Paging Dr. Frischer - Life Expectancy

How long can we expect to live? That depends on where and when in history we reside, what genes we've been given, our lifestyle choices, and a good dose of luck.The average life expectancy for everyone in the world today is approximately 67 years. (Note that there are numerous sets of data, years of collection, and sources of information on this topic. For the purposes of this article, I have selected data from reasonable sources.) Where in the world do people live the longest? The winning country is Monaco, where the overall life expectancy is a whopping 90 years of age. For men it averages 86, and for women 94. Why citizens of Monaco live so long is a complex question, as there are so many variables. Most countries with very high life expectancies are small, and indeed Monaco has only 35,000 full-time inhabitants. It is a beautiful port on the Mediterranean Sea, a monarchy, and has a non-intrusive government. Average yearly income is $215,000, and there are no income taxes! Residents follow a typical Mediterranean diet, and most have their own chef and servants. The city is maintained like a fine garden. Flowers are manicured daily by a staff of gardeners, the streets are swept daily, and though I have not yet visited Monaco, I can't help but picture Main Street in Disneyland. Where is the life expectancy lowest in the world? This statistic is in a state of flux, due to changing patterns of disease, civil war, etc. he two countries at the bottom are both in Africa: Swaziland and Angola. Men have a life expectancy of somewhere between 37 to 39 years, and women somewhat above that at 39 to 41. So, life expectancy in these countries is less than half of that of Monaco - why this huge discrepancy? These areas of Africa live in chronic poverty and food shortages are widespread. Infant mortality rates are extremely high. The tiny country of Swaziland is being devastated by the HIV/AIDS epidemic, with the infection rate the highest in the world, at 26% of all adults and over 50% of adults in their 20's. AIDS deaths among infants and young children have also risen, mainly as a result of the transmission from mother to child. Angolans also deal with HIV/AIDS, as well as epidemics of cholera, malaria, rabies, tuberculosis, dengue, African hemorrhagic fever, and various infectious parasitic diseases. In addition, Angola's 27-year civil war ravaged the country, leaving it with few resources to manage and treat victims of these deadly diseases. When we contrast Monaco to these parts of Africa, it is not difficult to understand the difference in hardships faced by their citizens and how they would impact life expectancy. So, where do we stand here in the USA? Much like Monaco and Africa, life spans here mirror the income gap. Overall we stand at about number 36 among the 194 (the exact number is debatable) countries in life expectancy, at 79 years overall. There is a wide range depending on the state in which we live: Hawaii has the highest life expectancy at 81, and Mississippi has the lowest at 75. Life expectancy for the nation as a whole has been increasing, and life expectancy for the affluent has experienced even greater gains. Wealth has a direct connection to infant mortality rates, death from heart disease, and some cancers. Important factors that affect life expectancy also include level of education, access to health care, quality of health care, nutrition, smoking rates, obesity rates, exposure to unsafe neighborhoods, participation in risky or unsafe behaviors, and whether or not we have health insurance. Most of us are well aware that women in the United States do outlive men, with the average life expectancy at 76 years for a man, and at 81 years for a woman. Men are gaining on women, though. Based on data taken from 1989 to 2009, a recent report from the Institute for Health Metrics and Evaluation found that male life expectancy jumped by an average of 4.6 percent, compared to 2.7 percent for women. Perhaps part of this can be attributed to women's entry into the work force. Woman are working harder, experiencing higher levels of stress, and smoking more. (In fact, women smoke at far higher rates over the past 25 years, and we are now seeing the effects of that unfortunate statistic.) My recommendations? Be born to wealthy parents, in a small and peaceful Mediterranean coastal country...or however and wherever you actually were born, maximize what you have by living a healthful and active lifestyle: eat well, drink in moderation, and never smoke. Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: June 14, 2012 - Volume 11 - Issue 09