the global data, a larger share of deaths is caused by non-communicable diseases (NCDs) — accounting for almost 90 percent of mortality — and much lower occurrence of preventable deaths such as diarrheal disease, undernutrition, and neonatal deaths. This is a common pattern across high-income countries: prosperity, high living standards, good healthcare systems (although there are large inequalities in healthcare access in the US when compared with other rich countries) have seen a successful decline in largely preventable mortality risks.
The majority of deaths in high-income countries therefore relate to to so-called 'lifestyle diseases', including NCDs, kidney, liver, and digestive diseases, or those which typically occur in older age (such as Alzheimer's and other dementias). This major shift in causes of death towards NCDs represents the so-called Epidemiological Transition which marks the transition from infectious diseases towards more chronic conditions. We see this process in the United States by looking at the shift in mortality across the 20th century. Leading risk factors for death in the United States are therefore now strongly linked to lifestyle choices such as smoking, obesity, blood sugar, dietary intake, and alcohol consumption.
Suicides in the United States rank highly on the list of mortality causes — above deaths from road accidents, and more than 2.5 times the number from homicides.
Germany — again representative of a rich country with high living standards — shows a similar pattern to that of the United States. Leading causes of deaths are dominated by NCDs, dementia, and diseases related to the liver, kidney or digestive systems. Two thirds of all deaths are caused by cardiovascular diseases and cancer.
An interesting distinction between Germany and the United States is its relative tally of road deaths. Road-related deaths in Germany ranked much lower than in the United States (0.5 percent versus 1.6 percent of deaths); in fact, more people died from alcoholism, and from diarrheal diseases in Germany than from road accidents. Homicide deaths are also very low — much lower than in the United States (0.07 versus 0.7 percent in the US). This creates an even greater disparity between suicide and violent deaths: around 17 times as many people died from suicide in 2016 than from violence.
Brazil provides an interesting contrast to the low homicide rates we see in Germany. As we see in the chart below, homicide ranks 7th in terms of the leading causes of death, claiming around 60,000 lives (4.6 percent of all deaths) in 2016. Like much of Latin America, the number of homicides greatly outnumber deaths from suicide. In Brazil, around four times as many people died from violence than from suicide.
Brazil, having experienced impressive economic growth in recent decades, now holds a middle position in terms of its distribution of mortality causes. Like the United States and Germany, Brazil's leading causes of death are NCDs and dementia. Causes of death which we might term 'largely preventable' such as diarrheal disease, and newborn complications lie within the mid-range of causes; they are not dominant, but remain significant. We would expect that with continued development, their significance would continue to fall.
South Africa is one of the few countries where cardiovascular disease is not the leading cause of death. Since the late 1990s, HIV/AIDS has been the leading cause of death in South Africa, reaching a peak of over 350,000 deaths per year in over 2006-2008. Since then, HIV-related deaths have more than halved, but the disease still remains the country's largest killer in 2016 at 164,000 (close to one-third of deaths). This is more than double the number of deaths from cardiovascular disease.
South Africa is not alone. HIV/AIDS remains the leading cause of death across several of its neighbours including Namibia, Zambia, Zimbabwe, Botswana, Mozambique and Malawi.
Working with data on global development one comes across a lot of very sad facts about the world. Still, there are some I find so shocking that they are impossible to forget. The leading cause of death in Kenya is diarrheal disease, claiming around 50,000 (almost 20 percent) in 2016 alone. Improving basic infrastructure related to clean drinking water, sanitation, and hygiene, as well as improving healthcare services related to the treatment of diarrheal diseases will be crucial for Kenya (and similar countries with high mortality rates) to tackle such preventable deaths.
In our global view of causes of death — and for all of the country-level examples above — terrorism-related deaths tend to rank very low.1 This is not the case everywhere. Whilst terror-related deaths have remained relatively low across the West, they have been increasing across the Middle East, North Africa, and to a lesser extent South Asia.
For a number of countries across the Middle East in particular, terrorist-related and conflict deaths can be high on the list of leading causes. In the chart below we see death statistics for Iraq in 2016. Here we see that conflict and terrorism rank 5th and 6th respectively, with more than 11 percent of deaths combined. Whilst terror statistics at a global level suggests a low incidence of death, in some regions the odds are much more cruel.
This post provides only a range of diverse snapshots of causes of death across the world. You can explore these trends for your own (or any other) country in the charts above. You will also find a wealth of additional data on causes and rates of mortality in our full entry on Causes of Death.