If you die in the United States, University of California, San Diego professor David Phillips will hear about it eventually. Even if you become just a number in a government database, he’ll figure out how you and millions of other people fit into a death trend.
That’s his job. Just this week, the medical journal Addiction published a Phillips study that found baby deaths in the United States from sudden infant death syndrome skyrocket on New Year’s Day to the highest level in the year, possibly because parents drink too much and don’t keep a close eye on their kids.
Among other things, Phillips has discovered that it’s possible to be scared to death and identified the American suicide capital (Las Vegas). He determined that women are more likely to die after their birthday (perhaps because they try to hang on through it) while men are more likely to die before. And thanks to him, we now know that people are more likely to commit suicide after landmark birthdays like 30, 45 and 60.
But Phillips, a sociologist and native of South Africa, may be best known for his work debunking a holiday myth about suicides and showing why Christmas and New Year’s Day are especially deadly.
I asked Phillips today to talk about his work and describe what he’s learned about whether death takes a holiday during the holidays.
Why did you decide to study death in the first place?
I was trained mostly as a demographic specialist, and they study either fertility or mortality or migration. I specialized in mortality.
Also, there’s fantastically good data on a huge number of deaths — 2 million a year — and the federal government has been providing this stuff for free for 40 years. It’s a good data set.
Another reason for doing it is that even though I had published in the very best sociological journals, my parents, who were both professors, didn’t pay attention to my publications. They only paid attention when I began to appear in The Lancet, The New England Journal of Medicine, the Journal of the American Medical Association and others.
The ignoble reason was that I was trying to impress my parents.
What did you discover about suicides and the winter holidays?
A long time ago, I did what appears to have been the first nationwide study of what suicide does around these holidays. Up until we did this study, it was believed based on very small psychiatric investigations that people got depressed around these holidays and there’s a spike in suicides.
What we found that in deed there is a small spike in suicides just after these holidays (and other holidays too), but there’s an even bigger drop just before the holidays.
It maybe that some people get depressed. But there’s apparently a larger group of people who look forward to the holidays, and they hold on.
But your research doesn’t tell you for sure why the rate goes down.
With the kind of data I investigate, you can’t get any details about what the mechanisms are. There’s probably not just one scenario that’s operating to produce this effect.
You also looked at the rates of deaths from heart disease and other natural causes during the holidays.
There’s a spike in heart deaths on Christmas and on New Year’s Day and one day after them. There are more deaths on those days than any other days, even after you correct for seasonal fluctuations in mortality. The spike is somewhere around 3-10 percent above what’s expected.
In a subsequent paper that was just published, we found this pattern not only just for cardiac deaths but pretty much for every major natural cause of death.
You get the same pattern for people who are dead on arrival at the hospital and people who die in the emergency department.
What explains this?
We don’t know. What you’ve got is millions of records, but you don’t have very much detail.
There are things that could be happening: It could be that medical care gets worse on these holidays because senior staff say “I’m going to take a vacation now,” and those left at the hospital are relatively more junior staff.
It’s unlikely that emotional stress is doing this because no one has demonstrated that emotional stress can have a very abrupt effect on a huge range of diseases, although it might in one or two diseases.
Might people postpone going to the hospital and get there when it’s too late?
That’s another possibility, that people are waiting too long to go in for medical care. They want to be with their families on the holidays, and waiting too long is not a good idea if you’re very sick.
People may be traveling and not be familiar with local medical services, but the trend holds up even if you stick with people who are in their home counties.
Why does this kind of research matter?
The impetus now is to find out why this spike exists. If it turns out to be because medical care degrades on Christmas and New Year’s, that says to hospitals, “Look, although it’s convenient to let senior staff go on these occasions, there are consequences.” That’s a potentially important implication.
What did you discover about sudden infant death syndrome and the holidays?
The peak is just on Jan. 1, and it’s a huge peak. There’s a 33 percent increase in SIDS death above and beyond what normally happens in the wintertime. It’s associated with a spike in alcohol consumption that is far greater than any other time of the year.
Has your research changed your approach to the holidays?
You have to be really careful about driving on New Year’s because there’s all these crazies filled with alcohol. For me, I don’t go out on the road on New Year’s Eve. I go to sleep at 9 p.m.
I know what happens: the spike in homicides and car crashes is enormous. Why run that risk for the sake of some ability to say the next morning that I stayed up until the new year?
So it’s made you a party pooper.
I was never very much in the way of a party booster!