Source: The Weekend Australian, 16 August, 1997, (Australia Today: An 8-page special) p.8
Chronic disease is taking some of the shine off increases in life expectancy rates, reports medical writer JUSTINE FERRARI BABIES born in the closing years of this century can expect to live almost twice as long as babies born 100 years ago. However, the pay-off for longevity is living with a chronic disease or disability. Australians are living longer, with the average life expectancy for men rising from about 51 years at the beginning of the century to 75 years in the 1990s. Women continue to outlive men and the gap in life expectancy between the sexes has widened, with women living an average 54 years in 1900 compared with 81 years today. But as the population has aged, the level of illness has grown. The lightning strike of deaths caused by infectious diseases or childbirth has been replaced by chronic, degenerative diseases, such as cancer and heart disease, which march more slowly towards death. The gains in life expectancy in the first half of the century were largely a result of rapid declines in deaths from infectious diseases and improved maternal and child health. Better nutrition and public infrastructure such as a clean water supply, sewerage and improved and less crowded housing assisted medical advances in antibiotics and vaccines to keep infectious diseases under control. Polio, tuberculosis, bubonic plague- even influenza, pneumonia and whooping cough were far more lethal. Advances in medical treatments have been important. particularly in making childbirth safer and causing infant death rates to plummet, while improved education standards have aided people's ability to understand and adopt good health practices. Injuries were a common cause of death in the first half of the century with unsafe working conditions the main culprit, but any improvements have been offset by the rise in deaths from car accidents, which only recently have started to drop, and a rise in suicide rates. The increase in life expectancy slowed during the 1940s and 1950s and even reversed in some age groups because of a dramatic rise in heart disease and lung cancer caused by smoking. Chronic diseases such as cancer, heart disease and musculoskeletal conditions like arthritis and osteoporosis have become more prominent as people live longer. Cardiovascular disease, particularly deaths from heart attacks and strokes, rose after World War II and peaked in the 1960s. While Australian Institute of Health and Welfare researcher Colin Mathers says some of the rise was due to changes in diagnosis, there was a real increase related to changes in lifestyle-the introduction of saturated fats and processed foods into the diet, smoking, less exercise and the weight that Australians, like other developed nations, continue to stack on. Cancer has remained fairly static, affecting about the same proportion of the population, but as more people live into old age, the actual number of people with cancer has surged. Some cancers have increased dramatically because of lifestyle changes, with smoking responsible for an 11 fold increase in lung cancer deaths among Australian men between World War II and the 1980s. The number of years spent suffering a disability that limits everyday activities has increased with longer life, rising from almost 14 per cent of people to more than 16 per cent just over the past decade. Similarly, the number of people suffering a long-term health con- dition (one lasting more than six months) rose from one in two people in 1978 to two in three in 1990 to three in four in 1995. The average number of conditions also rose from 1.78 per person in 1978 to 2.25 in 1990. While some of the rise in morbidity is slated to improved diagnosis and greater awareness of diseases, real increases have occurred in asthma during the past 20 years-with asthma symptoms now affecting one in five schoolchildren-and in mental illness, particularly depression. The incidence of heart disease has started to fall, but cancer will remain a significant cause of illness and death into the next century. Lower levels of immunisation mean infectious diseases still pose a threat and the recent emergence of new viruses highlights the need for eternal vigilance against the microbe world. Scientists have hypothesised that the biological limit of life is about 85 years, but so far Australian life expectancy shows no sign of slowing down with death rates falling in older people as well as among the young. But as people continue to live longer, the real challenge, as the Gerontological Society of America succinctly puts it, lies in adding life to years, not years to life.
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