\u201cTotal mortality [the number of deaths from any cause during a time period] peaked in the late 1960s, and it\u2019s been falling. We\u2019re gaining between four and six hours per day,\u201d he says. <\/p>\n
Deaths from cancer and cardiovascular disease have reduced over time, he says, but they are still the biggest killers.<\/p>\n
\u201cCoronary heart disease is still the single number one killer. It depends on if you look at a single [disease] versus a group [of diseases]. So all cancers are more common than all cardiovascular disease.\u201d<\/p>\n
The most common causes of death change as we age, so what are you most likely to die of \u2013 and when? <\/p>\n
In your 20s<\/p>\n
External injuries are the leading cause of death for people in their 20s.<\/p>\n
These are classified as intentional \u2013 suicide, self-harm or assault \u2013 or unintentional, including falls, burns, vehicle crashes, dog bites and drownings.<\/p>\n
\u201cThis age group is generally fit and healthy, so less likely to die from the usual suspects that lead to death in older age, [such as] heart disease and cancers,\u201d says Bridget Kool, professor in epidemiology and biostatistics at the University of Auckland.<\/p>\n
\u201cThey are often described as accidents, although we avoid this term as it suggests they are not preventable, which is generally not the case as they are usually both predictable and preventable.\u201d<\/p>\n
New Zealand has a high suicide rate in this age group and younger.<\/p>\n
Shaun Robinson, chief executive of the Mental Health Foundation of New Zealand, says this is a long-term trend.<\/p>\n
\u201cThere are many reasons that contribute to suicide, there is no simple answer … when things are not working well in our society, in our community, it\u2019s young people that usually suffer first and hardest, and that is definitely contributing to deaths by suicide.\u201d <\/p>\n
Marginalisation, economic disadvantages, drug and alcohol abuse, unemployment and bullying all play a part, he says.<\/p>\n
\u201cRangatahi M\u0101ori are twice or more times more likely to self-harm or die by suicide.\u201d<\/p>\n
Robinson says accessible mental health support services are key for young people.<\/p>\n
Kool says men generally have higher rates of unintentional injury than women, in part due to risk-taking behaviours.<\/p>\n
This is the case around the world, but there are some nuances \u2013 for example, New Zealand has many rural communities \u2013 where patterns of death differ from those in urban environments.<\/p>\n
\u201c[In] urban settings you\u2019re more likely to have violent injuries,\u201d she says.<\/p>\n
There are more unintentional deaths in rural workplaces, such as farms, or as a result of vehicle crashes on rural roads.<\/p>\n
In your 30s<\/p>\n
While conditions like cancer and heart disease begin to rise in frequency as we age, when tallied up, external injuries \u2013 things such as suicide, road crash deaths and assault \u2013 are still the leading cause of death for people in their 30s. <\/p>\n
Kool says prevention can help reduce the risk of death, but it is difficult to change behaviours.<\/p>\n
\u201cPrimary prevention is about addressing the risk factors.<\/p>\n
\u201cSo stopping injuries happening in the first place \u2013 seatbelts and smoke detectors and helmets for cycling, and drink-driving legislation.\u201d<\/p>\n
Environmental solutions \u2013 think of speed bumps on a road, or your car beeping at you until you put your seatbelt on \u2013 can also help prevent injuries.<\/p>\n
\u201cIt\u2019s very difficult to change behaviour. Behavioural education\u2019s really important to support that, but at the end of the day, making the safest thing to do the easiest [thing to do] is the most effective solution.\u201d<\/p>\n
Secondary prevention, through emergency medical services and effective treatment, is also key to minimising the impact of injuries. <\/p>\n
New Zealand had a national injury prevention strategy, but this no longer exists. Joining existing agencies, who work on water and road safety and other types of harm reduction, could help reduce injury deaths around the country, Kool says.<\/p>\n
In your 40s <\/p>\n
Cancer emerges as a major cause of death from the 40s onwards.<\/p>\n
In New Zealand, five types account for half of all cancer deaths: 18% are due to lung cancer, 12% bowel cancer, 7% prostate, 7% breast and 6% pancreas.<\/p>\n
George Laking, medical oncologist at Te Puriri o Te Ora\/The Regional Cancer and Blood Service at Auckland City Hospital, says lung cancer isn\u2019t diagnosed as frequently as other cancers \u201cbut the trouble is, it is just so much more deadly\u201d.<\/p>\n
He says the most frequently diagnosed cancer in New Zealand is non-melanoma skin cancer, which is less likely to be fatal. <\/p>\n
The number of people being diagnosed with and dying from cancer in New Zealand has increased over time, as the population grows and ages. But the mortality rate \u2013 the risk of dying \u2013 from cancer itself has fallen.<\/p>\n
\u201cOne of the reasons we see more cancer is simply because people are living to the age where they can get cancer. Screening programmes capture cancer earlier, so fewer people die, and mortality goes down.\u201d<\/p>\n
Laking says bowel or colorectal cancer<\/a> is the second-biggest killer from cancer in New Zealand, and cases are increasing among younger people. It\u2019s considered early-onset if diagnosed in people younger than 50.<\/p>\n Heart disease also emerges as a more common cause of death in this decade. <\/p>\n Dr Julia Shanks, a senior research fellow at the University of Auckland, says heart disease symptoms can be missed in younger women in particular, delaying diagnosis.<\/p>\n \u201cWomen are more likely to develop heart failure at a younger age if they\u2019ve had adverse outcomes during pregnancy … [such as] high blood pressure or gestational diabetes.\u201d<\/p>\n In your 50s<\/p>\n In your 50s, cancer is the leading cause of death. <\/p>\n \u201cM\u0101ori are about 60% more likely to die from cancer. Pacific, about 40% more likely. And if you\u2019re deprived economically, [you are] 55% more likely,\u201d Laking says.<\/p>\n \u201cThese things combine with each other, so you don\u2019t escape this extra risk if you\u2019re M\u0101ori or Pacific and you\u2019re wealthy \u2013 you still carry extra risk.”<\/p>\n When it comes to reducing cancer risk, the environment is a major factor. <\/p>\n \u201cWe\u2019ve got things in our environment that lead to cancer; a lot of them are really addictive things,\u201d Laking says.<\/p>\n Because smoking is the primary cause of lung cancer, environmental changes like higher tobacco prices and the ban on displaying tobacco products in shops are aimed at making it harder to smoke.<\/p>\n \u201cThat has changed the environment … and has actually done more to stop people smoking, compared to still having visible advertising, really cheap cigarettes and just saying, \u2018You\u2019ve got to quit from willpower\u2019.\u201d<\/p>\n Meanwhile, he says, \u201calcohol causes heaps of cancers<\/a> and alcohol\u2019s very much in our environment, in supermarkets for example. So we can expect to see more cancer. <\/p>\n \u201cThe general public health messages [are] don\u2019t smoke, it\u2019s probably best not to drink, or cut it down, put on a sunhat and cover up.\u201d<\/p>\n For people in their 50s, heart disease is the second-most-common cause of death, but symptoms can present differently in men and women<\/a>, and there are differences in the age of onset and how the condition develops.<\/p>\n \u201c[It\u2019s] traditionally thought of as a man\u2019s disease, and while it affects a lot of men, we\u2019re understanding more about [how it impacts] women \u2013 and it does increase in women post-menopause,\u201d Shanks says.<\/p>\n \u201cMen have the classic symptoms of a heart attack, a tight chest, and they get blockages in the big blood vessels in the heart, which we\u2019ve got quite a few good diagnostic techniques to now identify. <\/p>\n \u201cWhereas when women experience a heart attack, they\u2019re more likely to see blockages in the really tiny vessels of the heart, which might be missed.\u201d<\/p>\n She cites a recent study showing that under the age of 55, while men are more likely to have a heart attack, women are more likely to die from one or be readmitted to hospital.<\/p>\n \u201cMen are more likely to experience heart failure at a younger age and women are more likely to experience heart failure post-menopause.\u201d<\/p>\n In your 60s<\/p>\n Cancer remains the leading cause of death for people in their 60s, followed by heart disease. Age is a big factor in people\u2019s cancer risk.<\/p>\n \u201cIf we could live to be 200 everyone would get cancer, because the risk just goes up,\u201d Laking says.<\/p>\n \u201cThere\u2019s a little bump in risk earlier in life, and that\u2019s childhood and adolescent cancer. The rate is still low for children and adolescents, compared to people of retirement age.\u201d<\/p>\n The risk of heart disease increases in our 60s and beyond because as we get older, fatty plaques build up in our blood vessels. This causes them to stiffen and lose elasticity, making it harder for the heart to pump blood through them.<\/p>\n \u201cThe heart has to work a bit harder, the heart gets bigger and eventually loses its efficiency to pump blood around the body,\u201d Shanks says.<\/p>\n Heart disease encompasses a range of conditions; the deadliest of which is ischaemic or coronary heart disease, while heart failure is a chronic condition people live with.<\/p>\n \u201cIn terms of risk for ischaemic heart disease or [the] chance of having a heart attack, we usually see [it] in men at a younger age, and in women this can occur a little bit older.\u201d<\/p>\n In your 70s<\/p>\n As a group of diseases, cancer still poses the highest risk of death in your 70s, followed by heart disease. <\/p>\n The risk of getting breast cancer increases with age, which is why the age limit for free breast screening was raised last year and will roll out to become available for women aged 70-74. The risk of getting bowel cancer also increases with age; bowel screening is free for people aged 60-74.<\/p>\n Heart disease is the second-most-common cause of death at this age, and if you have high blood pressure or diabetes, it\u2019s important to get those under control to reduce your risk of getting heart disease or dying from it. <\/p>\n \u201cBeyond that, lifestyle interventions are really good at attempting to prevent heart failure, or if you\u2019ve got heart failure, improving symptoms … [by] staying active, reducing salt and improving your diet,\u201d Shanks says.<\/p>\n Respiratory diseases pose a risk of death in this age group, as immunity declines. Older people are also more likely to have other chronic conditions, such as diabetes, that impede recovery. <\/p>\n Common respiratory diseases include chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases caused by long-term inhalation of substances like asbestos or silica in a workplace, and pulmonary hypertension \u2013 high blood pressure affecting arteries in the lungs.<\/p>\n Covid-19 and influenza are also respiratory diseases that pose a risk of severe illness and death in elderly people.<\/p>\n 80s and beyond<\/p>\n When you reach your 80s, heart disease is the leading cause of death. <\/p>\n The risk increases over time because as people age, they\u2019re more likely to have comorbidities \u2013 other conditions such as high blood pressure and cholesterol, diabetes or obesity \u2013 that accelerate the process.<\/p>\n \u201cIt really is this progressive thing over decades, which is why heart failure increases as we get older,\u201d Shanks says.<\/p>\n However, it\u2019s never too late to make changes to reduce your risk, Jackson says.<\/p>\n \u201cCoronary disease is the number one preventable premature cause of death, because we basically know the causes \u2013 a diet high in saturated fat, high blood pressure, a diet high in salt, being overweight, smoking, high blood glucose. <\/p>\n \u201cIt\u2019s never too late to change your diet. It\u2019s never too late to stop smoking … [You can] reduce your risk surprisingly rapidly.\u201d<\/p>\n The risk of death from stroke rises in this age group as well, though strokes can occur at any age. <\/p>\n About 2000 people die of stroke in New Zealand each year and between 2018 and 2028, there is expected to be a 40% increase in strokes in New Zealand.<\/p>\n