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Happy Holidays: You're living longer (on average)
Trevor Butterworth, December 23, 2009
The news may persuade us that we're being ravaged by ever increasing risk, but the numbers reveal what's really threatening us.

The news from the Centers for Disease Control (CDC) that Americans are living longer should come as a surprise to those who have been keeping pace with the endless bulletins of their imminent demise. And though the increase for 2007 (the latest data available) may not seem that dramatic -- - 77.7 to 77.9 years -- its scale is better put in numbers adjusted to reflect changes in the age distribution of the U.S. population over time. That the death rate is now 43 percent lower than in 1960 really shows us how far we've come from a time many would consider more benign than ours (certainly, a time less overweight).

This is a remarkable triumph for public health. And as 2010 will be filled with ever new and novel research findings on carcinogenic culprits and toxic threats, it is worth noting that the record life expectancy of 77.9 years would probably be  higher if we had the good sense to expend more energy focusing on what is actually killing us rather than those risks that can't even be quantified, so tentative is the data when strung out across contingent chains of inference.

The CDC break the principal causes of mortality down, and they are, in descending order, heart disease, cancer, stroke, chronic lower respiratory diseases, and accidents. These, in multifarious guises, amounted to over 64 percent of all deaths in the United States. The diseases which we might associate with the burgeoning problem of obesity all experienced modest declines - deaths from heart disease were down 4.7 percent and those from diabetes down 3.9 percent

This does not, by any means, suggest that we are getting healthier; the impact of better and more sophisticated treatment is the caveat hanging over any triumphalism in the treatment of diabetes and heart disease. And such declines may be tested as an increasingly overweight and obese population ages. We know, too, that while cancer mortality is decreasing, lung cancer among women is still increasing, largely because it is still "cool"  -- or helpful as an appetite suppressant -- to smoke. We know that lack of exercise, poor diet and heart disease are fatally linked (and have known since the early 1950s, thanks to the work of  - brilliantly told by Simon Kuper of the Financial Times in TK). We know, too, that obesity is a strong predictor of disease. There is also evidence that even if we are living longer, we are living less healthily.

Ultimately, life kills us: cancer is primarily disease of old age, except when you increase the odds of getting it by 700 percent through smoking. The result, tobacco-related death accounts for almost one in five deaths each year in the U.S. Dissuading young people from taking up the habit (and encouraging women who currently smoke to quit), however, is so patently urgent and obvious a health intervention, it is boring. Vastly more energy,for instance, has been expended over the past few years in the media wondering whether a precursor chemical to Teflon -- PFOA -- is carcinogenic, even though the Environmental Protection Agency's Science Advisory Board admitted that the suggestion that it might cause cancer in humans is pure conjecture. There is no data to provide any quantifiable basis for cause.

The problem is that an endless focus on speculative risks produces a surfeit of pointless responses. Teflon cookware is not addictive like tobacco, so it's easy to imagine that, if you stop using it, you've taken a significant private health intervention to secure your future. Meanwhile the tough interventions, eating better and less, excercising more and more intensely, and quitting smoking are deferred.

That old news is no news and bad news is good news are the unhealthy habits afflicting the media. For example, at the time of writing, Google records some 556 stories noting the CDC's report that the diagnosis of autism in children has gone up (from one in 150 cases to one in 110 cases), but just 65 stories on the living longer data - many of those being consigned to blog entries on the nation's leading news sites.

One may make a prognostication for the coming year: should the CDC find a further gain in life expectancy in the 2008 figures, the news will receive as little play and have as little effect on national mood as this year's data. But should expectancy fall - and the  rise in obesity-related mortality and morbidity suggests this as a distinct possibility - expect to read all about it.



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