Was what ail'd ya what kill'd ya?

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'.

► 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.