Linda P. Fried
(Columbia University Mailman School of Public Health)
Linda Fried, dean of the Mailman School of Public Health at Columbia University, discusses her work and research into the intersection of aging and public health.
I am glad I was not the only listener surprised by the fact that neither Dr. Fried nor Brian noted that infant mortality skews the statistics on longevity enormously. In Psalm 90, which is, of course, Hebrew Bible old (c. 500bce, I believe), the psalmist speaks of our allotted "three score and ten." Now we get, as an allotment, about four score, I'd say.
But more fundamentally, I think there is a real question about whether there is value in living longer, even healthily. Epicurus--who, if you really read what exists of his work, had to be among the most brilliant philosophers of the ancient era--said that we should not fear death, for more life is not better than less life. What matter is quality of life. Pure joy in one moment, he argued, was no better than pure joy in ten moments. Joy is not additive that way.
It's a difficult argument. But imagine yourself dying at 40, and then at 70. Imagine that no one was sad either way--that they celebrated the life you had and were pleased for you to be going to rest. If your life had the same level of happiness through 40 as through 70, would it be more of a tragedy to die at 40? Yes, you missed some experiences, but if you were the same "level" of happy (imagine that idea means something for a moment), is it really a greater tragedy to go at 40? Isn't the quality of life, not the quantity, what matters?
I don't expect many people to agree with Epicurus. But a few of you might. At least, think about it.
@JonPope: I work in health care. The health insurance industry wanted to make "unhealthy" people pay more but its easier said than done. First, cholesterol, diabetes and high blood pressure are a problem for people of all sizes. Also, the main driver of cost increases to healthcare is catastrophic care, not obesity. Again, catastrophic care affects people of all sizes.
And quite honestly, the health insurance industry is afraid that if "unhealthy" people are forced to pay more they'll drop out of health insurance. "Unhealthy" people make up about 50% of the nation's population. This would be a death knell for the insurance companies because they would not longer be able to make any money from these people. Believe it or not, but "unhealthy" people keep the health care industry afloat.
A Republican representative recently made a comment about a person continuing to receieve medical care with a large inoperative brain tumor. As Sarah Palin would say - "Death Panels", this time proposed by a Republican. Who should make these choices? For Medicare, what percent of individual's care expense is incurred in the last year of life? Maybe we need to be more realistic about end of life care. Where is Jack Kervorkian? My father-in-law put off needed heart surgery for 3 years, partly out of fear. When he did have it, they found more damage than expected. He was in a come for 3 months in a specialized heart hospital. He did regain consciousness for about 3 weeks, then died, not peacefully. Cost: $1.2 million, most covered by Medicare. My father spent 9 years in a nursing home, largely covered by Medicaid. My family knows I do not want that. If I am terminal, withhold feeding and all except pain medication
I highly recommend Tai Chi for all ages and ability levels. It is particularly beneficial for seniors with limited physical activity and for those with depression, anxiety or PTSD. It has been proven to help improve breathing, balance, coordination, posture, flexibility, better focus, sleep, relaxation, boost immune system, strengthen joints, ligaments, spine, muscles, lower blood pressure, etc. (the list is too long). Practicing Tai Chi regularly has also shown to reverse the effects of age related Alzheimer, Arthritis and Parkinson’s disease.I am 50 years old and started practicing Tai Chi to cope with my own challenges with PTSD and Lymes disease. Tai Chi works great. I feel better, stronger, happier and calmer than ever before. For more information, please feel free to call/e-mail me: (609) 890-0812, email@example.com , or visit: www.TaiChiFusion.com
If you say you are unafraid of aging, you are just fooling yourself however, we stand a better chance of aging gracefully if you exercise, get regular check ups and eat right, but you will age nonetheless.
If I'm a bad driver because I get a lot of tickets and cause a lot of accidents, I'm going to pay a lot more for car insurance. This creates an economic incentive for me to drive safely.
It should be the same with health insurance. If I'm overweight or unhealthy for reasons that I HAVE TOTAL CONTROL OVER, I should have to pay a lot more for health insurance (rates are effected by age in most policies, not health). this would create an economic incentive for me to try and stay healthy. Plus it would make me pay my fair share of medical expenses I'd incur as unhealthy person vs a healthy person who will likely use the health system less frequently....
jgarbuz -- I'm totally with you on videogames!! I swear between the Martial Arts and the videogames that I share with my son, I am reliving my second childhood and quite happy. I think every elder care center should have video games.
Anybody want to bring up the fact that the obesity epidemic started in this country around 40 years ago when High Fructose Corn Syrup replaced regular sugar in most processed foods? I knew very few overweight children and adults when I grew up in the 1950s and 1960s.
Your guest epitomizes the "over educated" in need of work -using their "knowledge" to try to impose their will on us-as their career.So many of these types are women I noticied[though many men have taken on this role of busy bodies too]. I got the sense that- like the caller pushing suicide-she really had a problem with people living longer.[how dare you take up space-keep busy ,keep busy to justify your existence!]
give me a break! such hypocrisy!
how can anyone support a ban on sugary drinks when two of the most destructive and addictive drugs, alcohol and tobacco, are widely available and perfectly acceptable in our society?
Glad she's mentioning physical activity. I started Martial Arts at age 51. Before I started Martial Arts, I had started to slump, had hip pain because I carry a heavy bag for work, and suffered from sinus (or maybe migraine) headaches. I also had mild arthritis.
Lo and behold -- after the first few weeks of horrendous muscle soreness to the point that I could barely walk down steps, I've never felt better in my life. All those symptoms are gone.
I'm turning 55 this year -- half way to 110 and feel great. Now my next project is to lost the 10 pounds I gained after turning 50. The Martial Arts didn't help me lose weight. My run around the Central Park Reservoir seems to be providing short term results -- 3.5 pounds in 2 weeks. I've found I end up eating much healthier since starting this heavy duty exercise in Martial Arts. I am bound and determined to not end up a frail little old lady. I want to be able to fend off any pick pockets or muggers who think because I'm short and have white hair that I'll be an easy target!
Even if something happens to me whereby I can't be physically active, I figure that if I have at least one body part that moves enough to link into a computer, I'll still be happy. I just recommended to someone with an older parent who is bored in the hospital that they buy her an iPad and load it up with fun games.
There is always confusion about whether people have always lived longer, but now more of them are living longer because fewer are dying in infancy, or if the actual age has increased due to better health/environment. I believe it is both.
The vast improvements in heart disease treatment in the last 50 years have nothing to do with living past infancy. My 72-year old grandmother had a bad heart due to rheumatic fever. She died in 1961. At the time, she told my father that she would have loved to have had surgery—but there was none available then. Ten years ago, my dentist (who was in his mid-50s at the time) had a valve replacement because he too had rheumatic fever as a child. He's still in great shape ten years later, and he won't need to have the valve replace for another ten years.
My father had triple bypass surgery over a decade ago. He just turned 87. He wouldn't have lived that long without that surgery.
@james from nyc: The soda industry hasn't lost a dime because they sell bottled water!!
If these health "experts" are so concerned with sugary sodas, why don't they rail against the food industry for putting so much sugar in food?? Don't these people understand how many sugary additives are being put in the food?
By the way Brian, you should have the right to choose if you want a 32oz soda. If you believe that choice isn't healthy for you, then don't buy it. But then again, the proposed ban is silly because you will still be able to buy the sodas everywhere else except restaurants.
Why not implement the 5 or 10 cent tax that Governor Patterson was proposing for all drinks high in sugar - especially corn syrup - His proposal would discourage consumption of these drinks and would use the additional monies to fund public health which would have helped to improve health across the state. But for some reason the establishment in the state did not take it seriously and allowed the beverage industry to kill it.
The former New York State Health Commissioner Dr Richard Daines attempted to get a tax on sugary drinks and then the soda companies campaigned on television to combat the idea. Maybe Brian should interview the current NY State Health Commissioner.
I have been surprised at the unaware attitudes regarding elders. In my mother's last years she suffered from dementia and illness and was in a nursing home. She also woke up in the mornings happy. Happy to see the Christmas lights we'd strung up for her, happy to see the people who came in to see her. She fought off infections that no one thought she would survive. The will to live was strong but the" worthwhile-ness" of living had to do with her connection to people. When my sister and I were with her she thrived and the nursing staff was terrific: loving and kind and attentive. Any life feeling "worth it" depends on the same things- connection to people and interest in the world around. What level of interest may differ. I can begin to hear a rational for disposing of elders as being too expensive for the rest of us. I find these arguments offensive in the extreme.There are resources just spent on so many inhuman activities.I feel these questions about what kind of life is worth it - border on too many historical times when someone was deciding these things out of their own struggles with what made a life important.
Why can't we in the spirit of a true free market solution, set the insurance lobby against the food producers?
Freed just lost all credibility when she repeated the nonsense that Cuba has a better infant mortality rate than the U.S. Do you know why Cuba has a better infant mortality rate than the U.S.? Because when a woman becomes pregnant in Cuba she is required to undergo a screening to check on the health of the fetus. If there is any medical problem with the fetus—especially one which the awful health care system in Cuba can't handle—she is required to abort the fetus. In other words, Cuba practices its own form of eugenics. I learned this from my doctor whose doctor friend spent six months doing a medical tour there. And, by the way, my doctor's doctor friend is pro-choice (as is my doctor and I). She got so sickened by this Cuban abortion regiment that she left before her time was up. (My doctor mentioned to me one health problem as an example that the Cubans have no treatment for that is very treatable in the United States.)
Also, another reason why the U.S. has a higher infant mortality rate than many other countries is that the U.S. includes in its statistics a much longer time period for infant death than other countries. (I believe it's either six months or one year.) For instance, many countries will not count as an infant "death" any infant that dies one week after birth—so of course that is going to make a country's infant mortality rate much lower than the United States' rate.
The soda industry will loose a lot of money if we cut soda consumption
Among 52K+ decedents in NYC in 2010, 58% not born in US or territories.The same % foreign born among decedents 85yrs and over. (NYC DOHMH Vital Statistics Summary.)
It is far-fetched to ascribe anything re increased life expectancy to 8 years of Bloomberg!
My husband is 62 and lifts weights. He also works in construction. Boy, would I like him to be at my door if a mugger showed up. Don't generalize; not all older people are decrepit.
It seems silly that so many people can't figure out the eating healthy and exercising will help them live more likely to live free of disease and pain in older life. It seems like a planet of idiots.
I am afraid of age discrimination, not aging. I am over 55 by several years. I run, do yoga, eat health (not counting the croissant) and am in good shape. I also have a mortgage and college tuition to pay.
If I lose my job, despite my very good education and years of experience, I will be "unemployable." This is terrifying and, believe me, I'd get sick pretty darned fast if I had no money to pay my bills.
My parents worked into their eighties, and I want to do so as well. I'd feel a lot less scared about getting older if I had job security.
I want to live for only as long as I am healthy enough to be able to play video games. Some old people live to play golf, or to garden, or to pet their pets or grandchildren, read books, or watch movies. For me, it's to play good video games. Once I can no longer do that,life will have lost all meaning for me and death becomes preferable.
Reducing infant mortality is the same thing as extending our life expectancy. We have NOT "added 30 years to our lives".
I'm game for people living as long as they can or want to but, with birthrates as they are, at some point we need to consider where and how all these people are going to live on this planet.
Again ?? Is she for real.The next time she needs a policemanLets send the 65 year old police man to her door ...lol
Can Dr. Fried comment on the purported decreased life expectancy of the current generation in relation to the boomer generation.
Is this just a plateau given the limits on improving antibiotics, water quality in relation to increased stress, poorer industrial diet, etc.
Hoe much does Bloomberg donate to her school?
Infant mortality statistics are not created equal. In some countries deaths are not counted for various reasons. Do you trust the numbers from Cuba? Naivety anyone?
I was ALL the way with your guest but she just lost me by making this claim that Bloomberg has added 3 (THREE) (III) years to the life expectancy of New Yorkers. That is far fetched.
I do agree that he has made a strong effort to address major public health issues such as smoking. But I disagree with that figure. Did it come out from the mayor's public relations office? I also feel that Bloomberg has undermined the environment by underfunding public transit and by increasing the number of taxis on the road plus not pushing for solar and wind energy in the city
The life expectancy of New Yorkers has increased because the murder rate decreased exponentially, the quality of life increased in many neighborhoods and the city's population is much wealthier.
Isn't it more likely that the increase in life expectancy is due to poor New Yorkers being forced out of the city due to rising rents?
I've read that the increase in life expectancy is mainly due to reduction of infant death, but that the average life expectancy of people who have lived past the age of 10 has NOT increased very much.
Of course including infant death drastically reduces the average, but isn't that misleading?
Well, the main reasons for the increase were due to increasing hygiene, such as washing with soap, the move from hard subsistence-farming work to easier manufacturing and then post-industrial work.
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