Longevity Top 10
Dr. W. M. Bortz II
Q: As a 70-year-old, I am aware that my
future life expectancy is vastly brighter than that of a 70-year-old a century ago. To
what do you attribute this major gain, not only in life quantity but life quality as well?
A: The U.S. Centers for Disease Control
and Prevention (CDC), the prestigious government health complex in Atlanta, Ga., recently
nominated its list of 10 accomplishments that have led to the greater than 30-year life
expectancy in the last 100 years, a gain incidentally that has not been even remotely
approached before, nor will it again. But it is a huge gain nonetheless, and you and I and
the billions of our earth cousins are the immediate beneficiaries of it.
10 list is as follows:
|Control of infectious disease. |
|Highway safety. |
|Safer workplaces. |
|Vaccine development and use. |
|Decline in vascular disease (heart attack and
|Better nutrition. |
|Improvement in perinatal health. |
|Family planning. |
|Water fluoridation. |
|Identification of tobacco as a major health
The CDC observes that these and related
advances in public health are the proximate causes of 25 of the 30 gained years of life.
At the dawn of our century eight of the top 10 killers
in America were infectious diseases; tuberculosis, meningitis, pneumonia, syphilis and
scarlet fever dominated the obituaries. Antibiotics have been critical to the treatment of
these and other acute infections. Now the top killers are the chronic diseases. Further,
improved sanitation and cleaner drinking water have virtually eliminated diseases such as
typhoid fever and cholera.
there has been a dramatic drop in traffic-caused fatalities. Despite a huge increase in
miles and hours spent on the highway, often at high speeds, the nation's highway deaths
are at an all-time low. Probably the horse and buggy was more dangerous per mile driven
than today's freeway pattern. The National Highway Traffic Safety Administration
under the watch of its wonder director, Dr. Ricardo Martinez has led effective
campaigns on using seat belts, motorcycle helmets, air bags and safety seats, and has
decreased drinking and driving. Cars and highways, too, are redesigned for safety.
workplace is becoming safer, too. Deaths from mining, construction, transportation and
heavy industry mishaps have declined by 40 percent just in the last 20 years. Work-related conditions such as asbestosis, miner's lung
and silicosis are controlled by better recognition of inhalation precaution. Job injuries
caused by a lack of good protocols have diminished dramatically as all industries have
become super-aware of work site disability and death.
At the start of this century, there were five vaccines
available that were not very widely used; today, there are 30 vaccines, most in wide
usage. As a result, polio and smallpox have been totally eradicated. Just ponder the glory
of such a boast for a second. Additionally, other vaccine-susceptible diseases are
controlled, and we're not through yet.
One of our
wonderments is the huge decrease in our No. 1 contemporary killer: artery disease. Each
survey exhibits a further reduction. Whereas the heart surgeons have played their part,
most of this fall is a result of stricter management of risk factors, such as lessened
smoking, better blood pressure control, lower cholesterol levels, and for some, increased
physical activity patterns. Although this domain still has a long way to go, heart disease
and stroke deaths have fallen by more than 50 percent in the last 30 years.
implementation of our nation's nutrition has improved greatly in 100 years. Not only is
food contamination largely a thing of the past, but food nutritional value is markedly
better. Knowledge of the importance of the micronutrients such as calcium and
folate and iron has been a major bonus. Food fortification and improved economic
status have combined to diminish hunger in the United States.
Healthier babies and healthier mothers are a happy byproduct of
this century. The horror stories of perinatal misadventure of just a few decades ago have
been replaced by confident and healthful birthing and early life well-being. Maternal
mortality has decreased 99 percent in this century, infant mortality 90 percent.
The role of
enlightened family planning, although it still has a ways to go, has given hope to
increased numbers of wanted pregnancies and intact families. Teenage pregnancy is down.
Smaller families are the rule. The use of condoms has decreased AIDS and other sexually
transmitted diseases. The social and economic roles of women are vastly different as we
exit this century than they were at the onset.
of drinking water is now 55 years old. This practice, which is available to more than half
of the U.S. population, has resulted in a 60 percent to 70 percent reduction in tooth
decay in children and in adults. As a 69-year-old, I lament its lack of availability to my
generation, but celebrate its use with our nine grandchildren whose teeth lack all the
fillings I display.
Surgeon General's report on the risk of smoking has steadily gained momentum until now the
social norm is totally different. Work and public places are off limits. Planes,
thankfully, are smoke-free. Unfortunately, we still suffer some 1,100 smoking-caused
deaths daily, according to the CDC nearly the equivalent of three 747's crashing
each day. But we are learning. More and more people are stopping, fewer are starting, and
millions of smoking-related deaths are being prevented.
these 10 categories all have to do with disease prevention and health promotion. They are
simple, cheap, universally available and effective. What medication can make that claim?
Yet despite this argument, nearly the entirety of our nation's 1.5 trillion dollar per
year medical cost outlay goes to curative effort. Please take this as a plea for diversion
of a portion of this huge outlay to preventing illness.