Do you know what the difference is between healthspan and lifespan? You should, especially because while the average lifespan has increased from 75 to 77 since 1990, the average health span hasn’t budged. It's stuck at around age 65 according to research from the the renowned Institute for Health Metrics and Evaluation at the University of Washington.
What that means, in real terms, is quality of life. It is one thing to live longer, it is another to live better. "Healthspan" means simply the amount of time you are living in essentially good health, as opposed to being consumed or defined by disease.
Don’t get me wrong, it is possible to suffer from a chronic illness and still enjoy a good quality of life, and there are many illnesses, from rheumatoid arthritis to Multiple Sclerosis, to Congenital Heart Disease to blood clots to infections that are anything but self-imposed. Not only that, but some of the most inspiring stories I’ve witnessed or treated among my patients involve the courage to overcome chronic illness and to find the hope to soldier on.
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Still, it is shocking to find out that while 20% of U.S. adults lived with multiple medical problems back in 1990, the number is now closer to 30 percent.
Why? Obesity is certainly part of the explanation as is sedentary behavior, poor diet, and unhealthy chemical additives to our foods. And more obesity means more diabetes, a multi-system disease which is more likely the more you weigh, since the number of receptors for insulin we have is fixed but more is needed the heavier we are.
But the problem goes beyond even obesity, poor diet and diabetes, and includes anxiety, depression, and substance abuse. Following the COVID pandemic, heart disease remains our number one killer and cancer number two, and an unhealthy lifestyle including poor sleep increases the risk of both occurring dramatically.
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A new report from the American Cancer Society sheds further light on the issue. Overall, less smoking, early detection and improved treatments (especially when it comes to lung cancer) have led to 4 million fewer cancer deaths since 1990. But at the same time, cancer rates are increasing for some lifestyle-affected cancers including prostate, breast, endometrial, as well as colorectal and cervical cancer for younger patients. "Colorectal cancer has moved up from being the fourth leading cause of cancer death in both younger men and women two decades ago to first in men and second in women." This change is not a result of better detection, but is more related to an increase in carcinogens and the unhealthy lifestyle discussed above. The advances in technology helps you to live longer, but the chronic conditions cripple your healthspan.
Perhaps the biggest problem of all is our health insurance coverage, which is an illness-oriented rather than a prevention-oriented system, relying on fear of major illness to justify rising premiums. After all, if you are healthy and have a longer healthspan, you are less likely to want to pay massive premiums (or take a job you don’t like so your employer pays them) so that your illness is covered when your health span ends but your life continues. Health insurance is notorious for providing most of its payouts in the last years of life, when quality of life is mostly gone.
For increasing numbers, the solution to the problem is an array of pharmaceuticals, most recently including the weight-loss drugs Ozempic, Wegovy, and Mounjaro, which are effective but don’t address the underlying problem.
As a society, we need to exercise more, eat less meat, fewer carbohydrates and more vegetables, and in order to break our cycles of worry, we need more sleep.
At a time of political strife, wars overseas and division and hatred at home, we need more kindness and compassion, more acceptance and love. This country was built on healthy debate, not on the health consequences of fear and loathing.
