Do More People Die on Their Birthday or on Holidays? What the Research Shows

Stories about people who die on their birthday, or who seem to hold on for a holiday, are common. Researchers have tested them with large sets of death records. This article describes what they found and where the evidence is weak.

What is the “birthday effect”?

A finding that deaths are slightly more common on the day people were born. A 2012 study in the Annals of Epidemiology, led by Vladeta Ajdacic-Gross at the University of Zurich, examined about 2.4 million deaths among Swiss people aged one and over between 1969 and 2008. It found 13.8% more deaths on birthdays than expected, and 18% more among people over 60. NBC News reports that the excess appeared on the birthday itself, not on the days before or after.

The study broke the increase down by cause, according to news coverage. Reported figures include about 19% more deaths from heart causes, about 22% more deaths from stroke among women, about 35% more suicides among men, and 44% more fatal falls among men. These are relative increases in a rare event on a single day.

Do other studies agree?

Some do and some do not. Discovery UK summarizes a U.S. study of Social Security records for 25 million people who died from 1998 to 2011, which found a 6.7% increase, and a 2016 Japanese study of about 2.1 million deaths from external causes that found an increase, especially in older people. But a 1999 study of about two million deaths in Austria and Denmark found no effect, a German study of cancer deaths found none, and an analysis of England and Wales data found small anomalies in subgroups but not overall.

Why might it happen?

No one knows. The Swiss authors favored an “anniversary reaction,” also called birthday blues, in which stress plays a part, and called it more likely than the opposite idea of “postponement,” where ill people hold on until their birthday. NBC News notes they say they can only speculate. Mental Floss lists other ideas: more drinking and activity on birthdays, and recording errors, since some death dates may have been mistakenly entered as birth dates. That last possibility could account for part of any excess.

Do more people die on holidays?

At Christmas and New Year, yes, in U.S. data. A 2004 study in Circulation by David Phillips and colleagues looked at 53 million death certificates from 1973 to 2001. HealthDay reports spikes in both cardiac and non-cardiac deaths on December 25, December 26, and January 1, which were the worst days. A 2010 follow-up in Social Science and Medicine used about 57 million certificates from 1979 to 2004. It found the spikes among people who were dead on arrival or died in an emergency department, but not among deaths in other hospital settings. It estimated 42,325 more natural-cause deaths in the two weeks starting with Christmas than the normal winter increase would predict. Newswise reports that among dead-on-arrival and emergency cases, cardiac deaths were 12.4% higher than expected on Christmas, while inpatient cardiac deaths rose by only 1.6%.

Why would that happen?

Researchers think access to care is involved. Phillips has suggested that people with symptoms may put off going to the hospital until after the holiday, and that experienced staff are more likely to be off. Another researcher quoted by HealthDay, Kloner, raised emotional stress and reduced staffing. HealthDay reports that Phillips pointed out that stress cannot be the only explanation, because the peak also appeared among people with advanced Alzheimer’s. CNN’s report adds that substance abuse as a secondary cause was linked to a smaller holiday peak, not a larger one. Ideastream reports that Phillips’s advice is not to wait until after the holidays if you have symptoms. Anyone with signs of a heart attack or stroke should seek emergency care at any time of year.

Do people postpone death to reach a special day?

The evidence is mixed. A 1988 study by Phillips and Elliot King in The Lancet looked at 1,919 death certificates for people with Jewish-sounding names in California, according to the Jewish Link. The New Republic reports they found 8.1% more deaths in the week after Passover than the week before. A later study of the Chinese Harvest Moon Festival found a dip in deaths before it and a rise after, especially among older women. But economist Gary Smith disputed the findings. His reanalysis of California data, with a wider sample, found no such dramatic dip, and he argued that for women 75 and older the results are not statistically persuasive. Ideastream also notes that cancer deaths fell slightly at Christmas, which fits postponement, but that is only one finding. See Why People Wait Until Family Leaves to Die.

What should readers take from this?

That these are small shifts in timing, and for any one person they predict nothing. A birthday or a holiday is not a danger. The holiday findings mostly point to something practical, which is getting care promptly.

Where can I learn more?

See Why Do More People Die in Winter? and Honoring Anniversaries and Birthdays.