A couple of articles caught my eye today. Like most of us (i.e. Boomers), I have more than a passing interest in issues related to health and longevity. Naturally, then, when I considered where to start reading this morning– Jeff Sessions confronting accusations of lying to the Senate, another accusation of sexual assault against Roy Moore, presidential pressure for judicial retribution against a former rival (yes, in the U.S.), or research showing yet more reasons that coffee is good for us– you can guess where I clicked first. Latte in hand, I began to read.
Time Magazine (time.com) reported on a presentation by the University of Colorado medical school on their innovative analysis of the data in the landmark Framingham Heart Study. The strongest correlation they discovered was the link between drinking coffee (up to at least six cups per day) and reduced risk for heart failure, stroke, and coronary heart disease. Well, that called for another espresso!
Even sweeter for yours truly was the next article, about Harvard researchers proclaiming that “eating too quickly may be bad for your health.” Slow and steady eaters are less likely to become obese or to develop metabolic syndrome, with its associated stroke, heart disease, and diabetes. This was welcome information because my own research had only confirmed that slow eating can really irritate those waiting for you to finish. Bonus benefits seem to be that slow eaters may burn more calories and that, by chewing and swallowing more slowly, they recognize that they are filling up and consequently eat less. I am less convinced about this last finding, having learned through determined training that it is possible to eat slowly and still eat a lot. Save when one’s plate is prematurely whisked away.
As much as I enjoyed reading articles that supported the wisdom of two of my habits (and don’t we all?) it also reminded me that for every research finding there is usually another bit that more or less contradicts it, sooner or later. My favorite commentary on this observation comes from the 1973 movie, Sleeper, after the protagonist awakes from a 200 year cryogenic slumber:
Dr. Melik: This morning for breakfast he requested something called “wheat germ, organic honey and tiger’s milk.”
Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.
Dr. Melik: You mean there was no deep fat? No steak or cream pies or… hot fudge?
Dr. Aragon: Those were thought to be unhealthy… precisely the opposite of what we now know to be true.
Dr. Melik: Incredible.
In spite of this, most of us do our best. Many or most of our generation are determined not to go gently into that good night. Eyes and ears always open for any new idea, book, or product to bolster our anti-aging arsenal. But what efforts are going to be effective?
I spent some time with a friend last week who for the first time in his life has recently faced a couple of negative test results. This led him to take one of those interactive surveys that give you feedback on your health habits, your projected life-expectancy, what you can do to increase it, and by how much. I’ve done the same and his observation of the results was the same as mine: unless you are a smoker, are morbidly obese, or refuse to wear seatbelts, your increased life-expectancy if you make ALL the suggested changes amount to no more than a year or two.
Actually, there is one factor that the health questionnaires don’t address that would skew the results. The ones I’ve seen don’t ask the question, “Do you have good health insurance?” Their results are geared for those who do. Ah, you see where I am going with this, don’t you?
We want to believe that if we do all the right things, we will be rewarded with a long and healthy life. Research usually asserts that our individual choices do in fact affect our chances. A 5% lower risk of this or an 8% greater chance of that. Similarly, drivers who do all the right things and make good choices have better safety statistics and smaller risk of accidents. But, they still need insurance. Are mandated to have insurance.
When Massachusetts passed RomneyCare, or whatever they call it now, Harvard researchers found a 3% drop in the state’s mortality rate in the first four years of universal coverage. This in a state that already had a higher percentage insured than most others. The same source had this:
In 2002, the Institute of Medicine estimated that the death rate of the uninsured is 25 percent higher than for otherwise similar people who have health insurance. According to the study, 18,000 excess deaths occurred each year because 40 million Americans lacked insurance.
Of course, from listening to friends and reading the opinions of others, it seems safe to say that the quality of our lives matters at least as much as their duration. We would like a long life, but we would really like it to be as healthy as possible. So, whose quality of life do you predict will be better? Whose would you choose? Someone who has chronically deferred medical care due to lack of access or fear of financial ruin? Or someone whose annual physicals, lab tests, preventive and proactive care, and necessary surgeries have been a matter of routine?
For an individual to make smart, research-based choices for a healthy life is a baffling endeavor, a maze with conflicting signposts, detours, and dead ends. And, if we do well navigating that maze, perhaps we will live a little longer and hopefully more than a little healthier. Worth the effort and something we all can do.
But, we have no control over our DNA and limited control over the unforeseen accidents and other events that can derail the healthiest among us. And, by this point in our lives, most of us understand that everyone is derailed at some point, to some degree. If you have been there already, you know that you have never felt more vulnerable, never more dependent on others, never more naked. Everything else, except for the support of loved ones, is immaterial whether you are rich or poor.
While we live in a time that has reached a nearly-miraculous state of medical understanding and technology, we live in a country that somehow still struggles with the basic question of whether everyone deserves to benefit from it. It is clearly not a matter of whether it is affordable. It is a matter of values and priorities.
In its 2016 report, Universal Health Coverage and Health Outcomes, The Organisation for Economic Co-operation and Development (OECD) ranked its 35 member nations for population coverage for core health services. 24 of these countries have achieved completely universal coverage, 22 of them totally with public funds. The United States had the smallest percentage coverage, except for Greece, falling short of economic powerhouses Poland, Mexico, Hungary, and 30 others. While we attained runner-up to the bottom with 88% coverage, 54% of our population have primarily private insurance and only 34% public. The nation closest to that mix was Chile, with 93% coverage, 19% private and 74% public.
Each of these countries has recognized that the health of its state can be no greater than the state of their people’s health.
Is it any wonder that politics of divisiveness and partisanship are rampant when we have failed to agree on this most basic of social compacts? Indeed, it has become a perverse ideological litmus test to destroy what progress has been made.
A demonstration of this is taking place right now. The Republican effort to salvage the legislative year depends upon passage of a tax bill that will embody their priorities. The most recent strategy for preserving the greatest possible reduction of corporate taxes and individual taxes for the wealthy, without obviously doing so at the expense of the middle class, is to include the repeal of the ACA’s individual mandate. This would save several hundred billion dollars and result in 13 million Americans losing their insurance. If it passes, it is more than possible that deep cuts to Medicare and Social Security are next, as deficits resulting from the tax cuts need to be offset.
So, there it is. It is a big deal. Affecting us, affecting our families. Affecting what kind of country we are choosing to be. What to do? Order that book on the new cleansing diet? Or demand that our representatives represent our priorities and work for the longterm health of us all?