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Why A Good Life Need Not Be a Long Life
We like to think the traits that make life sweet are those that make it long. But a recent long-term study of longevity over decades suggests that's not so.
"I know I will not make old bones," says Achilles in Christopher Logue's modern Iliad. I personally have seen enough old people staring, drooling, groaning and pissing into their giant diapers to sympathize with a wish to quit while you're still ahead. Today, though, we're all supposed to want to live forever. It's not enough to be sad about Amy Winehouse's death at 27 this week. We're expected to feel something like outrage, because no one is supposed to die that young.
Other eras had a different view. In Book Nine of the Iliad Achilles recounts how his immortal mother had given him a choice. He could have a long, tranquil life at the end of which he would, like most of us, be utterly forgotten—or a life of triumph and glory, which would leave his name shining brightly for thousands of years. But that life would be short. As you're reading about him 3,000 years later, you know what he decided.
Which is hard to get the modern head around. With our technologies for life extension we think it normal to live past 65, 75, or even 85. This is one reason many nations are on the long-term road to insolvency: when the U.S. Social Security program was instituted in 1935, only half of men who lived to 21 could expect to make it to the retirement age of 65. Now nearly everyone makes it, which is threatening to bankrupt future generations.
Why do we think longevity so natural and right? In part, I think, it's because we think of it as the byproduct of living well: We like to think the traits that make life sweet are those that make it long. But this long-term study of longevity over decades suggests that's not so. Over 20 years, Howard S. Friedman, a psychologist at the University of California, Riverside, and his colleagues studied 1,500 "gifted" children identified in 1921 by Louis Terman, a psychologist at Stanford. Friedman's team looked at the lifetime data on these kids, who were about ten when first identified—their relationships, their personalities (as reported by teachers and parents) educations, work history and so on.
Of course, some of the kids in the study were more cheerful and optimistic than others. Some had better sense of humor. On average, they died sooner. Similarly, people who seemed happy-go-lucky and didn't stress about work also died at younger ages. And people who reported they felt loved and cared for? Also less likely to life longer. Friedman et al. believe the sunnier people were too cheerful for the long haul—expecting things to work out, they took too many risks.
Who did that leave to win the longevity sweepstakes? As the Publisher's Weekly review put it, "If there's a secret to old age, the authors find, it's living conscientiously and bringing forethought, planning, and perseverance to one's professional and personal life."
In other words, if you want to live long, you're better off being a bit of a buzzkill, with a touch of the bore. Plod along, don't stand out, eat your peas, get your mammogram and count your pennies. Society needs such people, for sure. But in a choice between an MP3 of Amy Winehouse singing and one of these citizens discussing their tax strategy, I'll take the late Ms. Winehouse, thank you. Society benefits from people with the charm, joy in the moment, monomaniacal dedication and lack of interest in self-preservation that seem to make for a shorter life. We don't all need to make old bones.
Winehouse died at 27, which is strikingly young (it's close to half my age, and I'd have hated to miss the past 26 years) but, as a number of media outlets reported, other stars have blown out at exactly the same age (Kurt Cobain, Jimi Hendrix, Janis Joplin and Jim Morrison). Many others went at roughly the same time in life (Heath Ledger, James Dean). The briefness of their time on Earth is sad; but mourning an individual does not require us to believe that no life should be brief.
That's the theme of this wonderful essay by Dudley Clendinen, a longtime Timesman who has amyotrophic lateral sclerosis (Lou Gehrig's disease) and who is clear, at age 66, that he is not interested in becoming "a conscious but motionless, mute, withered, incontinent mummy of my former self." Lingering on, he writes, "would be a colossal waste of love and money." Instead, he says, simply: "I'd rather die."
Until that moment comes, Clendinen says, he is having a good time, appreciating what he calls "the Good Short Life." He believe it is fine, sweet and decorous—fully and naturally human—not to make old bones. We could use more of this strain in our national conversation. In which we assume (if talking about future Federal deficits) that millions of people can and should live as close to forever as they can. In which we assume (if talking about our own lives) that we're obligated to hang on until the last machine-aided breath. In which we assume, if talking about technology, that the right question is how it can extend our lease on Earth for centuries—instead of asking what point and value all those lingering years might have.
It is sad to exit at age 27, or even at age 66. But it doesn't mean one didn't have a good life.
The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
A study by UK archaeologists finds that longbows caused horrific injuries similar to modern gunshot wounds.
- UK archaeologists discover medieval longbows caused injuries similar to modern gunshot wounds.
- The damage was caused by the arrows spinning clockwise.
- No longbows from medieval times survived until our times.
Battle of Agincourt.
The angle of entry into a cranium found during the excavation at a medieval Dominican friary in Exeter, England.
Credit: Oliver Creighton/University of Exeter
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Vegans and vegetarians often have nutrient deficiencies and lower BMI, which can increase the risk of fractures.
- The study found that vegans were 43% more likely to suffer fractures than meat eaters.
- Similar results were observed for vegetarians and fish eaters, though to a lesser extent.
- It's possible to be healthy on a vegan diet, though it takes some strategic planning to compensate for the nutrients that a plant-based diet can't easily provide.
Comparison of fracture cases by diet group
Credit: Tong et al.<p>The results showed that vegans were especially vulnerable to hip fractures, suffering 2.3 times more cases than meat-eaters. Vegetarians and pescatarians were also more likely to suffer hip fractures, though to a lesser extent.</p><p>One explanation may be that non-meat eaters consume less calcium and protein. Calcium helps the body build strong bones, particularly before age 30, after which the body begins to lose bone mineral density (though consuming enough calcium through diet or supplement can <a href="https://ods.od.nih.gov/factsheets/Calcium-Consumer/" target="_blank">help offset losses</a>). Lower bone mineral density means higher risk of fracture.</p><p>Protein seems to help the body absorb calcium, <a href="https://www.bonejoint.net/blog/did-you-know-that-certain-foods-block-calcium-absorption/#:~:text=Historically%2C%20nutritionists%20have%20warned%20that,may%20increase%20intestinal%20calcium%20absorption." target="_blank" rel="noopener noreferrer">when consumed in normal levels</a>. The recent study, along with past research, shows that people who don't eat meat tend to have lower levels of both protein and calcium. When the researchers accounted for non-meat eaters who supplemented their diets with calcium and protein, fracture risk decreased, but still remained significant.</p>
Credit: Pixabay<p>Another explanation is body mass index (BMI). Non-meat eaters tend to have a lower BMI, which is associated with higher fracture risk, particularly hip fractures. In the new study, vegans with a low BMI were especially likely to suffer hip fractures. That might be because having more body mass provides a cushioning effect when people fall.</p><p>Still, the study has some limitations. For one, White European women were overrepresented in the sample. The researchers also didn't collect precise data on the type of calcium or protein supplementation, diet quality or causes of fractures.</p><p>Another complicating factor: Producers of vegan products, such as plant-based milk, are increasingly fortifying foods with nutrients like calcium and protein, so modern vegans are potentially at lower risk of deficiency.</p><p>The researchers wrote that their findings "suggest that bone health in vegans requires further research."</p>