Last rant for 2010!
In an article recently published in the Journal of Gerontology, noted USC researchers Eileen Crimmins and Hiram Beltrán-Sánchez presented sobering statistics about the health of our aging U.S. population. While we have made great strides in life expectancy over the past century, this increase has slowed dramatically in the past several years. At the same time, the prevalence of disease, and of people living with functional disability, is increasing.
In addition to these results, it appears that the generation approaching old age is less healthy in many respects, which may bode ill for succeeding generations.
The article examines several complex aspects of morbidity and mortality, but it is worth noting that with our longer life expectancy, we have seen increases in the prevalence of many chronic diseases. Some of these have been controlled by advances in medications and other technologies, but it appears that this increased medical therapy may not be improving the bottom line goal of disability-free life.
There’s much in this article that can be discussed, but I would like to comment on some larger issues. Our worsening status, in my mind, is not so much a matter a lack of medical progress as it is due to other factors related to social constructs and other trends over the last 50 years.
As the U.S. has evolved over the past half century, some of the demographic trends which have made us quintessentially American may lie behind much of the data described above. Here are some examples:
– Our love affair with the automobile has moved us out of urban centers and created sprawling suburban communities whose design forces us to hop in the car for the most basic necessities, as opposed to other societies that have maintained walkable communities and areas more friendly to pedestrians and bicycles.
– We have an epidemic of obesity (and secondarily, diabetes and high cholesterol), due to both the above decrease in physical activity and to our deteriorating dietary habits. Our food is laced with hormones and high fructose corn syrup, and pre-fab food has become standard fare for many people. Also, food that is bad for us seems to be generally cheaper than good, well-prepared food, so families of limited means have no incentive to serve healthier fare. (BTW, if you haven’t seen “Food, Inc.”, make a resolution to do so in 2011.)
– Many of our health improvements in the 1960s and ‘70s were due to improved medication and prevention, but also much was due to the establishment of Medicare, providing medical coverage for older Americans. Unfortunately, we’re not keeping on that path for the rest of the population. It has taken decades of work to get our private insurers to cover preventive care and health maintenance (when I was in private practice, the Blues didn’t cover routine “well” visits—we always had to come up with some diagnosis for every patient, regardless of how well they were, or they wouldn’t be covered). And while we are finally making headway in this area, there are still 50 million Americans without any insurance and we are the only industrialized nation that doesn’t consider it an obligation to provide basic coverage for all.
The list goes on. The point is: the reason all of our medical advances haven’t translated to longer, healthier lives is that medical treatment is largely useful only after the fact of disease. It may mitigate decline, but does not provide wellness. We have created some wonderful drugs in past decades, but even if we didn’t invent another new pill in coming years, we could greatly improve our quality and quantity of life by improving other aspects of the way we live.
Full article Here