Prevention Matters

In a recent blog post, noted economics journalist Merrill Goozner says one reason the America lags behind other countries in terms of life expectancy because it seeks to increase longevity primarily through investing in technology to extend life rather than investing to prevent premature deaths.


"Why has our technological faith failed us?" asks Goozner, a former Chicago Tribune journalist and author of The $800 Million Pill: The Truth Behind the Cost of New Drugs. "The answer is simple. Increased longevity has nothing to do with extending the natural human lifespan. Societies increase longevity by eliminating premature mortality. Technology is one means to that end, but it is probably the least efficient  method. It’s definitely the most expensive."

Goozner says dramatic increases in longevity in the early 20th century resulted mostly from better sanitation that reduced infectious disease deaths, while gains after World War II came from better housing, better heating, less burdensome work, and more leisure. In more recent years, he says, cleaner air, less smoking, and better diets have played a bigger role than medical interventions in extending life.

While medical technology saves lives and "even performs miracles in some cases," Goozner says, "...the truth is that investment in technology will never bring the U.S. up to the longevity standards of other advanced industrial countries. Why? Because our misplaced faith has distracted us from tackling the real and enduring determinants of ill-health in our society– poverty, income inequality, social insecurity, and status anxiety, the hallmarks of our increasingly dysfunctional social order. There’s a vast literature on the social determinants of health. Alas, it has gone unnoticed and unremarked in the current health care reform debate."