Study: 70% of adults dying prematurely of natural causes do not seek medical help
Thursday, May 02, 2019
About 70% of adults dying prematurely of natural causes have not sought medical help within the previous 30 days, according to the results of a new study published in the journal PLOS One.
Researchers from The University of Texas Health Science Center at Houston (UTHealth) and the Harris County Institute of Forensic Sciences (IFS) teamed up to analyze autopsy reports and death investigation records of 1,282 people between the ages of 25 and 59 who died in Harris County in 2013. They discovered key factors relating to premature adult deaths.
Premature adult deaths are those that occur before the expected mortality age. There has been a significant increase in mortality rates of middle-aged white Americans since 1999, according to research published in 2015.
Lead author of the study, Stacy Drake, Ph.D., MPH, RN, was working at IFS when she noticed that younger people were dying, so she set out to identify the causes of death in that Texas county. Drake is now an assistant professor at Cizik School of Nursing at UTHealth.
This study identifies common characteristics between two growing categories of premature death among adults: deaths from natural causes and those from drug toxicity. Identifying these common characteristics, particularly modifiable characteristics, could potentially guide health care professionals in the development of interventional strategies.
“We were looking for factors that can be changed, e.g., individual, interpersonal, organizational, or community modifications,” said Drake in a press release. “We need to dive into what is going on with these folks and find out where we can break the chain of events leading to their deaths.”
The collaboration with Drake gave the co-author of the study, Harris County IFS deputy chief medical examiner Dwayne A. Wolf, MD, Ph.D., an opportunity to participate in the conversation about premature adult deaths.
“As medical examiners, we perform autopsies and present findings in court. As physicians, we appreciate the opportunity to translate our findings into improvements in health care, in injury prevention, or even in preventing deaths,” said Wolf. “Dr. Drake shares that goal and recognizes the unique value of the data that we gather in the course of our investigations. She has forged a collaborative relationship with our office, and this latest publication is an example of the power of this collaboration.”
Study identifies characteristics associated with premature natural and drug-related deaths
The research team review 1,282 records and found 912 deaths due to natural causes and 370 to drug overdoses. Furthermore, they found that 70% of those dying from natural causes had not visited a health care provider in the month before their death.
“They had symptoms and knew they were getting worse,” Drake said. “Yet, they didn't seek the attention of a health care provider. We need to conduct further research to answer the question of 'why?'”
To do that, researchers would need to speak with family members to identify other factors that contributed to the early deaths. Family members could shed light on whether some of those who died prematurely had an undiagnosed medical illness, for example, if they did not have adequate access to care, or if they simply had negative experiences with providers.
The research team was able to identify some associated factors contributing to these early deaths in both natural cause category and the drug overdose category. Among those that died of natural causes, 48% used alcohol, 42% used tobacco, 22% were current substance abusers, and 82% had a documented medical, psychological and surgical history. The top three causes of early deaths were associated with the circulatory system (62%), the digestive system (7%) and endocrine/metabolic diseases at (7%).
67% of adults in the study were single and 34% lived alone. At 52%, the majority of the adults in the study did not have a health provider. The three communities including in the study, North Central (Trinity Gardens), South (Sunnyside) and East (Baytown), have lower education, lower income, higher unemployment, and are medically underserved compared with other nearby areas.
“Overall, they're dying of diseases that we treat every day,” Drake said.
Of the drug-related early deaths, 91% were accidental, and 9% were suicide. Toxicology tests detected opioids 187 times, cocaine 165 times, benzodiazepine antidepressants 107 times, and alcohol 103 times. Most of the adults who died of drug overdoses also used alcohol and tobacco. The results of the study showed that whites were 2.22 times more likely to die from drug overdoses than were blacks.
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