Sickness in Retirement
A remarkable four out of five people live with multiple chronic medical conditions by retirement age in the United States. And advances in life expectancy are dragging as a result. A new report based on information gathered from 1.4 million Medicare enrollees shows that increases in life expectancy among Americans are slowing compared to much of the rest of the developed world. In a nutshell: the more chronic conditions you have in retirement, the shorter your life expectancy.
"Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States," said Eva H. DuGoff, PhD, in a press release issued by the Johns Hopkins Bloomberg School of Public Health. "The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy." DuGoff was lead author of the recent study, published in Medical Care.
And it's not just the number of diseases and conditions that impact life expectancy. It's the type. People diagnosed with heart disease, for example, are expected to live longer than those diagnosed with Alzheimer's disease. The combination of diseases also makes medical care more challenging, as more systems become involved. "The balancing act needed to care for all of those conditions is complicated, more organ systems become involved as do more physicians prescribing more medications. Our system is not set up to care for people with so many different illnesses. Each one adds up and makes the burden of disease greater than the sum of its parts," said senior author Gerard F. Anderson, PhD, a professor at the Johns Hopkins Bloomberg School of Public Health.
In a related story, the University of Southern California reported a few years ago that the United States could save $632 billion on Medicare and Medicaid expenditures if we could get 50-year-old Americans to be as healthy as their European counterparts. In decades past, Americans could take comfort in the knowledge that their life expectancy slightly exceeded that of Europeans. But that long-term trend has now been reversed. We're getting sicker, earlier, and not living as long as Europeans.
The difference in diseases at age 50 appears to explain the growing gap between Americans' and Europeans' life expectancies. And most of that can be attributed not to differences in our medical care systems, but to differences in "health behaviors." Sadly, Americans' health behaviors are poorer than Europeans'.
Eva H. DuGoff, Vladimir Canudas-Romo, Christine Buttorff, Bruce Leff, Gerard F. Anderson. Multiple Chronic Conditions and Life Expectancy. Medical Care, 2014; 52 (8): 688 DOI: 10.1097/MLR.0000000000000166
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