Let’s Not Be Dumb About Cutting Costs.

By Karen and Erica

Those of us who are the great beneficiaries of our new longevity owe it to public health advances in the 1950s. We learned this from Dr. Linda Fried, Dean of Columbia’s Mailman School of Public Health.

Public health was responsible for adding 25 of our increased 30 years of life expectancy over the last century. Now, public health needs to take the lead in ensuring those additional years are healthy. There is an opportunity for the United States to invest in a new vision of public health focused on healthy longevity for everyone. There are many dimensions where public health needs to rise and to redefine the role of the public health system, so as to deliver conditions that enable people in every community in this country to be healthy.

As ChatGPT says:

Advances in public health led to longer life expectancy and improved quality of life, enabling people to contribute to the economy for a longer period.

1. With more years of productive work, people could accumulate more wealth and savings, leading to greater investments in housing, education, and businesses.

2. Retirees with longer life spans also contributed to the economy through consumer spending and investment in new markets (e.g., leisure, tourism, financial services).

But not everyone sees the same picture. As Dr. Fried is well aware, this amazing gift of longevity to all of us is viewed with fear by many.

[Interviewer]: So now we have an extra 30 years added to the average life span and we know that if people can arrive at age 75 healthy, they are on track to stay healthy. What do we do with that “extra” life span?

Fried:  We need to invest in ways that will keep people healthy. If we increase the “health-span,” and we create the new kinds of social structures and institutions so people can stay engaged in making a difference — which they want to do — then we have the potential to fully experience the opportunities and assets of our longer lives. 

As we have recognized, nobody wants an aging population if the aging members of society take all of a nation’s resources and give nothing back. That means society need to understand the choices to be made as the populaiton of older people grows ever larger.

Dealing with Alzheimer’s is a case in point. Alzheimers is a dreadful disease that robs older people of their mental faculties. The incidence of Alzheimers is rising with the increasing size of the older population.

Alzheimer’s disease (AD) is the fifth leading cause of death among individuals 65 and over. Nearly 7 million Americans are living with AD in the United States. As the population ages, this number is expected to increase to nearly 13.8 million Americans by 2060, without significant development to prevent, slow, or cure AD. 

We’re scared of Alzheimer’s, especially since, for reasons not yet fully understood, women are  more susceptible to the disease. We have seen what Alzheimer’s does to people. So we have been excited by ongoing research that appears to show promise in detecting and treating these awful diseases.

Alzheimer’s and related dementias research has advanced at a remarkable pace over the past several years. This progress helps move us closer to developing effective prevention and treatment options that benefit all Americans. 

This research is spearheaded by the National Institutes of Health.

The National Institutes of Health (NIH) drives the nation’s research to better understand the complex and varied causes of Alzheimer’s and related dementias, identify early signs of disease, develop effective interventions to prevent or delay disease progression, and improve care and support for those living with dementia as well as their care partners.

But it seems the work will slow or stop.

An abrupt change in support for these essential costs, as was announced by NIH late Friday, would end, seriously jeopardize, or require significant scaling back of hundreds of research projects across the university, including work of critical importance to lifesaving medical discoveries, treatments, care, and cures in areas including cancer, cardiovascular disease, diabetes, the effects of aging, traumatic brain injury, mental health, and substance abuse, among many others. 

We are of course personally interested in the continuation of this research. But slowing work on a disease that could undermine the nation’s economy by making many of its citizens less productive and more costly seems a tragic choice. And also a short-sighted one.

Cutting costs is a fine objective. Cutting costs on the one side that massively increase costs on the other makes little sense.