Research article
Mortality rates and causes among U.S. physicians1

https://doi.org/10.1016/S0749-3797(00)00201-4Get rights and content

Abstract

Content/ Objectives: No recent national studies have been published on age at death and causes of death for U.S. physicians, and previous studies have had sampling limitations. Physician morbidity and mortality are of interest for several reasons, including the fact that physicians’ personal health habits may affect their patient counseling practices.

Methods: Data in this report are from the National Occupational Mortality Surveillance database and are derived from deaths occurring in 28 states between 1984 and 1995. Occupation is coded according to the U.S. Bureau of the Census classification system, and cause of death is coded according to the ninth revision of the International Classification of Diseases.

Results: Among both U.S. white and black men, physicians were, on average, older when they died, (73.0 years for white and 68.7 for black) than were lawyers (72.3 and 62.0), all examined professionals (70.9 and 65.3), and all men (70.3 and 63.6). The top ten causes of death for white male physicians were essentially the same as those of the general population, although they were more likely to die from cerebrovascular disease, accidents, and suicide, and less likely to die from chronic obstructive pulmonary disease, pneumonia/influenza, or liver disease than were other professional white men.

Conclusions: These findings should help to erase the myth of the unhealthy doctor. At least for men, mortality outcomes suggest that physicians make healthy personal choices.

Introduction

Although anecdotal evidence and conjecture abound regarding physician mortality and some causes of death, such as suicide, have been extensively explored, little is actually known about U.S. physicians’ age at death or causes of death. Most prior work1, 2, 3 has used small or unrepresentative samples or databases, compared only mortality difference among medical specialties, been applicable only to white male physicians, concentrated on specific causes of death, or has not removed the confounding of socioeconomic status or the healthy worker effect. In addition, little reliable recent comprehensive information has been published.

Physician mortality is of interest for several reasons. First, physicians’ personal health habits may affect their patient counseling practices, and mortality reflects personal health choices.4 Second, given that mortality rates may reflect lifestyle choices, it would be valuable for patients and others to know whether physicians’ average age of death suggest that they have made healthful lifestyle choices. Finally, physicians’ large amount of health-related education and high socioeconomic strata (as judged by education, income, and occupational level) should lead to lower relative mortality.5

Section snippets

Methods

We took data for this study from the National Occupational Mortality Surveillance database.6 This database is supported through the collaborative efforts of the National Institute for Occupational Safety and Health (NIOSH), the National Cancer Institute, the National Center for Health Statistics, and state health departments; it also contains information from death certificates from selected states. The death certificate records the usual industry and occupation of the decedent as reported by

Results

Table 1 shows mean ages at death for white and black adult men from selected states between 1984 and 1995. Among both white and black men, physicians were older when they died when compared with others in the population, with all examined professionals, and specifically when compared with lawyers. Despite the recent burgeoning of women in medicine, data for women are not presented because the relatively few older women in the physician population falsely skew downward the mean age at physician

Discussion

This is the first national study to examine age at death and causes of death for U.S. physicians. For both white and black male physicians, the average age at death was older than for other same-race professionals and nonprofessionals in the U.S. population. Because the number of (still primarily male) physicians has increased dramatically in recent years (nearly doubling, for example, between 1970 and 1990),13 this finding is especially impressive. Such a trend makes available a relatively

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