An unsustainable obsession

Aging is a problem for Americans, in two completely different ways. First, as in most industrialized nations, our age structure is getting top-heavy, and so fewer younger workers are available as time goes on to support more aging retirees. We’ve been hearing for years about all the problems our aging Baby Boomers are going to cause as they begin reaching retirement age in the next few years.

At the same time, our culture is obsessed with youth - Americans drop huge amounts of money on products that are designed to make us seem younger than we are, and on top of that, behavior resembling that of a normal 3-6 year-old seems to be more and more common in adults. And unlike in some of the few remaining cultures in which older people are respected and revered for their life experience and wisdom, we quickly cast our older family members aside and often ignore them; instead of valuing time spent with them because of what we might learn from them, we avoid spending that time because we see them mostly as a reminder of our own mortality.

The second problem may be hard to change, because it involves changing cultural norms, but the first problem is societal and absolutely must be addressed, because of the financial burden on society that will eventually result from not fixing it. We are already inching up retirement age for social security benefits, so it would be good if we could keep people healthy enough to work longer. Certainly, quality-of-life issues have become more and more important in medical research in recent years. But although we say that quality of life is now an important consideration in health care, our development of more and more treatments of disease designed to stave off death, is simultaneously and ironically reducing quality of life for many people through over treatment.

What receives the news and attention is not public health measures we already know we could do (with some money) to raise the quality of life for older people, but rather any research result that suggests that an anti-aging pill is right around the corner - our continuing obsession with a Fountain of Youth. Great for you (perhaps), bad for society. This New Yorker article from two years ago spells out just how important - and underserved - geriatrics care is becoming.

While there is money for aging research, which even has its own institute within the National Institutes of Health (funding groups such as this), there is a huge shortage of primary care physicians interested in specializing in geriatrics, which focuses on improving quality of life for people right now, and is of course is one of the fastest-growing needs in health care. One obvious way to address shortages in primary and geriatric care would be to provide incentives for doctors to go into these areas through loan forgiveness and/or subsidizing medical school. So far, though, this has yet to happen.

What funding there is for quality-of-life versus quantity-of-life research is not at the same scale; for example, an advertised grant for “Improving the Quality of Life for Persons Living in Nursing Homes” was for a paltry $10,000. (The situation may be improving in the changing political climate, though - NIH currently has a grant program for $500,000 for up to five years to address the issue of reducing healthcare costs while increasing quality of life.)

Technically, the imbalance in funding priorities shouldn’t be surprising. After all, who provides the funding for most research? Typically, of course, it is powerful older men who think they should be able to live forever. This attitude plays a big part in our current unsustainable trajectory in health care.

Ironically, if all the research into new drugs to extend lifespan comes to fruition, it will just create more top-heavy demographics and strain our resources further, contributing to the system’s unsustainability. For though the stated goal of the research is generally “to extend healthy and productive human lifespan,” in the end, what have previous extensions of lifespan really given us? On a large scale, just more new diseases to spend billions combating, and thus more healthcare costs to add to the pile. That’s why aging research and funding should mainly focus on better comfort for those of us lucky enough to reach an age at which we will suffer the typical ills naturally associated with aging, not simply on extending our lifespan.

Tags: health

This entry was posted on Thursday, July 9th, 2009 at 4:46 pm and is filed under health, humans, quality of life. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.