Cleaveland: Inequality in length, quality of life

photo Dr. Clif Cleaveland

Place of residence and race play significant roles in both life expectancy and quality of life for senior Americans. For the nation, life expectancy rose 1.4 years during the decade from 1997 to 2007. The average life-expectancy for women rose to 80.4 years and to 75.3 years for men. For blacks, life expectancy lagged by five years for men and three years for women.

On July 19, the Centers for Disease Control and Prevention released a study comparing healthy life expectancy (HLE) at age 65 for residents of each state. HLE is based upon the quality of health during the estimated number of remaining years of life from age 65 onward and depends upon such factors as presence of chronic illnesses or disabilities.

The CDC report compares life expetancy and healthy life expectancy by sex and by race for the 50 states. Excluding Florida, residents of West Virginia and Southeastern states, including Tennessee, had shorter life-spans with fewer years of HLE than residents of other states.

Tennesseans can anticipate an average of 18 years of life expectancy and 11.9 years of HLE at age 65. For the same age group, Alabama residents have a life expectancy of 17.6 years and HLE of 11.1. Georgia residents have a life expectancy of 18.2 years and HLE of 12.4.

Seven states, including New York, California, Florida, and Minnesota have life expectancy's that exceed 20 years and HLEs of 14.6 to 15.4 years.

States with the lowest life expectancy and HLE have the highest rates of both childhood and adult obesity. More than 30 percent of adults in Tennessee and Alabama are overweight or obese. In Tennessee, Georgia, Alabama, Mississippi, Arkansas, Kentucky and West Virginia, at least 35 percent of children are overweight or obese, according to the National Conference of State Legislatures.

Predictably, states with the highest rates of excess weight have the highest rates of weight-associated diseases, including adult-onset diabetes and high blood pressure, which are prominent precursors of atherosclerotic heart disease and stroke.

These numbers can be approached with indifference - "that's just the way it is" - or cynicism - "you can't change human nature." These attitudes condemn thousands of residents of Tennessee and neighboring states to shorter lives in which too many years are spent in needlessly declining health.

What if our elected officials from state to local government adopted an aggressive, coordinated program to make our state progressively healthier? Premature deaths would be reduced. A greater portion of retired years would be spent in good health. Expenditures for chronic illnesses among seniors would be dramatically reduced.

Here are several suggestions for governmental action:

• Schools. Habits for good health are set in our early years. A curriculum that emphasizes healthy eating and regular physical activity from first grade forward is essential. Lunch rooms must adhere to healthy menu options. Physical education should be a mandatory component of curricula. Regularly scheduled screenings for obesity, elevated blood sugar and other risk factors should be undertaken with results forwarded to parents and guardians along with recommended action.

• Public education. Grocery stores, convenience stores and fast-food restaurants can be enlisted to provide healthier food selections along with guidelines for proper nutrition. Network and cable television channels can promote healthy diet and practices in public service announcements that run regularly during intervals of high viewership.

• Access to health care. Uninsured people do not have access to screenings, preventive care or counseling in avoiding harmful practices. These services can be provided either by expansion of Medicaid or by funding a network of public clinics, including mobile facilities, for poor people.

• Legislation. Sadly, trans fatty acids, clearly linked to atherosclerosis, can still be found in some baked products and in deep-fried items on fast-food menus. Safe alternatives are readily available. New York City has banned trans fatty acids; other jurisdictions should follow.

The CDC report highlights a significant problem for the health of Tennesseans. Tens of thousands of years of healthy life expectancy are at stake. How will our elected leaders respond? Indifference should not be an option.

Contact Clif Cleaveland at cleaveland1000@com