How many people died in the US from heart diseases in 2019? The answer is harder than it might seem to pin down. Using a broad definition, such as “major cardiovascular diseases,” and including any deaths where this was listed on the death certificate, the number for 2019 is an astonishing 1.56 million deaths, according to the CDC. That number is astonishing because there were 2.85 million deaths in total in the US, so over half of deaths involved the heart or circulatory system, at least in some way that was important enough for a doctor to list it on the death certificate.
However, if you Google “heart disease deaths US 2019,” you get only 659,041 deaths. The source? Once again, the CDC! So, what’s going on here? To get to the smaller number, the CDC narrows the definition in two ways. First, instead of all “major cardiovascular diseases,” they limit it to diseases that are specifically about the heart. For example, cerebrovascular deaths (deaths involving blood flow in the brain) are not including in the lower CDC total. This first limitation gets us down to 1.28 million.
But the bigger reduction is when they limit the count to the underlying cause of death, “the disease or injury that initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury,” as opposed to other contributing causes. That’s how we cut the total in half from 1.28 million to 659,041 deaths.
We could further limit this to “Atherosclerotic heart disease,” a subset of heart disease deaths, but the largest single cause of deaths in the coding system that the CDC uses. There were 163,502 deaths of this kind in 2019, if you use the underlying cause of death only. But if we expand it to any listing of this disease on the death certificate, it doubles to 321,812 deaths. And now three categories of death are slightly larger in this “multiple cause of death” query, including a catch-all “Cardiac arrest, unspecified” category with 352,010 deaths in 2019.
So, what’s the right number? What’s the point of all this discussion? Here’s my question to you: did you ever hear of a debate about whether we were “overcounting” heart disease deaths in 2019? I don’t think I’ve ever heard of it. Probably there were occasional debates among the experts in this area, but never among the general public.
COVID-19 is different. The allegation of “overcounting” COVID deaths began almost right away in 2020, with prominent people claiming that the numbers being reported are basically useless because, for example, a fatal motorcycle death was briefly included in COVID death totals in Florida (people are still using this example!).
A more serious critique of COVID death counting was in a recent op-ed in the Washington Post. The argument here is serious and sober, and not trying to push a particular viewpoint as far as I can tell (contrast this with people pushing the motorcycle death story). Yet still the op-ed is almost totally lacking in data, especially on COVID deaths (there is some data on COVID hospitalizations).
But most of the data she is asking for in the op-ed is readily available. While we don’t have death totals for all individuals that tested positive for COVID-19 at some point, we do have the following data available on a weekly basis. First, we have the “surveillance data” on deaths that was released by states and aggregated by the CDC. These were “the numbers” that you probably saw constantly discussed, sometimes daily, in the media during the height of the pandemic waves. The second and third sources of COVID death data are similar to the heart disease data I discussed above, from the CDC WONDER database, separated by whether COVID was the underlying cause or whether it was one among several contributing causes (whether it was underlying or not).
Those three measures of COVID deaths are displayed in this chart:Continue reading