Christmas – Deadliest Day of the Year

Drop by any time.

Here’s a little exercise in critical thinking. More people in the United States die on Christmas Day than on any other day of the year. It’s our deadliest day. New Year’s Day is the second deadliest day.

The first question a critical thinker would ask is: Is that really true? Here’s the evidence: an article published in Social Science and Medicine in October 2010, that analyzed 54 million death certificates from 1979 through 2004. (Click here for the abstract and charts; the full-text is behind a pay wall). Regardless of the setting or the cause, the number of deaths clearly peaks on Christmas Day. This affects all demographic groups, except children.

The next question a critical thinker might ask is: Why would that be? Here the logic gets a little fuzzy. As the authors of the research paper point out, they tested nine different hypotheses but believe more research is necessary. So let’s think about it a bit.

• Hypothesis 1: Perhaps it’s because people overeat on Christmas Day, overloading the digestive system, causing systemic stress and death. Really? One big meal causes death? If that’s the case, many of us would be long gone already.
• Hypothesis 2: It’s the stress of having all those family members and in-laws around. True, that’s a lot of stress but a lot of other holidays cause stress as well. If that’s the case, why wouldn’t we also see spikes on Thanksgiving or July 4th?
• Hypothesis 3: maybe sick people hang on until Christmas and then let go. It’s possible — people can and do keep themselves alive until a big event. But that doesn’t explain why mortality rises in the days and weeks before Christmas. If people were hanging on, you would expect to see a dip in deaths just before Christmas.

The hypothesis I like — which I spotted in the Daily Beast (click here) — is that Christmas isn’t abnormal in terms of life-threatening incidents, but is abnormal in the way people behave when a life-threatening incident occurs. If you feel chest pains on any random day, you may just head straight for the hospital. That’s a good idea because the sooner you get there, the better your chances of survival. On Christmas, however, people may delay, not wanting to spoil the festive atmosphere or leave the family celebration. They may also believe that they’ll get poor service at the hospital on Christmas. The hospital will likely be understaffed or staffed by second stringers, etc. Better to wait ’til tomorrow to get better service.

The next question a critical thinker might ask is: If this is true, what should we do about it, if anything? This hypothesis, of course, is not fully tested. We can’t claim conclusively that it’s true. But there is a certain logic about it. Perhaps enough that we can make Pascal’s wager — the evidence isn’t conclusive but it’s strong enough to make a bet. If we’re wrong we don’t lose much. If we’re right, we can save a lot of lives. So, what do we do? Perhaps we can advertise the phenomena and encourage people to get to the hospital quickly, even if it is Christmas. In fact, consider this article a public service announcement. If you have chest pains today, get your butt to the hospital pronto!

Merry Christmas!