life expectancy

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Around The World, Living Longer But Not Living Better

(Vedant Gulati/Wikimedia Commons)

(Vedant Gulati/Wikimedia Commons)

By Judy Foreman
Guest Contributor

A massive new study out today shows that around the world, people are living longer than they did 20 years ago, but there’s a catch: many of these extra years are spent in poor health — in some cases with conditions that might be preventable or treatable.

The collaborative project, published in a special issue of The Lancet and led by researchers at the University of Washington and a consortium including the Harvard School of Public Health and the Johns Hopkins Bloomberg School of Public Health, found that some of the old scourges of humankind — infectious disease and childhood illnesses — that were once the leading causes of death have decreased dramatically, even in many developing areas. Deaths among children under five used to be the biggest contributor to the world’s health burden; now it’s chronic diseases that cause severe pain, impair mobility or keep people from seeing, hearing and “thinking clearly,” as the university put it in a statement.

But as childhood deaths have decreased, there has been a troubling increase in deaths among young adults, those aged 15 to 49 – mainly because of violence and HIV/AIDS. And while malnutrition – including starvation – used to be the leading risk factor for death worldwide, now it’s the opposite that’s the big threat: poor diets and physical inactivity. In fact, dietary risk factors and physical inactivity now account for a whopping 10 percent of the world’s health burden, as excess weight and high blood sugar continue to soar.

We are living longer, but some of those “extra” years are years of pain, sickness, immobility, depression, anxiety and other forms of poor health.

As some health problems have lessened worldwide between the new study, called the Global Burden of Disease Study 2010 and its predecessor in 1990, others have soared, chief among them lower back pain and road accidents. The latest research, funded by the Bill and Melinda Gates Foundation, was a massive endeavor with 486 authors from 302 institutions and more than 30,000 survey participants in more than 100 countries. It resulted in seven scientific papers being published together.

In statistical terms, what’s happening is that although life expectancy from birth is still increasing all around the world, what might be called the “healthspan” is not keeping pace. In other words, we are living longer, but some of those “extra” years are years of pain, sickness, immobility, depression, anxiety and other forms of poor health. Continue reading

New York Vs. Boston: Manhattan Wins On Life Expectancy

Comparing Boston, NYC, Mass. and national life expectancy

(Data from the Institute for Health Metrics and Evaluation, University of Washington. Chart by Jesse Costa for WBUR.)

The medical journal The Lancet recently published a fascinating piece on the dramatically rising life expectancy in New York City, giving major credit to Mayor Michael Bloomberg for his public health initiatives.

New York Health Commissioner Thomas Farley told The Lancet: ““We have really the nation’s first and maybe the world’s first public health mayor, who has made clear that he is willing to take controversial positions if they’re going to improve the health of his citizens.”

Well, naturally that raised my Boston hackles a bit. We, too, have a longstanding mayor who has made major efforts on the public health front, including the current “Boston Moves For Health” campaign, which aims to get Bostonians to lose 1 million pounds and walk 10 million miles. How, I wondered, do we compare to New York?

We’re not looking so great, according to the data kindly provided by the Institute for Health Metrics and Evaluation at the University of Washington. Their valuable data also served as the basis for The Lancet piece. As I read the graph above, we started out ahead and lost our lead. Looks just like far too many of our play-off seasons.

Now, needless to say, the influence of place on health is an exceedingly complex issue, and Lancet author Ted Alcorn notes that all kinds of factors are at play, from improving treatments for HIV to migrating populations. (New York County is Manhattan; Suffolk County roughly overlaps with Boston. It’s speculation, but I imagine people of more modest means have been priced out of Manhattan’s truly astronomical real estate more than out of Boston’s.)

But readers, I’d like to throw this question out to you: What does this graph say to you? How do you see history converging with health? And does this mean Boston Mayor Thomas Menino should emulate Mayor Bloomberg and ban Big-Gulp-sized drinks? Please stay tuned; I plan to gather opinions this week and wrap up on Friday.

Money Can’t Buy You (A Longer) Life

Despite lavish spending on health care in the U.S., our life expectancy rates are falling behind other countries

Here’s a shocking fact: despite the United States’ exorbitant spending on health care, our life expectancy rates are slipping behind other countries, according to a new study published in Health Affairs by Columbia University researchers. Our life expectancy is lagging when compared to other rich countries, yes, but also in comparison to poorer nations like Costa Rica, Singapore and Chile. I’m told Cuba could be next.

In the past, we’ve targeted the usual villians: Americans are fatter, we smoke more, we have more homicides, more car accidents and more minorities — and all these factors conspire to pull down our life expectancy ranking.

Well, according to Peter Muennig, assistant professor of health policy at the Mailman School of Public Health at Columbia, and the study’s lead author, the true culprit is “none of the above.”

He says that smoking and homicides have declined in the period researchers were studying, 1975-2005, and traffic deaths are fairly constant. More Americans were actually obese 30 years ago, and over that time, other countries have caught up, weight-wise. The U.S. immigrant population, which has a higher-than-average life expectancy (amazing fact: Asian women in Bergen country, New Jersey have an average life expectancy of 88!) more than offset the generally lower life expectancy of African-Americans.

So what gives?

Apparently, Dear Reader, it is our top-of-the-line, $2 trillion health care system that is killing us before our time.

“The unnecessary care Americans are getting is potentially driving up costs and affecting our longevity,” Mr. Muennig says. “Unnecessary care is very likely the culprit.”

What he’s saying is that a fee-for-service payment system so heavily reliant on specialists tends to work like this: one uneeded test leads to an unecessary procedure; that procedure causes an infection, and that leads to a hospital admission.

“Our health care costs are sapping our federal expenditures,” Mr Muennig says. “And this is taking money away from all social programs,” some that could actually improve health, like transportation, education and others.