Last updated 2 Sep 2000
Everyone knows that the average life span of humans has increased markedly in the 20th century, but has it increased for everyone? An informal study of U.S. presidents may yield some surprising answers.
My aim is to look at the effect of medical advances over the last two centuries on the longevity of those who are most likely to have access to those advances. I think presidents make an interesting (if small) sample because of their demographic uniformity: all are white male politicians, almost all are military veterans, and presumably all had sufficient wealth and/or prestige to command whatever medical resources were available in their later years.
Of the 41 men who have held the office, 5 are still alive (Ford, Carter, Reagan, Bush, Clinton), 4 were victims of homicide, all from gunfire (Lincoln, Garfield, McKinley, Kennedy)*, and 32 died of natural causes (4 while in office: Harrison, Taylor, Harding, FD Roosevelt). These 32 are listed below by date of death. The "ordinal" figure is the order in which each served as president, Cleveland having served two non-consecutive terms.
|AGE||CAUSE OF DEATH***|
|Washington, George||1||1799||67||peritonsillar abscess|
|Adams, John**||2||1826||90||heart failure, pneumonia|
|Jefferson, Thomas**||3||1826||83||old age, multiple diseases|
|Monroe, James||5||1831||73||heart failure, tuberculosis|
|Madison, James||4||1836||85||old age, multiple diseases|
|Harrison, William Henry||9||1841||68||pneumonia|
|Jackson, Andrew||7||1845||78||old age, multiple diseases|
|Adams, John Quincy||6||1848||80||stroke|
|Polk, James K.||11||1849||53||cholera|
|Taylor, Zachary||12||1850||65||food poisoning|
|Van Buren, Martin||8||1862||79||heart failure, pneumonia|
|Tyler, John||10||1862||71||"biliousness", bronchitis|
|Buchanan, James||15||1868||77||pneumonia, pericarditis|
|Grant, Ulysses||18||1885||63||throat cancer|
|Arthur, Chester A.||21||1886||56||chronic renal failure, stroke|
|Cleveland, Grover||22,24||1902||71||multiple diseases|
|Hayes, Rutherford B.||19||1903||70||heart attack|
|Roosevelt, Theodore||26||1919||61||heart attack|
|Harding, Warren G.||29||1923||57||heart attack|
|Wilson, Woodrow||28||1924||67||multiple diseases|
|Taft, William Howard||27||1930||60||cardiovascular disease|
|Coolidge, Calvin||30||1933||60||heart attack|
|Roosevelt, Franklin D.||32||1945||63||stroke|
|Hoover, Herbert||31||1964||90||internal bleeding|
|Eisenhower, Dwight||34||1969||78||congestive heart failure|
|Truman, Harry S||33||1972||88||old age, multisystem failure|
|Johnson, Lyndon B.||36||1973||64||heart attack|
The last 5 presidents to die did so after 1960, when modern surgical techniques were well established, cardiovascular surgery was rapidly developing, there was a large antibiotic armamentarium, and many cardioactive and and vasoactive drugs were available. The median age of death of these 5 was 81.
Each group consisted of one nonagenarian, two octogenarians, one septuagenarian, and one sexagenarian.
The second half of this group died between 1885 and 1994. The median age of death was 65.5 years (!)
Each half contains one individual who clearly died as a result of substance abuse: Pierce from alcoholic liver disease, and Grant from pharyngeal cancer due to his enormous cigar consumption.
The figures don't speak very loudly to modern medicine as a prolonger of life, at least for famous old white men, but I think we have to give medicine its due in certain individual cases. Washington died at 67 of quinsy, and I think just about everybody would agree that such deaths are very uncommon in modern times. Three other presidents clearly died before their time: Harrison of pneumonia, Taylor of a "typhoid-like fever," and Polk of cholera. Again, I think most people would agree that these untimely deaths would probably not have occurred in modern times (odd cases like Jim Henson's group B strep sepsis notwithstanding). Possibly ENT surgery could have saved Grant, as it apparently did Cleveland, and colorectal surgey saved Hoover and Reagan. The medicine of the fifties possibly kept Eisenhower's Crohn's disease sufficiently at bay, whereas a similarly afflicted counterpart of the nineteenth century may not have remained hale enough to rise to such high position, likewise for Kennedy and his Addison's disease.
*In addition, at least 3 presidents were survivors of gunshot wounds: Jackson, T Roosevelt, and Reagan (Jackson was shot in a duel prior to becoming president. The other two were victims of assassination attempts while in office [Reagan] or running for same [TR]).
**In one of the interesting coincidences of American history, Thomas Jefferson and John Adams died within a few hours of each other on the 50th anniversary of the signing of the Declaration of Independence, July 4, 1826. James Monroe died five years later, to the day.
***Causes of death of the early presidents are speculative and highly controversial. There was no microbiology to speak of until the last third of the 19th century, so such diagnostic categories as "tuberculosis" and "cholera" are rather suspect. The diagnosis of "biliousness" recurs in pre-modern medicine, and it is difficult to determine what modern diagnoses correlate with this. One could speculate that fatal biliousness could refer to any abdominal catastrophe that causes nausea, vomiting, and distention.