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Adding Length to Your Life

October 30 2017 - by Dr. Derrick Aarons, Ethicist, Caribbean Public Health Agency

Would seven (7) years of additional life be valuable to you? If your current lifestyle would cause you to die at age 60 years, would you prefer living instead to age 67 years? Or if you are on target to live to age 70 years, would you prefer to be around until you are 77 years of age? What answers would your colleagues and staff provide to these questions?

Well, research has found that by not smoking, by limiting alcohol intake, and by maintaining a healthy weight, we can add several years to what is termed a disability-free life!   Research seeks to obtain new knowledge that is beneficial to society, and research in health has contributed vastly to our understanding about the functioning of our bodies, our food intake, and our interactions with our environment.

Well-designed Research

The value of well-designed research is that its outcome may assist in informing persons or groups of persons far beyond the community or country in which the research was done.This was demonstrated in a recent publication by researchers from the Department of Health Management and Policy at the University of Michigan in Ann Arbor in the USA and the Max Planck Institute for Demographic Research in Rostock, Germany, who analyzed data from 1998 to 2012 regarding 15,000 Americans aged 50-89 years from the National Health and Retirement Study.

They studied the healthier cohort (group) who had never smoked cigarettes, were not obese (they had a body mass index [BMI] of between 18.5 and 29.9), and drank alcohol in moderation (which was fewer than fourteen (14) drinks per week for men and seven (7) for women).  When compared with the entire population in the US, these persons had a life expectancy at age 50 years that was seven (7) years longer, with the onset of any disability delayed by up to six (6) years.

 Improved Life Expectancy

Currently life expectancy in the USA is 78 years for men and 82 years for women, but for the low-risk group in this study, life expectancies were 85 and 89 years, respectively.  The researchers emphasized that their findings showed the magnitude of health gains that could be achieved if more persons adopted low-risk behaviours. 

Previous research had focussed on the effects of a single behaviour, such as smoking or drinking too much alcohol.   The researchers informed that studying the effects of multiple health behaviours being exhibited by persons simultaneously provided new insights into the levels of health that are achievable without the use of any of the new life-extending medical technologies.

Interestingly, the researchers also found a striking difference between the best and the worst health profiles among the population studied. They found that 50-year old women who had good behaviour on all three key factors lived twelve (12) years longer than women of the same age who had smoked, were obese, and drank more than moderately. 

Behavioural Risk Factors

For men, the life expectancy gap between the worst and best-behaving was just a little over eleven (11) years.  Each of the three (3) behavioural risk factors were independently associated with some early disability, with obesity being the biggest driving factor. On average, obese men became disabled at age 64.9 years, and obese women at 63.0 years, which was three (3) and six (6) years earlier respectively when compared with their non-obese counterparts.

Persons who exhibited all three (3) good behaviours had the longest delay of disability, with men in that group having the first sign of disability at age 72.1 years and women at 75.2 years.  Not surprisingly, however, those who consistently lived the healthy lifestyle that was described in the research study were found to be in the great minority of persons.

Majority with Unhealthy Behaviours

The study found that by age 50 – 59 years, nearly 80% of adults in the USA had either smoked, been obese, or both.  Further, although less people are now smoking when compared with the past, obesity is steadily increasing, and so the researchers were concerned that obesity may be off-setting the gains to be made by not smoking. 

The researchers further found that people who quit smoking at least ten (10) years before entering the research study experienced an exceptionally long disability-free life if they were also at low risk with regard to the other behavioural factors.  This result is consistent with previous research findings that quitting smoking and making favourable changes, even if these occurred later in life, help to increase longevity. 

Consequently, we should strongly advise our staff and all persons within our spheres of influence to discontinue any unhealthy behaviours they currently have, and adopt the healthier lifestyle that has been prescribed for us all.

 

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the Ethicist at the Caribbean Public Health Agency – CARPHA.  (The views expressed here are not written on behalf of CARPHA)

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