Wednesday, April 2, 2008

Americans living longer, enjoying greater health

This, in spite of the obesity epi-panic, we're living longer, healthier lives. Well, except for that obesity thing.

Average life expectancy continues to increase, and today’s older Americans enjoy better health and financial security than any previous generation.However, rates of gain are inconsistent between the genders and across age brackets, income levels and racial and ethnic groups. Some critical disparities also exist between older Americans and older people in other industrialized countries. These and other trends are reported in Older Americans 2008: Key Indicators of Well-Being, a unique, comprehensive look at aging in the United States from the Federal Interagency Forum on Aging-Related Statistics.

“The ‘greatest generation’ made enormous gains in health and financial security, although the gains were not shared equally,” says Richard Suzman, Ph.D., director of the Behavioral and Social Research Program at the National Institute on Aging, part of the National Institutes of Health. “We’ll be tracking their children, those just reaching their 60s, to see whether those gains can be sustained or even improved.” Suzman cautions that there could be problems, however. For example, he notes that increased rates of obesity among today’s middle-aged could threaten the health of these adults as they age.
“The sheer size of the baby boom cohorts is certain to affect our health, long-term care and pension systems,” says Benjamin E. Sasse, Assistant Secretary for Planning and Evaluation, Department of Health and Human Services. “As we look ahead, it is imperative that we collect and analyze quality data to help policymakers plan for the future of these programs so important to aging Americans.”

In spite of all the studies that show being fat, as you age, can help you survive some catastrophic illnesses, fat threatens your health. Tell that to my grandmother who was moderately fat and survived lung cancer (with one lung), a couple of strokes, and lived to the age of 86. Tell that to my grandfather who was moderately fat and survived heart problems and cancer and lived to the age of 90. Tell that to my other grandmother who was fat and survived hypertension and heart problems and lived to be 85. They were all born around 1900-1910 and didn't have the benefit, when they were young, of all we've learned in the last 50 years (all 3 of them have been dead for at least 15 years).
Health Status - Americans’ longevity continues to increase, although life expectancy at age 65 in the United States is lower than that of other industrialized countries. While older people experience a variety of chronic health conditions that often accompany aging, the rate of functional limitations among people age 65 and older has declined in recent years.

The percentage of people age 65 and older who are obese, as with other age groups, increased between 1988-1994 and 2007-2007, from 22 percent to 31 percent. However, over the past several years, the trend appears to have leveled off.

I think there's a misprint here, the 2007-2007 should probably be 2000-2007, which makes the increase in obesity correspond to the decrease, in 1998, in BMI standards for overweight and obesity. It bears repeating, and repeating, that when standards are lowered arbitrarily, of course the number of people exceeding that lowered standard is going to increase, without those people having done a damned thing other than exist.
Health Care - Health care costs, particularly for prescription drugs, have risen dramatically for older Americans.

* Between 1992 and 2004, average inflation-adjusted health care costs for older Americans increased from $8,644 to $13,052. Costs varied by race and ethnic group, income and health status.

* In 2004, as in the previous 4 years, over half of out-of-pocket health care spending (excluding health insurance premiums) by community-dwelling older people was for purchase of prescription drugs. By 2004, prescription medications accounted for 61 percent of these out-of-pocket expenses. Out-of-pocket costs for prescription drugs are expected to decline because of the savings available through the Medicare prescription drug program.

* The implementation of the Medicare Part D prescription drug benefits is included in the Indicators volume for the first time. From June 2007 through September 2007, the number of beneficiaries age 65 or older enrolled in the program increased from 18.2 million to 19.7 million, with two-thirds selecting stand-alone plans and one-third in Medicare Advantage plans.

Does anyone see the relationship between the rise in cost of drugs for older Americans and the pharmaceutical companies coming out with new drugs/combination drugs that don't work any better or even as well as older drugs (Vytorin, anyone)?
I'm all for innovation and new drugs, if they are more effective than older drugs. But to put a new drug out there that doesn't work any better (and may be even less effective or have worse side effects than current drugs) just because that older drug is going generic and you're going to be making less money off it, is money-grubbing corporate greed. It's expensive to develop new drugs, I understand that. Research and testing aren't cheap, but when their trials tell them early on that a drug isn't going to be any better than what's already on the market (and they know what most of the side effects are for that one), why the hell do they have to keep pushing to develop that drug that isn't going to work any better, may not work as well, and may have worse side effects? Is big pharma so lacking for profits that they can afford to overlook health outcomes for the people who will take those new drugs just because big pharma can afford to propagandize the hell out of the drug and doctors don't have the time or inclination to read up on it to see if it really will help their patients better than existing drugs?
My take on all of this:
In spite of the fact that fat people aren't dying off in droves at younger and younger ages, they're still pushing the fact that obesity has increased since 1997 (gee, could it be that the standards for obesity were lowered in 1998 that is driving this humongous increase in fatness?) and that it's eventually going to lower our life expectancy (even though that isn't happening yet, and probably won't). Because we aren't #1 in life expectancy in the world anymore, it has to be caused by something, and fat is a good scapegoat, even though we're not dying off at younger and younger ages (in fact, life expectancy is increasing). Why are other countries ahead of us now in life expectancy? Could it be that they have finally reached (or surpassed) us in monetary wealth and all the benefits that brings? Could it be that they have caught up with us (and in some cases, passed us) in the quality of their health care? Could it be that more countries are now enjoying the same (or better) standard of living that we have had for so many years? Do we really begrudge them that higher standard of living?
I don't know what the reasons are for life expectancy in the US not being the highest in the world, and I don't think it really matters. I don't want to live forever, life isn't a race to see who lives the longest and dies with the most toys and best looking body. Life is a journey to be traveled, enjoyed, and lived as best you can with what you've been given (and it's up to you to decide what that "best" is, not some government entity that thinks Big Brother knows best). For me, I plan on living my life hard, fast, and filled with fun and love. If that means going to my grave fat and looking like something the cat dragged in, so be it. At least I will have lived!
I think the medical establishment, in general, has gone way overboard with their desire to stamp out all disease. I don't think it's possible to eradicate from the face of the earth every disease known to mankind. Mother Nature is one smart old gal, and as soon as you get rid of one, there's a mutation of it or a new disease is discovered to replace it. By insisting that everyone has to enjoy optimum health at all stages of their lives (and the standards for that optimum are being lowered all the time, now we have to be as healthy and fit as a 20 year old man at his best), they are setting us up for failure. I'm sorry, when I was 20, I was fit and in the best shape of my life. But everyone ages, and as I've aged, everything that I've gone through in my life has contributed to the changes in my body. Like death and taxes, it's inevitable. You can't stop change (it's the only thing that stays the same), change is what makes life interesting and worth living. By insisting that everyone must live up to this ideal of health and beauty, you advocate getting rid of diversity. It's diversity that creates the great moments of life, the great books, movies, inventions, innovations, artistic creations that enrich our lives and make them worth living. Do we really want to live without all the contributions every person can make? Do we want to live without the inventions and innovations that can be discovered/created by thin/fat/in-between people? Because it's not just the thin people that are smart and creative and innovative, it's also the fat people, and the not-so-fat people, and the thin people, and the not-so-thin people, and all the people at all their sizes/shapes/colors/sexes/religions/beliefs/etc/etc that make this world such an interesting place to live.


  1. Would you similarly go after the clothing industry for designing new clothes even though they could save money by selling us the same shirts each year? After all, it's not as though new fashions keep us warm and covered up any better than the old ones; they're just an excuse to line the pockets of designers and manufacturers.

    You should also rant about how "big literature" keeps spending millions of dollars producing new books that have nearly the same plotlines as the old ones when most people haven't read the old ones yet. And then they put up ads trying to convince us to buy a new mystery novel or pop psychology book that's not so different from the old one I spent money on last year and didn't get through then.

    And what about the food conspiracy? How many different kinds of food do we need? Why can't we all just eat the same couple of meals over and over again and be done with it instead of needing enormous grocery stores full of options?

    Every industry puts out lots of things, lots of new things, because someone wants them. You may think that we don't need yet another pill for the same disease, but for the people who can't take the old pill because of its side effects or allergies or for whatever other reason, that new pill is a godsend.

    The pharmaceutical industry isn't any different from any other. They're selling people things that they want to buy. They're caught up in a crazy political fight over healthcare that causes outcomes that none of us like, but that's not a reason to demonize the people putting out the pills, who are doing exactly what people in every other industry are doing: selling consumers products they want to buy. If no one wanted to buy the stuff, the companies would fail.

  2. anonymous - New fashions aren't going to kill people, new books aren't going to kill people, new foods most likely aren't going to kill people. But, new drugs that haven't been tested well enough and long enough to know what side effects they will have on people, and if those side effects are worse than the disease, can, and do, kill people every day. Phen-fen is a case in point. How many years was it prescribed before they found out it was giving people PPH? How many people died, or needed heart/lung transplants before it was taken off the market? And this is a drug that didn't even promise permanent weight loss unless you took it for life. What about Avandia? How many diabetics did it kill before it was taken off the market? How about Vioxx? Is it worth killing people because a few will benefit from it and not die from the drug or its side effects? Where do you draw the line? How many people die from a drug versus how many benefit from it? How do you decide how many people to kill in order to save a few? That's what I'm ranting about, that drug companies are playing with our lives when they don't fully test new drugs, when they rush them to market before everything that needs to be known about benefit vs risk is known, and when it is known, the risks are downplayed, or hidden, or outright lied about. Drug companies aren't in the business for altruistic purposes, they're in it for money, and the more money they have, the more they want. Why do you think they're pushing the obesity epi-panic? More drugs, that won't work for permanent weight loss, to be pushed on consumers who have bought into the 'thin at any cost' mentality. To hell with your actual health, just get thin and you'll automatically be healthy. Bullfuckingshit. They're making millions/billions of dollars off baseless fears that they promote in order to make more money. In spite of the fact that people are living longer and are healthier than they've ever been in history, the majority of the medical establishment, doctors and pharmaceuticals, are pushing that this obesity is going to kill us, and we're going to die at younger and younger ages. Well, we all have to die sometime, there is no fountain of eternal youth, there is no fountain of eternal good health. All you can do is live your life as best you can, and take care of your body as best you can. The rest is up to whatever higher power in which you believe. Making informed choices about the drugs you take can go a long way towards helping a person reach and maintain good health, but it's really hard to make those choices when the information isn't readily available to the general public without a lot of digging and research.

  3. You've said just about everything I could have thunk about the article already. Excellent counterpoints.

    To anonymous - I can't remember now who said it, but I remember reading a quote about how a modern grocery store has more abundance than a king's banquet of a hundred or more years ago. And I guess it was Toffler who called that Future Shock. Such it is. We are sometimes overwhelmed by choices. Sometimes that's great, other times not so great.

    Doesn't change the fact that drugs can and do kill. And surgeries, which are literally being advertised on television now (LapBand - commercials FFS - what the hell?) also kill. Add to that the fact that we are being lied to about the results of real science and what it says about fat and diet and drugs and surgery, and you have yourself a righteous rant. Or three. Or many many rants. I say we don't stop ranting about it until the facts all come out and get known - or else we're all headed for happy fun camps in the end - along with smokers and gun owners (heaven help the person who is all three.) I say rant.

  4. I recently finished reading The Obesity Epidemic: Science, Morality, and Ideology by Michael Gard & Jan Wright.

    One of the main themes discussed in the book, is how little the obesity epidemic has to do with science at all. It has more to do with morals people want to attribute and put on other people.

    They explain that there really is no, and never has been, any quantifiable scientific evidence that something is wrong with being fat. That the knowledge about how and why the body is a certain size is no different, than the knowledge they had back in say 1977.

    I really reccomend reading the book to everyone who sees this post. It is very good at explaining why it seems all the medical information about the obesity epidemic seems so rediculous. Cause it is. It's mostly speculation based on how human beings lived in primative times, when they hunted and had to survive. As well as the concept of the body-as-machine model, which is quickly dismissed as realistic at all in the book.

  5. "The pharmaceutical industry isn't any different from any other. They're selling people things that they want to buy." Anonymous you are being sarcastic or work in the pharmaceutical industry. I drugs,pills is not something I just want. As for living longer the Changing Aging blog recently had the opportunity to sit down with Dr. Brent Ridge, Vice President for Health Living at Martha Stewart. Where he answered 10 Questions on aging, geriatrics, his role at Martha Stewart,longevity. A good read


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