Background Most cultures believe in ghosts and for the Chinese, the seventh lunar month—the ghost month—causes particular concern. ‘The gates of hell’ are open for the first 14 days of the month which allows the restless ghosts of people who were hungry when they died to haunt the living. In this study, it was hypothesised that if the notion that ghosts are out to harm the living could affect the Chinese, this may be reflected in death statistics.

Methods Because the Chinese believe death is more likely during the ghost month, male and female deaths from all causes and from four common causes of death in the first and second fortnights of the seventh lunar months of 1995–2000 were compared in Hong Kong Chinese. Deaths in two consecutive fortnights 30 days before each year's seventh lunar month were used as controls. Death data were compared using the binomial test with a null hypothesis probability of 0.5 between the first and second fortnights.

Results There was no difference in male deaths between the first and second fortnights of the control and seventh lunar months. While there were no significant differences in female deaths during the control month periods, fewer women died overall in the first fortnight of the seventh lunar month (p=0.026).

Conclusion To protect their family, the Chinese women postpone death until after the hungry ghosts have been fed and hopefully banished forever.