The Five Ways You are Most Likely to Die

Every Thursday for many years, I’ve run a multi-family group in an addiction treatment center for young adults and their families. Last summer, I wrote this list on the board and asked them to guess its significance:

  • Car crash
  • Hiking
  • Shoveling snow
  • Heart Attack
  • Cancer

People were dumbfounded and mostly had no response. I told them that these were the mostly likely ways that I would die (in no particular order). We’ll come back to that group. A few days later, I offered up the same list to my friends, parents, and my ex-wife. Only two friends got it right. My ex-wife figured it out after hearing just the first three.

One family member in the group exclaimed that it was a morbid topic. Another played into my hands by asking me how I arrived at that list. I explained to the group that I often drove above the speed limit and that there is a high correlation between speed and accidents. I discussed how I am hiking higher and higher mountains and have recently started hiking in winter conditions including deep snow and on sheets of ice. My driveway is over 100 feet long and opens into a large parking area – I shovel it alone and it often can take three or four hours. While I exercise and neither drink alcohol nor smoke cigarettes, I do have a diet high in red meat and I avoid vegetables. I have a sweet tooth and also smoke cigars. There is no known history in my family of cancer, but there is one for heart attacks. After explaining my list, I stated that I could lessen the chances of dying those ways by engaging in the following behavioral changes:

  • Drive slower. Never text or eat while driving.
  • If I’m taking a dangerous hike or going in extreme conditions, always have a guide or a partner.
  • Take breaks every half hour while shoveling snow. Don’t make speed a point of pride.
  • Eat a bit healthier. Lose some weight.
  • Eat a bit healthier. Reduce sugar intake. Cut down on cigars.

I have fully committed to items 2 and 3. I am slowly addressing items 1, 4, and 5 (ironically, those are the most likely ways I’ll die). I had every group member silently write down their list of the five ways they are most likely to die. Then I had them break up into smaller groups and share their lists. They were instructed to discuss what behavior changes they could attempt in order to reduce. After a half hour, I brought everyone back into a big circle. Their most common answers: drug overdose, car crash, cancer, heart attack, respiratory disease, and suicide. These are six of the ten ways that most Americans die (a note on the four group members who mentioned suicide – none of them had active suicidal ideations but they all had a history). The talk surrounding how to reduce these outcomes was lively and suggestions included: quit smoking, see a therapist, keep going to 12-step meetings, stop texting while driving, eat more vegetables, and take medication as prescribed.

Three other answers stood out. An older father listed diabetes. It developed from drinking and he has to monitor his blood daily, take insulin shots, and get regular medical checkups. Most of the clients did not know that heavy drinking could cause diabetes. A 2016 Cato Institute Study reported that diabetes is actually a top-ten killer of Americans.

Three people listed either “getting shot” or “getting killed.” They were clients in their 20s with long drug histories. One woman expressed fear about an ex-boyfriend who was currently incarcerated. I suggested talking to her counselor and a lawyer and to consider a restraining order. The two men who said they might “get shot” did not have a particular person in mind but each had dozens of friends who had either overdosed or were killed as a result of their lifestyle. Both agreed that remaining drug free and avoiding their home town greatly increased their life expectancy.

Three others listed “terrorist attack.” I addressed this issue from the flank. I wrote down the lifetime odds of Americans that die via falling (1 in 133), motorcycles (1 in 949), poison (1 in 1,355), fire (1 in 1,454), heatwave (1 in 10,745), and animal attacks (1 in 30,167). I wrote down the number of Americans killed in America by foreign born terrorists between 1975 and 2015. The Cato Institute reports the number is 3,024 and the lifetime odds are 1 in 45,808.  I asked the group why some people would be more concerned about terrorism, shark attacks and lightning strikes over problems caused by speeding, alcohol use, prescription drug abuse, smoking, and lack of exercise. A 23 year-old male who was five months clean replied, “We don’t want to acknowledge the problems that are our fault and have to make changes. It is easier to be afraid of things beyond are control and that are on tv a lot, like terrorists and shark week.”

It was the kind of statement that group therapists strive for – I couldn’t have put it better and it was much more impactful coming from him. There are a number of lessons here, and I would like readers to jot down their own list and discuss it with their friends and/or family members. And figure out what you can change so that you can live a little bit longer.