Life with Chronic Conditions: Medicine vs Lifestyle

I love archeology, particularly the paleoindian period, which is over 11,000 years old. I’ve been working on various digs and am amazed to hold the tools these people made. Now with the advent of DNA research, we’re getting a better handle on who these people were, how they lived and yes their life expectancy.

I was fascinated when Vermont’s state archeologist, Jess Robinson, spoke about how farming was the undoing of the Paleoindians as they had it made with their hunter-gatherer lifestyle. So this week I was immediately drawn to an article in the Huffpost Does Medicine Actually Make People Live Longer?

In spite of the research I’m actively involved with, I had no idea that the paleoindian lifespan (for those surviving childhood) was pretty similar to today's. Once people started cultivating crops, longevity suffered. Populations boomed, unsanitary conditions arose, humans and domestic animals lived in close proximity and it wasn’t long before infectious diseases significantly impacted life expectancy. Note that children, up to the 20^th century and the arrival of vaccines, were at high risk for early deaths.

Life expectancy did not start rising again, and finally attain similar levels as our 10,000 year old ancestors, until about 100 years ago. Sanitation/public health was the primary reason. Due to a better understanding of germs, significant changes in drinking water, improved hygiene of those attending births and caring for the sick, building sewers etc. all contributed to a spike in life expectancy. By the mid 20^th century, vaccines helped to eradicate many childhood diseases so more people achieved adulthood and the arrival of antibiotics helped to stop some of the diseases that have plagued humans since they began farming.

While heart disease, which hunter-gatherers rarely develop, is the leading cause of death, with cancer in 2^nd place, I was surprised to learn of the 2016 British Journal of Medicine study  that found medical error is the third leading cause of death in the US. Interestingly medical error is not included on death certificates or in rankings of cause of death.

I find it fascinating that people are obsessed with a vegan diet, swearing it improves life expectancy, while at the same time there are many who find they feel healthier eating a Paleo diet. In truth, we’re not going to be adopting a hunter-gatherer lifestyle anytime soon-and no they were definitely not vegans.

But let’s not throw the baby out with the bath, medicines have definitely saved lives and they are important. My question is simple, does medicine deserve the power that society today gives it? Might we do better if we had as much promotion for healthy lifestyle choices as we do medications? Would we do better to invest in communities to make the healthy choice the easy choice?

I’ve written about this many times in this blog, but we only need to look at the Blue Zone cultures to see that lifestyle makes a far bigger impact on longevity and quality of life than access to medical care. Programs  are underway in the US to bring the Power Nine lifestyles of the Blue Zones to the US.

The research is showing that it’s not too late to make changes as significant advantages are happening in communities where they are making the healthier choice the easy choice. However, many health professionals I talk to have never heard of the Blue Zones studies and would rather promote medicines (cause it’s easier and people are more likely to do it) than lifestyle changes. Interestingly though, when you look at who is sponsoring a lot of the Blue Zones projects it’s health insurers. They’re not stupid as they save money when people adopt healthier lifestyles and therefore don’t need a lot of medical care.

Ultimately medicine today is a “sick care” model. If we want to be active and healthy for as long as possible we need to start shifting our focus at creating healthy communities. Clearly the early public health pioneers did this when they worked to implement sewers and other measures that resulted in improved lives and life expectancy. We need to be building on that model by creating communities that promote walking; places for people to gather and socialize; ways for people to be involved so they have a sense of purpose; public gardening and more.