Recent Newspaper & Online Columns by Kate Scannell MD

We are getting older

November 16, 2014

Tags: aging, increasing lifespan, National Center for Health Statistics, Groucho Marx, Oscar Wilde, getting older

Kate Scannell, MD, Syndicated columnist
First published in print: 11/16/2014

In my medical practice, patients often asked what they could do in hopes of attaining long lives. But the funny thing was, no one wanted to accomplish that if it required actual aging -- which it most certainly did. Like Oscar Wilde's fictional character Dorian Gray, they hoped to pass through time without time passing through them, affecting their bodies and health, stealing their youth.

But, looking at the proverbial big picture, it's quite evident that "getting older" is what we are, indeed, doing. New research released last month by the National Center for Health Statistics confirms that the average life expectancy -- the expected average number of years of life remaining -- continues to lengthen for people in the U.S. For example, after examining 2012 mortality data, researchers found that our average life expectancy at birth now reaches 78.8 years. And life expectancy for the average 65-year-old American has risen to 19.3 years.

That is good news for the "average" American -- whoever he or she might be. However, for the rest of us, the devils reside in the details.

For one thing, sex really matters. By that I mean, "on average," women can expect to live a few years longer than men do. That's true at the starting line -- birth -- where U.S. life expectancy for females now extends to 81.2 years, compared with 76.4 years for males. And that's also true at the age of 65, where average future life expectancy now reaches 20.5 years for women, versus 17.9 for men.

There are many bad jokes but little good scientific data to explain to men's shorter life spans. Differences in genetic makeup, lifestyle habits, divine programming, health status, access to medical care, money and socioeconomic factors -- they've all been considered in generating various theories. Still, the mystery remains age-old.

The researchers also confirmed that longevity within the U.S. continues to correlate with racial categories, raising ethical questions about health disparities and health care justice. For example, within each category based upon sex, age-adjusted death rates remained disproportionately higher for blacks compared to whites, and for whites compared with Hispanics. The good news is that positive trends have been spotted that allow us to hope for continued future diminishment of those differences.

In our quest to equalize and increase the quantity of life available to everyone, it's always interesting to examine the leading causes of death. Knowing which conditions or diseases associate with the highest mortality rates allows us to target life-extending interventions and research in a more rational manner.

In 2012, 10 leading causes of death fully accounted for nearly 74 percent of all deaths within the U.S. Heart disease led the pack, followed rather closely by cancer. The remaining eight causes included, in order: chronic lower respiratory disease, stroke, unintentional injuries, Alzheimer's disease, diabetes, influenza and pneumonia, kidney disease and, lastly, suicide.

It's concerning that, among these 10 leading causes of death, only one -- suicide -- showed an increased age-adjusted mortality rate compared to the prior year. Data from other studies have documented that about 37,000 people within the U.S. now die by suicide each year, and 650,000 others receive emergency treatment after attempting suicide. The observed rise in U.S. suicide rates has been attributed to various phenomena including our recent economic downturn, but no one can convincingly explain the reasons behind it.

Ostensibly, most people hoping for a long life envision living that life free of disability, dependence and chronic disease. And on that front, there is much they can do by practicing healthy lifestyles to reduce or forestall some age-related physical decline -- which tends to happen to the best of us.

In the end, for my patients who have wanted to live longer lives, the good news is that the chances for doing so seem to be improving -- at least, on average. But to reach a ripe old age, they will still have to ... well, age. And, hopefully, age well.

Of course, they could also strive to alter their subjective sense of time to make it seem that life is longer. After all, we grow older surrounded by clocks and calendars that can too rigidly shape our experience, distancing us from time's fluid, nonlinear realms. As Aristotle noted, "The ultimate value of life depends upon awareness and the power of contemplation, rather than upon mere survival." Perhaps, then, we can create the experience of a longer life by choosing to live more contemplatively in valuing slower time, closer to an ageless dimension of being that is fully present in the eternity of each moment.

Comedian Groucho Marx clearly appreciated this subjective realm of time, even suggesting a dietary approach to facilitate one's philosophical grasp of it. As he illustratively remarked, "Last night I had a typical cholesterol-free dinner: baked squash, skimmed milk and gelatin. I'm sure this will not make me live any longer, but I know it's going to seem longer."
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Kate Scannell is a Bay Area physician and the author, most recently, of the novel "Flood Stage."
Copyright 2014, Kate Scannell

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