Friday, 21 December 2007

More life before death

reposted from:

Something wonderful is happening: people are living longer, healthier lives. So why don't we hear more about it?

December 9, 2007 12:00 PM

The past week has brought three pieces of outstanding good news. One received a short grunt of media acknowledgment, the others not even that. Yet they tell us more about human wellbeing than any number of health scares, gone-to-the-dogs jeremiads or nightmare scenarios.

The first piece of news is that we are, yet again, shown to be living longer than ever. What's more, the typical lifespan is not just up, according to the latest data from National Statistics this week, but rising at an accelerating rate: we are adding extra years, faster. Men have taken only about four years to put on their latest year of life expectancy. Astonishing.

Especially heartening for those zipping through middle age is where the gains come from. In earlier periods, it was improved infant mortality: as fewer babies died, the average lifespan increased. Now it derives as much from life extended at the end as sustained at the beginning. A 65-year-old man in 1981 could typically expect to live to 78. A 65-year-old man today will typically make it to 82.

Humbug, say those who feel that more years of life will be life endured, or, as Auberon Waugh almost put it: nothing is worth a couple of extra years in a nursing home in Weston-super-Mare.

But this brings us to the second hallelujah.

On average, the extra years are turning out, for women, to be healthy years, and about three-quarters of them for men. This lengthening of the so-called "healthy lifespan", measured either by the way people report their own health, or by subtracting the number of years of long-term disabling illness, challenges the presumption that longer life must mean decrepit life. We're getting wrinkly, not crumbly.


Source: National Statistics

That could imply more good news about the effect of an ageing population on health costs. Often described as a time bomb, it might be less explosive than suggested by the worst-case scenarios, which simply take the cost of healthcare in the few years before death and assume the line goes on flying upwards as the population wrinkles. The more accurate model might be that costs do go up, but that it is the proximity of death that sends them soaring, not the addition of what turn out to be healthy years before death.

The third piece of news is that, fast as life expectancy is rising for women, it is rising even faster for men. For so long the laggards, they are now closing rapidly. We don't know why, but we can speculate. For example, it may be that fewer men work in industries that, sooner or later, killed them. It could be that more women are in paid work, or enjoying lifestyles more like men's and so becoming more like men in this respect too. But the data suggest that men's progress is speeding up, rather than women's slowing down.

These gains are mightily impressive, and probably reliable. We can measure well enough the ages at which people die. The margin of uncertainty around the figures is tiny, the trends unmistakeable.

Of course, it's always possible there'll be bad news just around the corner, and the trends will reverse. Accelerating gains in lifespan can't go on forever - can they? - or one day the end will be receding faster than our approach. But just for now, we live, and live a bit more, in extraordinary times.

Despite the unrelenting coverage of everything that's wrong with our health service, the toxic soup people supposedly live in, the wretchedness of our diet or the stresses of modern living, something very good indeed is also happening, and on a huge scale; it's just that few talk about it.

We do not argue that all is right with the world, that no one experiences poor standards of welfare, or dies too young. On the contrary, we recognise huge demands for further progress. We know the gains are far from equally shared, and that a healthy old age might still mean a relatively impoverished one. We see that longer lives mean, other things being equal, more people.

But the numbers are a useful glimpse of the bigger picture. They are testament to how much people are continually achieving - and will go on to achieve - to improve wellbeing. Contrast that with how well they recognise this achievement, and one can't help but wonder at the lack of proportion. Longer life doesn't seem to make us grateful.

The authors will be speaking at Wanstead Library, Spratt Hall Road, London E11 2RQ on Thursday December 13 at 7pm. For details email