Longer life is no guarantee of health


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Yes, we’re living longer — much longer. But longevity doesn’t always translate into healthy living.  In 2000, there were approximately 36 million Americans living beyond the age of 65. It is estimated that by the year 2025 that number will double, and most of the male and female population by that time can expect to live to 84 and 86 respectively. Technical and medical advances will make it possible to live longer, but those advances won’t guarantee quality of life.

In fact, according to a recent AARP study, Americans who reach age 50 are in much poorer health then their counterparts in other industrialized countries. That’s a tough fact to accept when you consider that the amount of money spent on healthcare per person in America is twice that of other developed countries.

But the underlying truth may be even tougher for some to accept: We are in this mess not because of Obamacare or another kind of care; it’s “I don’t care.”

It is tough to avoid obvious inferences when I see patients suffering with preventable conditions displaying the most disregard for how they dress, their self-respect and their overall energy level and focus. I have many patients whose lifestyle suggests they simply don’t care — don’t care about how they look,  about how they feel or about how they are perceived by others. At some point, maintaining self-respect became a secondary priority.

Even those fortunate enough to have a gold-standard insurance plan are not guaranteed a healthy life. Consider the circumstances of a patient of mine. He is 60 years old, average height, has a BMI (Body Mass Index)  of over 40 (classified as morbidly obese), and demonstrates the early stages of congestive heart failure. Due to excessive smoking, he also suffers with COPD (Congestive Obstructive Pulmonary Disease). Suffering with chronic low back and neck pain, he came to my office for treatment. Until his 40s, this patient maintained normal weight and was in good health. What happened in the intervening years that caused his health to deteriorate?

WE ARE NOT THOSE IMAGES

As a culture we are pelted with images of  sexy, lean bodies and messages of secret formulas capable of transforming our poor health and poor self image into something Hollywood-like. Yet, every day I see in my practice patients who reflect the widening gap between the images of good health, high energy and attractiveness projected at us, and the reality that so many have given up caring about themselves enough to enact change. My 60-year-old patient is one of them. He destined for a lifetime of treatment for preventable chronic diseases. Treatment for millions of people in his situation places an enormous burden on a national healthcare system.

Whether one is on Obamacare, Medicare, gold-plus insurance care or anything else, it ultimately won’t matter unless we care. If we break it down to its lowest common denominator, “I don’t care” amounts to a lack of self-respect. One’s quality of life is not measured in dollars spent on medical procedures, pharmaceuticals or surgeries; it begins with personal choices that develop into a philosophy of health. A national health care system can only work effectively and economically if the people it serves assume personal responsibility for their health.

If we want to talk seriously about creating a long-term, sustainable, positive change in such a system, then we need to pay attention to those diseases that are preventable or can be limited by behavioral lifestyle changes.

The Centers for Disease Control reported in 2010 that obesity-related diseases would soon be the primary cause of mortality in America. Heart disease, cancer and, of course, diabetes, are diseases that often begin with a slow onset and, as one ages, become more insidious and extremely expensive to manage. The costs of treatment for obesity-related diseases are astronomical. Estimated annual healthcare costs related to obesity approach $200 billion That figure is about 21 percent of all annual healthcare spending in America.

In my view, obesity is not a disease. Obesity is a condition that, for most people, is the result of complex, learned behavioral patterns that are conditioned by ethnic, cultural and social influences. But these unhealthy, negative behavioral patterns can be altered. We can change. Genetic dispositions explain only a small percentage of those considered obese by medical standards.

A BMI of 25 to 30 is considered overweight, and a BMI of more than 30 is considered obese. Seventy percent of Americans are overweight, and one-third of those are obese. In 2000, 3.9 percent of adults in the US had a BMI of 40 or greater. That figure now has grown to about 9 percent. Those morbidly obese people are, on average, 100 pounds or more overweight. New science is showing that a rapid rise in childhood Type 1 diabetes appears to have a genetic component. These initial findings may indicate a biochemical evolution occurring in our gene pool.

NEXT GENERATION MOST AT RISK

Obesity is the most common health problem facing children. Twenty-two percent of American children are overweight and 15 percent are considered obese. A recent study in the Journal of Pediatrics has reported that 80 percent of obese 10- to 14-year-olds have at least one obese parent and are much more likely to be obese in adulthood than children with “normal-weight” parents. The skeletal structure of a growing child is unable to support the stress load that obesity places on the body. Consequently, many of these children suffer with constant ankle, knee, hip and low-back pain. I frequently see this in my practice. During treatment, I explain  to children and their parents the necessity of losing weight so that they will reduce the stress on their joints, thereby relieving their chronic pain.

For most, my suggestions and advice fall on deaf ears. For those who make the simple changes I recommend, the health outcomes over time improve significantly.

The obesity epidemic has prematurely aged at least a third of our population by decades. And this is  a huge economic strain on a healthcare system that pays medical bills for diseases that would be prevalent at “old age” but instead are being paid to treat a much younger population. In fact, many medical studies confirm the aging process is starting earlier for a significant percentage of our population. The other two thirds of the Baby Boomers will  have a longer lifespan then any previous generation but will suffer and  be treated for more chronic diseases that are extremely costly. One example of that: It is estimated that by 2030, 25 percent of boomers will have diabetes. Those between the ages of 50 and 64 presently are being treated for one or more co-morbidities as  a result of diabetes. Because of longer life expectancy, despite living with long term illnesses, most boomers will chose to live in their homes as long as possible. This choice will motivate private insurance to develop comprehensive home health care delivery systems.

It is essential that the nation bring down obesity rates. And that will trigger a decrease in morbidity rates. There are no medical mysteries to unravel. It’s simple. Begin with respecting yourself. Look in the mirror.

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