 question, which has become painfully felt in a country like Japan, is if it is worth mentioning how many years you just live. Is it an enviable place where most senior citizens just managed not to die yet, with lots of medicines regularly taken and constant care needed, whose endlessly rising cost has to be shouldered by the shrinking young population? No, this is a hell on earth. Something is definitely wrong with a society whose future is darkened by the crowds of regressive pensioners who on the one hand create huge financial burden on the youth and are on the other hand determined to oppose any political reform or societal change, such as taking more immigrants, liberating the financial market or crushing the pork-guzzling interest groups, not to mention of taking away the voting rights from the 80 and over age group, which are all needed to clear the social bottle-neck. Seriously, what's the point of heeding the voice of people whose days are numbered and who naturally don't care about the future of the society? In today's Japan, aging is no cause of celebration. If you think I'm being rather lunatic, just look at how those old brain-dead zombies are going to enthuse about Mr Ass-hole, a super regressive pork-distributor and new prime-minister-to-be in the coming weeks.
Obviously poverty is a big barrier to proper health care but I'm still not clear why inequality is. Poverty and inequality are not the same thing. Surely poverty is what we are trying to eliminate, not inequality.
IL SARDO wrote: "But, healthy researchers are excellent at receiving grants
and at writing whatever the politicians wish to hear. If you
can write what your government wants to hear you will survive
longer than your peers."
I'm not entirely sure that governments were thrilled to be told that their failed policies were causing unnecessary deaths, because that is exactly what this report tells them.
And, quite frankly, what do you think is causing more people in the developing world to die younger: their genetics, or the fact that they cannot easily access clean drinking water?
...)"It will not likely get anything done at all if the owner of that body doesn't want to do it. Not all care about health issue equally and some don't want to live at all that's why it's called suicide, active or passive.
@oso_mijares wrote:(September 02, 2008 22:48)."That's most absurd. Why they don't drink diet coke then? What about Mexicans' weakness for Damiana, Margaritqas, Tequila.? Bet they love the drink than die of dirt also... ahhhh? Moreover, Mexican diet is one of the worst diet in the world. Very unhealthy. They can't cut their fat and sugar intake? Again, either way people die anyway, we all die at the end. I believe many prefer die happyly with a drink on the left and a cigarette on the right.
Having not read the paper in reference, I hesitate to criticize... but I would say that "health" is a broad measure and can certainly be broken down to subgroups. For example, it is quite common to measure life expectancy which is, of course, a certain measure of health. But in most developed nations, and I can speak specifically about the US, while life expectancy is clearly higher than in generations past, quality of life (as measured by specifics of health, or "wellness") is often not. In order to stay alive as long as we have been in the developed world, we are undergoing many surgical and other medical procedures and relying on many medications. This can be seen as good fortune, for otherwise we may have succumbed sooner. But these life-savers have many side effects and quality of life is often reduced in some way(s.) Meanwhile, many aspects of lifestyle-- such as diet, exercise, socialization and security (personal, job, financial etc) are connected with quality and vitality in life. Personally, I would emphasize these more than they are currently being, "if I were king."
On a related note, while it is quite tempting to blame those who engage in unhealthy lifestyles-- or at least charge them some sort of premium on their health care-- it is simply not always productive. Yes, some statistics show people to be more likely to change health behaviors in response to a direct, short term financial cost than because of negative health effects resulting from maintaining their current behavior patterns. But, all the data I know of, show people more likely to make health behavior change with more social support. Whether this comes from the workplace, family or government is someone else's discussion to have, but pinning responsibility on people to change their behaviors yields much better results when those same people are provided with tools or systems for such transformation.
Finally, oso mijares, I have been in Mexico numerous times. I am not a soda drinker and I almost never had a problem finding clean bottled water. If people are going to pay for beverages in Mexico, they can just about as easily drink water as Coke, if that were their choice.
In the theory of evolution genetics is the key and
only variable for survival--another term for good health.
In the world of politically correct research, genetics are
ignored and public policy is given prime consideration for survival.
But, healthy researchers are excellent at receiving grants
and at writing whatever the politicians wish to hear. If you
can write what your government wants to hear you will survive
longer than your peers.
Dr. Valdez and brendan steuble,...)
Brendan Steuble, Even in universal health care systems you have the option of opting out to the fancy private system. And because the public health system is so cheap compared to, say, health care in America, even adding the monthly fee of your health company, you will be way better than under a fully private US system which presumes of providing freedom of choice but fails to keep the life expectancy of its folks high.
Collectivism, sirs. If you can figure out how to let me "opt out" of your grand scheme: great. Otherwise: war.
In America today the working poor often feel trapped in suboptimal jobs simply because health care is unavailable to them through any other means. They must accept greater stress in these jobs, and any innate entrepreneurship they may harbor is suppressed. Because zoning laws and government transit expenditure favor suburban sprawl, they must endure long commutes, further adding to stress and reducing productivity. With less time at home, their opportunities for education, childrearing, exercise and relaxation are diminished, further adding to stress and reducing productivity. Similarly, they have less time to shop for and prepare healthful meals. Since government policy subsidizes the overproduction of commodities like corn and soy, leading to overproduction of substances like HFCS and hydrogenated soybean oil, it is with little wonder that the resulting processed convenience foods find their way disproportionately into the diets of the poor.
So while my libertarian soul categorically rejects the nanny state, I see far too many ways in which government policy not only abets but encourages unhealthful (and unsustainable) lifestyles. Therefore, as this report seems to suggest, a very broadly conceived revolution in government policy must play a role in correcting them.
Yet as wilfred knight and Heimdall suggest, I think it is self evident that the individual is the primary caretaker of his own health, and that an ounce of prevention is worth a pound of cure. It is therefore a further challenge to academics, policymakers, the healthcare establishment, and society as a whole to shift our very culture in the direction of personal health promotion.
Cutting edge drugs, Nobel prizes, and medical super specialization are all very sexy and profitable, but rather inefficient at converting resources into healthfulness. With all the money so spent, we could instead research and implement mundane, peculiar, but potentially rewarding ideas like workplace calisthenics, workplace childcare, midday siestas, community gardens, real bicycle paths, etcetera.
Thinking further outside the box, government could tax processed white fat, sugar, and starch. It could request an annual health assessment to be filed with one's income tax return (with incentives built in). Choice can and should be respected, but government can and should promote healthful decisions.
The reality is that personal management and government policy are parners in creating individual and societal health. In reexamining the ways humanity can promote these, this report is a step in the right direction.
It is indeed not something new. Many people who ever worked in health in a developing country know this. Other problem is that these suggestions are never implemented by governments. We are a research group working in Bolivia with local people, we see exactly the same problems and many with us. Visions are published, waiting for people to be read and taken into account.
Dr Valdez-I thought the article was a bunch of posturing also, though perhaps not for the same reasons. I cannot be convinced that the state is the source of ANY goodness. The criminal justice system in every country is bankrupt and generally helps to keep the poor that way, or to, (from an American movie the Shawshank Redemption) cast its enemies "down among the sodomites" (a death sentence now).However, I am very interested in your linking of decalcification and the consumption of CO2 saturated beverages. Could you perhaps provide some reference? I drank Coke all my life and it has caused real problems for my teeth, which the "common wisdom" in the US puts down to the sugar.My best wishes for yourself and your family.Brendan Steuble
Dr. Frenk was not precisely very worried about Mexican's poor with his policies: M�xico is problaby the number one country consuming sweeten gaseous beverages as Coke and others: A disproportionate amount is consumed by the poor.
Dr. Frenk did nothing to avert this consumption of those beverages that produce obesity, decalcify people and rob income to a proper nutrition among the poor.
He was not the 'the white knight' for the poor people's health in M�xico.
What a wonderful plan! Why don't they try it in Cameroon, say, or Sudan? If it works well in Iceland, it should work in Africa, no? What was it that Swift said about the people who floated on clouds?
wilfred knight,I presume that only "socialist" governments view the health of their citizens as critical to the health of the country as a whole?I agree with you that personal responsibility is critical. But so is access to preventative health care. In the US we have a "fix it when it's broken" attitude towards health care, with 2 specialists for every GP.What if we had a "preventative maintenance" approach, with the ratio reversed and basic preventative care provided by a single-payer government sponsored system (a la Medicaid)? Pay more for fancy pants insurance that covers speculative gene therapy, if you want, but *everyone* gets access to basic care.Or is our country healthier when millions can't even afford vaccinations? Because at least then we wouldn't be "socialist"?
The WHO report is very timely, because health, measured in extended lifespan, may be about to enter a new era of inequality and social stratification particularly in the West.
Several years ago, Francis Collins, Nobel Laureate and one of the pioneers of the human genome project, predicted that there were people alive today who would live to be 125 years old thanks to genomic medicine. Of course, he was talking about people who had access to the finest medical practitioners and finest medical science in the world. Without saying it aloud, he also was talking about the very rich in every society who can afford such care.
The Potomac School in McLean, Virginia (a private school where many of the wealthiest American families send their children), already has acted on the Collins prediction. In the last year, the school's Board of Directors started a health education program based on the expectation that students will live 30 years (one full productive lifetime) longer than their parents. The Potomac School education program teaches students to understand how lifestyle decisions combine with the kind of healthcare they (and few others) will be able to afford will extend productive lifespan.
Within one generation, democratic governments everywhere may find themselves attempting to explain to their electorates why the economic and political elites in society are living productively 25-50 years longer than the other strata of society. The health-lifespan disparity between the developed and less developed world may pale next to the social and political consequences of inequality within developed nations.
One wonders how the bar chart accompanying this article would change, and what the message it would convey, if lifespan in Great Britain and the United States were broken out by net worth and not location.
...What ? ? "The Economist" leads on healthcare without castigating the Doctors ? Or blaming lack of insurance, or the the 'healthcare system' ?
Wonders will never cease.
Is the concept of PERSONAL RESPONSIBILITY finally emerging from that socialist swamp that passes for "The Economist's" thinking on healthcare ?
Choices --on food, drink, exercise ,work & retirement age, separate the Glaswegians in their longevity expectations.
Therein lies the achilles heel of all socialist healthcare systems , particularly your beloved NHS.
Why should the prudent , industrious , abstemious , & self-disciplined , subsidize the slothful, gorging , boozing slackers ?
Socialism's battle-cry is the juvenile "fairness". Well, where is the equity when some people smoke, eat & drink themselves into obesity, heart disease, diabetes, alcoholism & violence ? Why should others have to pay for these habits ?
@atashi"If a large number of Calton's deaths are due to driving under influence, suicide and firearms, the problem have nothing to do with health."I would say that suicide and firearms just reinforces how important is income disparity and low quality of life (measured not only by material means) in reducing life expectancy.
nickdziegler wrote:"It seems conceivable that, though income surely allows people better access to healthcare, there might be another correlation here: those who make more money tend to do much less physically demanding labor."Well, most of my ancestors are farmers, but there have been plenty of 90 some or 100 some in the family even back in the 19th century. So I wouldn't say hard work is bad for health."But why, asks the panel, do men born in Calton, a rough part of Glasgow, tend to die more than two decades sooner (see chart below) than men from the dormitory town of Lenzie a few miles away?"The question is what caused their death. If a large number of Calton's deaths are due to driving under influence, suicide and firearms, the problem have nothing to do with health. It's a problem of life style. Life expectancy is a tricky data, it's not how old you can expect you health get you to, but how old you can expect to die, regardless of your health. As such, a suicide trend among teenagers will drag the life expectancy of a community much harder than alcoholism or obesity among the 50 some. Unless the life expectancy's calculus include only those who die of sickness and old age, the data are barely related to health.