America is the land of dreams. We are so fortunate to live in a place where dreams about positive futures for ourselves and our families have a real chance of coming true. Yet for many around the world, including many in America, dreams of what could be often give way to more immediate critical needs like where the next meal will come from or where we will sleep tonight. Even these folks have a better chance to survive and thrive than people in many other countries.
Our most pervasive “American Dream” isn’t about buying some flashy new car, RV or even a home of our own. It is about our children. We dream about and have come to expect that the lives of our children will be longer and better than our own lives or those of our forebears.
The average life expectancy of Americans has risen every year almost without exception for as long as we have kept records of such things. The life expectancy figure is a compelling metaphor for our overall wellbeing, both in terms of personal health and, in a larger sense, the health of the country.
We have much to celebrate when we see the number increase. Likewise, when and if the number goes down, we had better pay attention and consider why this is happening in the richest of nations.
The “we better pay attention” warning came once again with the release of the most recent year of statistics on life expectancy released by the Centers for Disease Control.
The life expectancy for Americans declined for the second straight year — the first such double year decline since the early 1960s — nearly two generations ago. The life expectancy is now 78.6 year, ranking the USA 30th among nations.
Any of us working in local government know that poor health in the community is a major public administration issue not just a personal health one. Indigent health care is a public expense, not to mention one which impacts the insurance premiums for those lucky enough to have coverage.
The large bulk of fire-rescue calls have nothing to do with fires. Rather they are medical calls. Local law enforcement is our prime acute mental health intervention agency, notwithstanding limited training for officers in this area.
Mental illness aligns with economic dislocation and drug use to create homelessness, hunger and yet more health issues. Lack of insurance coverage drives many to delay or avoid the health care they need until the problem is acute and hugely expensive emergency rooms or trauma units become a person’s doctor’s office.
There are more gun violence deaths now than vehicle accident deaths in 21 states and the overall number of such deaths is converging. Suicide ranks in the top 10 causes of death … in a tragic lineup with heart disease, cancer, accidents, chronic lung disease, stroke, influenza, kidney disease, diabetes and Alzheimer’s.
The science behind most of these plagues is increasingly better understood. But science alone is not the answer to longer and healthier lives. The politics of the country, along with education and science, determines the life expectancy of our children.
A nation without universal health care access is not a truly advanced one. A nation where shortages in available health care professionals is chronic in many places has to rethink its support for the education of physicians and nurses. The debt faced by new doctors, now averaging $190,000, retards health care. The burdensome paperwork and insurance restrictions make doctors want to call in sick.
We undervalue prevention and health education in favor of intervention only after acute symptoms of illness appear. That intervention, we all know, usually comes in the form of drug prescriptions. I know you believe me, but just in case you don’t, try calling in sick yourself one afternoon. Waste hours of your precious life watching daytime TV. This “delightful” experience is highlighted by a constant litany of drug commercials, intermingled with lawyer commercials urging you to sue the makers of “bad drugs.”
A final key element in this depressing discussion is the increasing difficulty we seem to have in accepting personal responsibility for what we do.
Lifestyle choice, or lack of choices, drives many of the leading causes of death. Smoking — and now e-smoking — along with little or no exercise, poor diets and meager social engagement harm our physical and mental health.
What can we do? We can begin by realizing that our best hope for longer and healthier lives rests at the personal level.
A brilliant doctor friend responded to my question about how to lose weight by saying, “Eat less, move more.” That is a powerful prescription.
It goes along with not watching as much TV or otherwise staring at the screens of our electronic toys. Instead, engage more with friends, volunteer for charity work, take up hobbies and, as my K9 health professionals remind me, get a dog.
At the community level, we can create “healthy community” initiatives, improve parks, issue challenges, involve local businesses and schools, and teach every one of our kids about actions to improve health while caring more for others.
These ideas are every bit as important to our personal “security” as building fences and walls and hiring additional police officers.
Despite all of this, however, only a national “brain transplant” to implement universal health care, to encourage innovation in science and bureaucratic process improvement, to mitigate health professional’s debt in trade for public health service, and to create sustained support for preventive health will return the dream of longer and better lives for our kids and ourselves.
We have the knowledge to improve life expectancy. The question is whether or not we have the will to do so.Hero 1