Posts Tagged ‘life expectancy’

Life Expectancy in the US Dropping

Wednesday, August 1st, 2012

In 2009, a baby born in America could expect to live an average of 78 years, according to estimates from the U.S. Centers for Disease Control (CDC).  But this is now changing: A study in the Journal of Health Metrics shows the United States now ranks behind 10 other developed countries when it comes to life expectancy, even though Americans spend more on health care than people in most other countries.

Another study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, found that between 2000 and 2007, more than 80% of counties in the US fell in standing against the average of the 10 nations with the best life expectancies in the world. Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind Honduras, El Salvador, and Peru. Four of those counties, along with Humphreys County, MS, have the lowest life expectancies for men, all below 67 years, meaning they are behind Brazil, Latvia, and the Philippines.

Nationwide, women fare more poorly than men. The researchers found that women in 1,373 counties – about 40% of US counties – fell more than five years behind the nations with the best life expectancies. Journal of Health Metrics editor, Dr. Chris Murray says “It’s a real surprise to us in the study that women are faring so much worse than men. American women still live longer than men by five to eight years. But they have picked up some bad habits: Women are now smoking more.  The obesity epidemic in women is greater than in men. Progress in tackling blood pressure is much worse in women,” Murray added.

So, what we need right now is more Blue Zones in the US.  The phrase was coined by in 2004 by author, Dan Buettner, who teamed up with National Geographic and hired the world’s best longevity researchers to identify pockets around the world where people reach age 100 at rates 10 times greater than in the United States – the blue zones. Some of them are:

  • Okinawa, Japan
  • Sardinia, Italy
  • Loma Linda, California
  • Nicoya, Costa Rica
  • Ikaria, Greece

So, where are our Blue Zones? Women live the longest in Collier, FL, at 86 years on average, better than France, Switzerland, and Spain. Men live the longest in Fairfax County, VA, at 81.1 years, which is higher than life expectancies in Japan and Australia. Women are also living long lives in Teton, Wyoming; San Mateo and Marin, California; and Montgomery, Maryland. For men, long life spans also can be found in Marin, California; Montgomery, Maryland; Santa Clara, California; and Douglas, Colorado.

Healthcare: Saving Lives or Prolonging Suffering?

Thursday, August 12th, 2010

There is a cacophony of voices in the media talking about healthcare reform, but it’s more heat than light.  That why Atul Gawande’s most recent article in The New Yorker is so important. Boston-based Brigham and Women’s Hospital general and endocrine surgeon Gawande examines how the trend to prolonging life is one of the reasons behind soaring healthcare costs.Is healthcare saving lives or prolonging suffering?  Everyone needs to read this.

According to Dr. Gawande in Letting Go, “Twenty-five percent of all Medicare spending is for the five percent of patients who are in the final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit.  Medical spending for a breast-cancer survivor, for example, averaged an estimated $54,000 in 2003, the vast majority of it for the initial diagnostic testing, surgery, and, where necessary, radiation and chemotherapy.  For a patient with a fatal version of the disease, though, the cost curve is U-shaped, rising again toward the end – to an average of $63,000 during the last six months of life with incurable breast cancer.

The big question Gawande poses is thus:  What are we getting in return?  “Patients who were put on a mechanical ventilator,” Dr. Gawande continues, “given electrical defibrillation or chest compressions, or admitted, near death, to intensive care, had a substantially worse quality of life in their last week than those who received no such interventions.  And, six months after their death, their caregivers were three times as likely to suffer major depression.”

Dr. Gawande notes that in one study, “Researchers followed 4,493 Medicare patients with either terminal cancer or congestive heart failure.  Surprisingly, they found no difference in survival time between hospice and non-hospice patients with breast cancer, prostate cancer, and colon cancer.  Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months.  The lesson seems almost Zen:  you live longer only when you stop trying to live longer.”

In one case Dr. Gawande describes, “Aetna decided to let a group of policy-holders with a life expectancy of less than one year receive hospice services without forgoing other treatments.  A patient like Sara Monopoli (who was diagnosed with terminal lung cancer at the age of 34) could continue to try chemotherapy and radiation, and go to the hospital when she wished – but also have a hospice team at home focusing on what she needed for the best possible life now and for that morning when she might wake up unable to breathe.  A two-year study of this ‘concurrent care’ program found that enrolled patients were more likely to use hospice:  the figure leaped from 26 percent to 70 percent.  That was no surprise, since they weren’t forced to give up anything.  The surprising result was that they did give up things.  They visited the emergency room almost half as often as the control patients did.  Their use of hospitals and I.C.U.s dropped by more than two-thirds.  Overall costs fell by almost a quarter.”

Americans Aging, Gracefully

Tuesday, August 3rd, 2010

By 2030, an estimated 72 million baby boomers will make up 20 percent of the population.  Americans are aging and living longer than ever, according to a report entitled “Older Americans 2010:  Key Indicators of Well-Being” compiled by 15 federal agencies.

The full report, which details demographics, economics, health status, health risks and healthcare can be found at a dedicated website.  According to the report, Americans who live to 65 can expected to survive approximately 18.5 additional years, four more years than in 1960. Women who live to 85 can expect to live 6.8 more years and men 5.7 years.  As impressive as those life expectancies are, people living in most of Europe, Australia, New Zealand, Japan, Singapore, Hong Kong, Costa Rica – and even Cuba — can expect to live longer.

An estimated 39 million Americans were 65 or older in 2008 – approximately 13 percent of the population.  In 2030 – when the entire baby boomer generation will be 65 or older – there will be 72 million senior citizens or approximately 20 percent of the population.  By 2050, the over-85 population is expected to grow from 5.8 million to 19 million.  Healthcare costs for the average senior, adjusted for inflation, rose from $9,224 in 1992 to $15,081 in 2006.  Heart disease remains the leading cause of death for people 65 and older, though at half the rate recorded in 1981 – just 1,297 per 100,000.  Strokes, cancer, respiratory diseases and Alzheimer’s are the next leading causes of death.  Healthcare ate up 28 percent of out-of-pocket spending among the poor and nearly poor in 2006; that compares to 12 percent in 1977.