“My worst disappointment on the health front has been not seeing anything new happening in public health and not seeing a better outcome. There is great risk-taking, big ideas and a lot of good ideas. However, our results are far from encouraging for policymakers and the general public, as we have seen so many major developments recently that have not yielded significant medical benefits, have sometimes raised a red flag, and have all but been abandoned by some.” Frieden continues, addressing the issue of whether or not our efforts have been enough, saying: “A primary reason that we have not seen enough improvement in global mortality rates over the past few decades is the fact that there are not enough health system systems, institutions, and countries for everyone who is dying. We certainly think that improved access to healthcare for all people is imperative, but even more important is improving access to life-saving drugs and interventions … We have made some significant progress, but we also find that many people will be dying who would have died even years ago as a result of lack of access to healthcare.” We have known that it was not the lack of healthcare which was to blame, but the availability of better and cheaper treatments . The authors of the report, “Public Health at an Unmeasured Crossroads: The Surprising Rise and Fall of Life Expectancy in the United States,” examined several variables including poverty, population density, income, and education. All five variables were shown to strongly correlate with a shorter life expectancy . In the final phase of the research, the authors found that poor people were four times more likely to die early. In addition, the majority of deaths were “early mortality.” What is early mortality?
Precursors of early death in the U.S. were explained by several of the underlying factors. Poverty: “The United States is a rich country, yet as people move up the income scale, mortality due to premature death rises. This is true in the U.S. for both children and adults. In the high-income United States, as the income of the poor goes up, the risk of early death from premature death also rises. In addition, the risk of early death due to premature birth or complications relating to pregnancy and childbirth also is high” . This was clearly noted in the introduction of the report by the researchers, “It is no secret that America’s poor and middle-income earners live in a society that is quite unequal, with a growing concentration of wealth and poverty at the bottom of society and a widening in-between: a middle income gap. In our current globalized economy, those at the top of the income ladder today are doing much better than the poor or the middle class even 10 years ago. The rich and wealthy nations are diverging from the United States in some key respects: poverty, the number of births per woman and the proportion of pregnancies that result in induced births are falling, while life expectancy is rising. Some regions or countries, however, are failing to catch up to these changes.”
This is no surprise, as poverty has increased worldwide and has increased for the last few decades, but the correlation between poverty and early death in the U.S. has been even sharper. As it has become harder to find high-paying jobs, more of our workforce is entering poverty, poverty is more often associated with low income and education, and high levels of education do not protect a life from such death. Poverty is a symptom of much deeper problems. Death is the result of a large array of exceptions or complications and events, including but especially including the following:
Poor nutrition, which is linked directly (though often in isolation) to the poor diet and poor health. This link is true for those in both rich and poor countries. It’s probably most well known here in the U.S., but in rich countries, particularly in Europe, we’ve known about this link for decades in many cases.
Low blood pressure . Low blood pressure can often be treated effectively, though this does not protect against premature death in many people.
A “healthy” life span, which a good diet, low or no stress (i.e., stress is often associated with higher mortality), and high levels of physical activity lead to, is associated with a healthy life span. Although the relationship is generally thought to be causal, this could be due to confounding factors such as a certain diet, stress, and lifestyle not taking place during early life, especially among children and low income (as low educational attainment often leads to low levels of physical activity, which is linked to a healthy life span).
Poor diet? Poor diet has been linked to numerouspreventableconditions, including obesity, diabetes, depression, cancer, and Alzheimer’s disease This has been strongly shown in a recent study and more studies are needed to understand the link between poor diet and poorer health, but is also likely linked to an increased risk of certain chronic conditions