title: Is four a deadly number for the Chinese?
abstract: BACKGROUND
  The numbers 4, 14 and 24 are associated with death for Cantonese-speaking Chinese people, as the words for these numbers sound like the words for "death", "must die" and "easy to die", respectively. A previous study in the United States investigating psychological stress engendered by fear of the number 4 found more cardiac deaths in Chinese and Japanese people, compared with white Americans, on the 4th day of the month.
  
  
  OBJECTIVE
  To determine whether more cardiac deaths occur in Hong Kong Chinese people on the days of the month with "deathly connotations" (4, 14 and 24).
  
  
  METHODS
  Analysis of mortality data (1995-2000) of the Chinese population of Hong Kong from the Census and Statistics Department of the Hong Kong Government for these three days of the month, compared with the remaining days, according to both the Gregorian and Lunar calendars.
  
  
  RESULTS
  There were 17 346 cardiac deaths registered under ICD-9 codes 410-414 in 1995-2000. The mean (+ 1 SD) of the cumulative number of cardiac deaths on each day of the month was 587 (+ 30) for the Gregorian calendar or 573 (+ 24) for the Lunar calendar. The mean number of deaths on the 4th, 14th and 24th day of the month was not significantly different from the mean number of deaths on the remaining days of the month.
  
  
  CONCLUSIONS
  Our study of Hong Kong Chinese people does not support the concept that more cardiac deaths occur in Cantonese people on the 4th, 14th and 24th day of the month.
authors.affiliation: Department of Chemical Pathology, Faculty of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China. nspanesar@cuhk.edu.hk
authors.forename: Nirmal S
authors.initials: NS
authors.lastname: Panesar
authors.forename: Noel C Y
authors.initials: NC
authors.lastname: Chan
authors.forename: Shi N
authors.initials: SN
authors.lastname: Li
authors.forename: Joyce K Y
authors.initials: JK
authors.lastname: Lo
authors.forename: Vivien W Y
authors.initials: VW
authors.lastname: Wong
authors.forename: Isaac B
authors.initials: IB
authors.lastname: Yang
authors.forename: Emily K Y
authors.initials: EK
authors.lastname: Yip
mesh_terms: D002423:Cause of Death; D002681:China / Q000208:ethnology; D006331:Heart Diseases / Q000208:ethnology* / Q000401:mortality; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016012:Poisson Distribution; D013483:Superstitions / Q000523:psychology*