If you ask most educated people what the leading causes of death is in New Zealand or any other developed country, they will tell you without having to think: heart disease. (You can confirm this by looking at the Ministry of Health’s website: the top cause of death for all people (Maori and non-Maori, men and women) is ischaemic heart disease.)
It’s an important thing to keep in mind. In this world where it’s very easy to be afraid of being hit by a car, or being in a plane accident, it’s things like heart disease and stroke that should terrify us.
They should terrify us in the sense that they drive us to action – to take steps to reduce the likelihood that this might be our premature fate. Of course, we can’t guarantee that these things won’t befall us; part of it comes down to luck, and ageing is a big part of the equation – in most cases, age is the biggest risk factor, and the longer we live, the more at risk we are.
If we can take steps to reduce the likelihood of dying from heart disease, this raises an interesting question. Which brings me to a provocative paper by Dr Ralph L. Keeney of Duke University. In this paper he suggests that Personal Decisions Are the Leading Cause of Death.
In the introduction, Dr Keeney explains:
“This paper investigates a different framing of the major causes of death in America. With this frame, the major cause of death is not heart disease or cancer, nor is it smoking or being overweight. The leading cause of death is personal decision making”.
So: is heart disease the real cause of death, or is heart disease a result of the personal decisions we make over the course of our lifetime?