Wednesday, June 17, 2015

Humans Living Longer, (But) Many With Some Sort Of Disability

Human Health & Wellness

Living Longer in Poor Health:
Photo Credit: Arden/Flikr Commons. Colombia, 2015
Source: IHME; University of Washington

A post in Science Daily, citing an article published June 8th in the British medical journal The Lancet, looks at the effects of poor health, including disabilities and injuries, on a global scale; the comprehensive and broad-based study. which involved 188 nations and included 301 diseases and disabilities, was conducted by an international consortium of researchers working on the Global Burden of Disease project and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, in Seattle. (Funding was provided by the Bill and Melinda Gates Founation.)

Simply stated, people are on average living longer, statistically speaking, but many are living with a disability and are in poor health. The key metric in this study is the term, years lived with disability, or YLDs, which will become more prominent in mainstream health reporting. In “As death rates drop, nonfatal diseases and injuries take a bigger toll on health globally”; the post  says:
Using a measurement known as years lived with disability, or YLDs, researchers from around the world quantified the impact of health problems that impair mobility, hearing, or vision, or cause pain in some way but aren't fatal. In 2013, low back pain and major depressive disorder were among the 10 leading causes of YLDs in every country. Other leading causes globally included neck pain, anxiety disorders, migraine headaches, and diabetes. The leading causes of years lived with disability have remained largely the same during this period, but they are taking an increased toll on health due to population growth and aging.

YLDs per person increased in 139 of 188 countries between 1990 and 2013, meaning that more people are spending more time in poor health. Musculoskeletal disorders, combined with fractures and soft tissue injuries, accounted for one-fifth of YLDs globally in 2013, ranging from 11% in Mali to 30% in South Korea. Mental and substance abuse disorders also caused 20% of YLDs globally, ranging from 15% in Germany to 37% in Qatar.
The complete study, which is for the period between 1990 and 2013, is worth reading.  For example, the top two causes of YLDs on a global scale are low back pain and, major depression. This was true in every nation studied; also noteworthy is that YLDs increased between 1990 and 2013 in the majority of the nations studied. In short, people are living longer, but not necessarily in a healthy or disease-free condition; this means that health-care systems will generally face a population of older persons who will require greater attention. The lead authors, C.J.L. Murray and T, Vos, state rather unequivocally “The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa.”

This reminds me of a quip from the American actress, Mae West: If I had known I was going to live this long, I would have taken better care of myself.”

We now know that this is true, that prevention is half the battle, genetics the other half. Yet, society will have to soon find ways to solve an increasing problem of both the current cadre of older persons in poor health and the large cohort of boomers (including this writer) who will have to face old age with diminished capacity of some sort or another; a depressing thought, no doubt, but an expected reality. In many cases, this means more resources—in the way of health-care staff and beds in public institutions—will be found and allocated, either to help families (with older persons under their care at home) or to build more public institutions.

No doubt, these are good and necessary measures when considering how to cope with a large number of people who need constant or continuous round-the-clock care. Or as some would deem it: a form of mass surveillance of the aged and ill-bodied? Even so, I would hope that other solutions can be found in my lifetime; I for one do not desire to end my days in such “public warehouses for the old.” Depressing is too mild a word to describe these places.

I think that we can do better; I am ever hopeful that we can, depending on modern science to come up with something humane within the next 20 to 25 years.

For more, go to [ScienceDaily]; for the original publication, go to [TheLancet]

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