Life expectancy: and now for the good news…
We’re living longer. So why do campaigners and public-health workers keep trying to scare us to death?
Given the number of health panics we are constantly bombarded with, you’d think we all had one foot in the grave. One way or another, it seems, we’re going to eat, drink or smoke ourselves to an early grave. That is, if bird flu or some other horrible lurgy doesn’t get us first. But the reality is that we’re living longer, in spite of those things.
Last week, a paper in the International Journal of Epidemiology provided chapter and verse on this good news story. In Western Europe, since 1970, life expectancy has typically increased by between six and eight years. Moreover, as the author David Leon notes, these trends are ‘overwhelmingly driven by changes in mortality in adult life, not in infancy or childhood’. Some of this is due to the gradual decline in smoking, but much of it is also due to improvements in the treatment of disease. That’s important because it means there some basis to hope that these trends will continue for some time, whereas the room for improvement at the start of life is more limited.
There are parts of the world where things have not gone so well. In both Eastern Europe and in Sub-Saharan Africa, life expectancies fell dramatically in the last 10-15 years of the twentieth century, though they are now recovering. The spread of AIDS and the disruptive effects of political change were mainly to blame. But where there were already good levels of healthcare, economic development and relative social stability, life expectancies have greatly improved.
As it happens, while the effect on overall life expectancy is relatively small, there have still been significant improvements in infant mortality rates, too. The UK Office for National Statistics reports this week that infant mortality in the UK fell from 12 deaths per 1,000 live births in 1980 to 4.5 deaths per 1,000 live births in 2009, reflecting improvements in neonatal care.
All this has been going in the midst of an ‘obesity epidemic’ that was supposed to be threatening to reverse the trend in life expectancies. Leon told the Independent that there might even be some benefit in carrying a little extra weight. ‘If you get poorly you lose weight. So if you fall sick it may be better if you have got something in reserve to call on.’
British news coverage of Leon’s paper featured a certain amount of crowing that UK life expectancies remain ahead of those in America. In 2007, US life expectancy at birth was 78 years compared to 80 in the UK. On this basis, the economic wealth of a country may not be a perfect predictor of health outcomes. But the over-riding observation is that for most countries in the world, people are living longer than before.
By historical standards, this is big news. As Professor Tom Kirkwood, director of the Institute for Ageing and Health at Newcastle University, told the Observer earlier this month: ‘There was no change in longevity between Roman times and 1800. But after that we see considerable alteration. Every century the lifespan of British people increased by 20 years. Nor is this rise an exclusive British phenomenon. It is observed in most countries today. Only those with particular health problems, like South Africa’s HIV infections, have failed to see rises.’
So, has this good news finally persuaded health campaigners to give us all a break from the lectures? Has it hell. For example: ‘A pie with your pint can contain as much salt as 15 packets of crisps, according to research which says men are risking their lives by regularly tucking into the popular dish’, declared the Guardian last Thursday. ‘Pubs are the worst offenders for the high salt content of their meals which can cause high blood pressure, strokes and heart disease but supermarkets are also highlighted for their salt-laden pies.’ You can’t even have a pie and a pint without some telling you it will kill you, it seems.
This was just the latest salvo from Consensus Action on Salt and Health (CASH), in its long crusade to persuade us that our bodies’ highly evolved mechanisms for internally regulating salt and fluids should be superseded by a centrally imposed target from the government. Yet the evidence that salt is a major health hazard is pretty thin, despite the endless campaigns and lectures about cutting down. And there’s a surprising lack of evidence for many other health threats we are assured will mean an early visit from the Grim Reaper.
We now have a great swath of the health industry that has every interest in reminding us of our vulnerability. No forkful of food can be free of guilt about the dangers of obesity or heart disease, something that the addition of calorie counts to many restaurant menus will only reinforce. No swig of an alcoholic drink is permissible without making sure that we count the number of units. No sexual liaison can now be free from the nagging thought that there might be some horrible health consequence, something handily reinforced by seemingly every pub and night-club toilet, the walls of which are adorned with reminders of the terrible fate that may follow that next inebriated shag.
So bad is this constant harping about how we’re all going to die, maybe it’s time we started to worry about those who work in public health. It seems as if they simply cannot compute the idea that there might not be all that much to worry about, healthwise. Perhaps, in fact, this is a medical condition itself. May I be the first to christen this condition: Good News Omission Mentality Syndrome (GNOMES).
Let’s all work for the day when we can eradicate GNOMES altogether. Now all we need to do is pick which colour the awareness ribbon will be…
Rob Lyons is deputy editor of spiked and blogs at Panic on a Plate.
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