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All too often, we hear that the reason
life expectancy has been increased
is thanks to the marvellous
developments in modern medicine. This
is a message that is repeated many times
and promoted by the medical industry,
but with little or no evidence. In fact, the
opposite may be the truth.
A combination of not understanding
the concept of life expectancy, ignoring
scientific facts, plus a willingness to take
credit when it is not due has seen the
medical industry promote itself as the
reason we live longer. Behind the scenes,
this is little more than a marketing strategy
for the big pharmaceutical companies.
Don't get me wrong; this does not
undermine the fantastic role medical
doctors play in acute life-saving events.
These make a huge contribution to an
individual's life expectancy, but an
insignificant contribution to life expectancy
for all of us. The overemphasis of modern
medicine on the pharmaceutical model
and "silver bullet" approach has led to a
disempowerment of individuals over their
own health during the past few decades,
during which we have seen a huge rise in
chronic illness. The more specialists and
the bigger the medical budget, the poorer
the health of the public.
Let's take an example: the United States
uses 50% of the world's pharmaceuticals
and spends more per person on medicine
than any other nation, yet has one of
the poorest health outcomes in the
developed world. Modern medicine tends
to focus on prescriptive treatment of
disease, rather than health promotion,
prevention and management 1,2. It is likely
that everyday medical care provides little
contribution to increased life expectancy of
a population 3,4.
Gains in life expectancy worldwide have
been greater during last century than at
any other time in recorded history 5,6.
Statistical analyses show that since the
early 1800s, life expectancy at birth has
seen a linear rate of increase 8. Within
this time, it has been human advances in
sanitation, increased food supply, improved
access to water, and basic preventative
medicine that have helped drive these
steady increases in the developed world
-- not pharmaceuticals. The majority of
life expectancy gains were made before
pharmaceuticals to treat heart attack,
stroke and other forms of chronic illness
were even developed.
However, it is important to understand
the concept of life expectancy. It is the
average number of years of life remaining
at a given age for a selected population.
Life expectancy at birth is commonly used
as the main indicator of human health and
wellbeing. It is said to give an indication
of the overall mortality of a population 5.
However, it is a poor indicator of population
Life expectancy is poorly understood.
Most people think it is increasing the age
to which they can live; for example, people
at 50 think that they are going to live longer
because of an increase in life expectancy.
This is not the case. Life expectancy is a
statistical anomaly, which takes the average
of the age of a person's death. It includes
everyone: infants, children, teenagers right
through to those in their old age. This
means that if the rates of infant mortality
are reduced, the average life expectancy
is dramatically increased overall. A simple
example will highlight this. If 50% of the
population died before one year of age and
50% of the population died at 80 years of
age, the average age of life expectancy is
around 40 years, even though 50% lived to
80 years of age. If you eliminate the infant
mortality, the life expectancy goes up to 80
years of age. This does not mean people
are living longer -- they are still dying at 80
years of age, but the statistical average, the
"life expectancy", has increased.
This reduction of child mortality skews
the life expectancy 9. Statistical analysis
has revealed that the trends in cohort
geriatric mortality follow those of reducing
childhood mortality 10. This means that
benefits from improvements in mortality
rates of younger generations provide a
false impression of the benefits to older
generations. Furthermore, life expectancy
Where is our life
heading? Dr Peter Dingle
PhD suggests we look
beyond the accepted
truth to gain a clearer
view of our community's
'The overemphasis of modern medicine on
the pharmaceutical model and "silver bullet"
approach has led to a disempowerment of
individuals over their own health during the past
few decades, during which we have seen a
huge rise in chronic illness.'
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