Was what ail’d ya what kill’d ya?

► In a sample of Union Army veterans, we compare the medical conditions diagnosed by pension surgeons with causes of death listed on death certificates. ► In a sample of 8332 veterans, 96.4% were diagnosed with one or more of the 20 chronic conditions that qualified the veteran for a pension. ► The...

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Bibliographic Details
Published in:Economics and human biology 2013-07, Vol.11 (3), p.269-280
Main Authors: Fogel, Robert W., Cain, Louis, Burton, Joseph, Bettenhausen, Brian
Format: Article
Language:English
Subjects:
Aged
American Civil War
Cause of Death
Chronic disease
Chronic Disease - mortality
Databases, Factual
Death Certificates - history
Hazard ratios
History, 19th Century
Humans
Insult hypothesis
Male
Medical Audit
Middle Aged
Pensions - history
United States - epidemiology
Veterans
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Summary:► In a sample of Union Army veterans, we compare the medical conditions diagnosed by pension surgeons with causes of death listed on death certificates. ► In a sample of 8332 veterans, 96.4% were diagnosed with one or more of the 20 chronic conditions that qualified the veteran for a pension. ► The average number of conditions was 4.71. ► In 44.7% of cases, a diagnosed condition was listed as a cause of death. ► In 51.2% of cases, a diagnosed condition was listed as either the cause or a contributing cause of death. Making use of those Union Army veterans for whom death certificates are available, we compare the conditions with which they were diagnosed by Civil War pension surgeons to the causes of death on the certificates. We divide the data between those veterans who entered the pension system early because of war injuries and those who entered the pension system after the 1890 reform that made it available to many more veterans. We examine the correlation between specific medical conditions rated by the surgeons and death causes to gauge support for the hypothesis that death is attributable to something specific. We also examine the correlation between the accumulation of rated conditions to the length of time until death to gauge support for the “insult hypothesis.” In general, we find support for both hypotheses. Examining the hazard ratios for dying of a specific condition, there is support for the idea that what ail’d ya’ is what kill’d ya’.
ISSN:1570-677X
1873-6130
DOI:10.1016/j.ehb.2012.12.001