Top Ten Reasons Alaskans Die

Fair lady, throw those costly robes aside,
No longer may you glory in your pride.
Take leave of all sour carnal vain delight,
I’m come to summon you away this night.
-- Medieval verse from “Death and the Lady” (Roud, 1031)

If you want to know why Alaskans died in Alaska, you go to the Alaska Vital Statistics 2020 Annual Report, the most recent version available. It was released late last year and updated earlier this year. It is weighty reading and covers lots of other topics such as births, marriages, adoptions, etc. But we’ll focus on deaths. Before we jump into the top ten reasons Alaskans died, here are a few interesting facts of note:

• 5,183 Alaskans died of all causes in 2020
• December had the most deaths by month (529)
• the average age of death for men was 64, but the oldest male decedent was 104 years old
• the average age of death for women was 69, but the oldest female decedent was 106 years old
• in 2020, the top ten leading causes of death were responsible for 3,755 deaths, or 72 percent of all deaths

Speaking of the top ten leading causes of death, let’s jump right in. The top 10 leading underlying causes of death (defined as “the injury or disease that initiated the train of morbid events leading directly to death”) accounted for 72 percent of all deaths. They were, in order:

#1 Malignant Neoplasms (Cancer): 1,043 deaths

Cancers made up 20 percent of all deaths, with an age-adjusted death rate of 145 deaths per 100,000 population (age-adjustment is a statistical process applied to rates of disease, death, or other health outcomes which allows groups with different age structures to be compared). However, American Indian/Alaska Native residents had the highest age-adjusted death rate by race, at 217 deaths per 100,000 population. Cancers were responsible for the deaths of approximately 129 men for every 100 women. Bronchus and lung cancer were the leading type of malignant neoplasms, and were responsible for 239 deaths, or 23 percent of all malignant neoplasm deaths

#2 Diseases of the Heart: 915 deaths

Diseases of the heart made up 18 percent of all deaths, with an age-adjusted death rate of 143 deaths per 100,000 population. American Indian/Alaska Native residents had the highest age-adjusted death rate by race, at 246 deaths per 100,000. Men in general did not fare well. Diseases of the heart were responsible for the deaths of approximately 165 men for every 100 women.

#3 Accidents (Unintentional injuries): 465 deaths

Accidents made up 9% of all deaths, with an age-adjusted death rate of 66 deaths per 100,000 population. American Indian/Alaska Native residents had the highest age-adjusted death rate by race, at 136 deaths per 100,000. Compared to women, men were especially hard hit. Accidents were responsible for the deaths of approximately 188 men for every 100 women.

Unintentional injuries were also the number one leading cause of Years of Potential Life Lost (YPLL) which measures the impact of premature mortality. It is defined as the difference between an expected natural lifespan of 75 years, and the actual age of death before that time. Accidents were responsible for 12,862 years lost (YPLL) in 2020.

Poisoning or exposure to noxious substances were the leading type of unintentional injury, and were responsible for 179 deaths, or 39 percent of all unintentional injury deaths. This was followed by motor vehicle accidents, which were responsible for 81 deaths, or 17 percent of all unintentional injury deaths.

#4 COVID-19: 231 deaths

COVID-19 represents a new category introduced in 2020. COVID-19 was the fourth leading cause of death in 2020, and was responsible for 231 deaths. This made up 5% of all deaths, with an age-adjusted death rate of 32 deaths per 100,000 population. American Indian/Alaska Native residents had the highest age-adjusted death rate by race, at 100 deaths per 100,000. Seniors were most likely to die from COVID-19, with 78 percent of COVID-19 deaths occurring among residents aged 65 and over, and an average age at death of 74 years old. Once again, men did not do well. COVID-19 was responsible for the deaths of approximately 154 men for every 100 women.

Moving right along, the last 6 causes of death are:

#5 Cerebrovascular Diseases (Stroke): 212 deaths

#6 Chronic Lower Respiratory Diseases: 205 deaths.

#7 Intentional Self-Harm (Suicide): 204 deaths

Interesting side note here. Suicide was the most common cause of firearm-related death, at 133 deaths. Suicides made up 76 percent of all firearm-related deaths.

#8 Diabetes: 174 deaths

#9 Chronic Liver Disease and Cirrhosis: 167 deaths

#10 Alzheimer’s Disease: 139 deaths.

Drugs per se are not listed separately among the top 10 causes of death in Alaska. Nevertheless, they are an important cause of death. It’s complicated. Drug-induced mortality includes deaths due to drug overdose, medical conditions from the chronic use of drugs, or the misuse of drugs or drug combinations. These can be due to use of illicit, prescription, or over-the-counter drugs. It does not include injuries, or other causes indirectly related to drug use.

In 2020, there were 179 drug-induced deaths, with an age-adjusted death rate of 24 deaths per 100,000 population. American Indian/Alaska Native residents had the highest age-adjusted death rate by race, at 47 deaths per 100,000 population. Drug overdoses (regardless of intent) were responsible for 160 deaths, or 89 percent of all drug-induced deaths in 2020.

Opioids, psychostimulants, and benzodiazepines are three of the most common general classes of drugs involved in overdose deaths. Opioids were found in 112 overdose deaths, or 70 percent of all overdoses. Non-methadone synthetic opioids, the class of opioid that includes synthetic opioids such as fentanyl was the most commonly found opioid, identified in 62 percent of opioid overdoses (with fentanyl or one of its chemical analogues being referenced in the descriptions of 66 overdose deaths).

Psychostimulants, the class of psychotropic drug that includes illicit methamphetamine, were found in 77 overdose deaths, or 48 percent of all overdose deaths. Methamphetamine specifically was referenced in 65 overdose deaths. Benzodiazepines, a class of sedative drugs, were found in 21 overdose deaths, or 13 percent of all overdose deaths.

Well, that’s it. Death in Alaska. Want to know more? Maybe you are interested in births or adoptions or other vital statistics? Check out https://dhss.alaska.gov/dph/VitalStats. Not just numbers, but real Alaskans living their lives. Each one has a story...

Originally published in Anchorage Press.