Saturday, December 22, 2001

Study says fear of
‘4’ spikes deaths of
Japanese, Chinese

Heart attacks among those people
tend to rise on the fourth of the month

From staff and news reports

Beware the number four -- or at least the power of the ancient Chinese superstition that links the number to death.

A researcher at the University of California-San Diego has found that deaths caused by heart attacks among U.S. residents of Chinese and Japanese descent tend to spike on the fourth of the month, an increase linked to the psychological stress brought about by fear of the number itself.

David Phillips, a UCSD sociologist, examined more than 47 million computerized death certificates for the 25-year period to 1998 for a study published in the December edition of the British Medical Journal.

The study, undertaken with UCSD mathematician Ian Abramson and a team of student researchers, found 13 percent more deaths caused by heart attack than expected on the fourth of the month for Japanese and Chinese Americans.

That trend was even more pronounced in California, where cardiac deaths among Japanese and Chinese residents spiked by 27 percent on the fourth of the month during that period, suggesting the power of the superstition is stronger when it is reinforced by a larger group of people who share it, Phillips said.

In Hawaii, reaction from the medical community was that Phillips' findings were interesting but likely based on coincidence. Although several doctors said it was true that some of their Japanese and Chinese patients were superstitious of the number four, they have not seen increased anxiety based on the time of the month.

"I think it's misleading," said Dr. David Lee Pang, who estimates that about 90 percent of his patients are of Chinese descent. "I know patients who make sure that their license plates don't have the number four in them, but that's all.

"It's not an anxiety that affects their health."

Dr. Nobuyuki Miki, a Japanese national who has lived in the United States for 22 years, said, "I haven't read the study, but it sounds like coincidence."

The word "four" is read as "si" in Chinese Mandarin and "shi" in Japanese, a close homonym for the word for "death" in both languages and in the Cantonese dialect spoken in Hong Kong.

Because of the superstition, the number four is often avoided in numbering hotel and hospital rooms in China and Japan.

The Chinese air force also avoids the number in designating military aircraft, apparently because of the superstition, Phillips said.

"I have often wondered if people could indeed die by fright and, if so, how this could be investigated quantitatively," said Phillips, an expert on mortality trends who has made a special study of the links between death and stress.

Despite the Western superstition that the number 13 is unlucky, the study found no statistical link between that number and deaths among Americans of European ancestry.

The idea for the study came earlier this year when Phillips and a group of students on a lunch outing drove past a Chinese grocery store called Ranch 99, a number, one Chinese student explained, apparently chosen for its lucky connotations.

The conversation then turned to Asian views of unlucky numbers, including the taboo surrounding four. For Phillips, who had been casting about for a statistical way to test the power of fear, it was a revelation.

The conversation also reminded him of the legendary Sherlock Holmes story "The Hound of the Baskervilles," in which Sir Charles Baskerville is frightened to death by the appearance of a hound. In his study, Phillips calls the spike in deaths linked to superstition "the Baskerville effect" after the story by Arthur Conan Doyle.

"Conan Doyle was not only a great writer, but a remarkably intuitive physician as well," Phillips concluded.

Reuters news service and Star-Bulletin writer Rod Antone contributed to this report.

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