Sunday 23 October 2016

Ignore the gloomy hand-wringers, we are actually getting healthier

Endless negative talk about health issues obscures the fact that people are living longer lives

Published 22/05/2016 | 02:30

Drinking: We are already close to the top of the European league table of drinkers, and reports of people having liver failure at younger ages are common
Drinking: We are already close to the top of the European league table of drinkers, and reports of people having liver failure at younger ages are common
Waist: We are on course to become a nation of fatties Photo: Fiona Hanson/PA Wire

The health service is in crisis. Obesity rates are soaring and Ireland is on course to be one of the world's fattest nations in the next decade. We are already close to the top of the European league table of drinkers, and reports of people having liver failure at ever younger ages are common. Suicide is at epidemic proportions.

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Last week, a major new report on excessive use of antibiotics warned of the rise of untreatable superbugs. Last Friday, as changes to EU plain packaging laws for cigarettes came into effect, the European Commission pointed out that smoking last year killed 700,000 Europeans prematurely. Outlawed drugs continue to take their toll.

With so much grim news going around about health, one might think that everything is going to the bad. But that would be very wrong. For all the negative factors affecting our health, the positive ones are outweighing them as we get healthier year in, year out. There is every reason to believe that this happy trend will continue.

The single best measure of health is how long we live. Last week the World Health Organisation published its big annual compendium of data on the well-being of the planet's peoples (it says something about the media's preference for negative health stories in that it got almost no coverage).

There's a lot of good news in it. The best news from an Irish perspective is that we are living longer and the lengthening of lifespans continues apace. In 2015, life expectancy at birth was just over 81 years. For those who think everything has gone to the dogs since the economy has crashed, that represents an increase of 1.5 years since 2008. It amounts to a full decade of extra life since 1975.

The news on improved health has been particularly good for men. That women have always and everywhere outlived men remains one of the great mysteries, but that the gap is narrowing in Ireland (and many other places) is beyond dispute. According to the WHO estimates, women's lives are now only 5pc longer than men's, down from almost twice that as little as two decades ago.

This is happening because many of the negatives mentioned above are either exaggerated or plain wrong. It is also happening because many factors, which are much less talked about, are making us healthier all the time.

Let's start with the positives. Medical care and outcomes are improving all the time, whatever problems may exist in the health service. Incidentally, the hyping of problems and downplaying of successes is not just because the media prefers bad news, but also because those involved in healthcare can make a better case for more resources if politicians are scared of accusations that they are not doing enough or, worse still, that they are callously uncaring towards those who are ill.

There are many reasons for better medical outcomes.

A lot of that has to do with advances in technology. Better treatments in general, and treatments for ailments that previously could not be treated, have resulted in fewer early deaths. New and better medicines and improvements in how procedures are carried out are both contributing.

The result has been a decline in deaths from health conditions that were once fatal. Cancer survival rates for many types of that awful illness have improved, and in leaps and bounds in some cases. The improved quality of care is also to be seen in sharply falling death rates among 70somethings, a huge factor in allowing more people to live into their 80s and in the overall increase in longevity.

Another factor making us healthier is nutrition. For all the talk about an obesity epidemic and the many bad things we're munching on, most people are better nourished than ever. And for everyone who lives off junk food and fizzy drinks, there are more who pay almost obsessive attention to what they eat, reducing salt, sugar, fats and excessive calories.

This is reflected in available figures over the past two decades or so.

National consumption of things that can be harmful in excess, such as butter and salt, is down, while intake of fruit and vitamins is up.

Whatever negative bias there is about eating habits in the national conversation, there is a lot more about drinking and smoking. Again, and despite a lot of guff, the trends in both cases point towards better health.

Take tobacco first.

There is no doubt that a great many people die prematurely because of their nicotine habit, as mentioned earlier. But here again there is a lot more good news than bad news.

The proportion of the adult population that smokes has fallen from almost three in 10 in 2003 to under two in 10 in 2014, according to HSE data. And the trends are sharply downwards as prices rise and the habit becomes less socially acceptable, even if that is to the chagrin of a certain junior health minister. Another big gain has been the near elimination of passive smoking thanks to the ban on puffing in public places.

The decline in smoking has, to some extent, turned the attention of life's hand-wringers ever more to alcohol. There is never any shortage of comment about how we Irish need to change our drinking culture. There is far less comment about the fact that alcohol consumption per person has been declining for well over a decade, and, it's worth pointing out, that fact hardly got a mention as minimum pricing laws went through the Oireachtas, despite the pretence towards using evidence as input into the law-making.

Evidence has been even more absent in another cause of premature death - the tragedy of suicide. It has been said far too frequently that it is at "epidemic" proportions.

Thankfully, this is wrong. Ireland's suicide rate stood at 14 deaths per 100,000 people in 1998 before falling by 25pc over the next decade. It did tick back up a little after the onset of recession, but it remains well below previous peaks and is lower than the European average.

More progress has been made in another cause of tragic loss of life - car crashes. Ireland has in fact been particularly successful in curbing road deaths, with the number of fatalities falling faster than in most other countries and deaths per 1,000 people are now among the lowest in the developed world.

All these developments taken together show that we are living longer, healthier lives. And if this is not enough good news, there is even more to come.

All serious analysts of longevity - from actuaries to scientists - believe that the long upward trend in lifespans will continue for as far into the future as they can predict.

That we can expect to enjoy more of life is surely cause for cheer on a Sunday morning.

Sunday Independent

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