Holiday Thoughts

As the year draws to a close it might be worth looking at some good news for the global healthcare system where most of us work.  Since 1990 there has been tremendous progress on global life expectancy as reported in Lancet last week.  We are living longer lives and have seen a huge shift in the diseases that cause death around the world.  In 1990 only 33% of deaths occurred in people over the age of 70.  That number has improved to over 43% in 2010.  This huge improvement was caused by significant declines in infant mortality, malnutrition and deaths from infectious diseases.  Take a couple minutes and look at a review of the report in The New York Times.  Yes we have made tremendous progress, driven in part by the pharmaceutical industry, and the story should continue to get even better over the next decade.

The obvious cause of most of the good news is that the world is becoming more developed.  Infant mortality has been cut in half during this period which has resulted in dramatic rises in life expectancy in some countries.  Vaccines and drugs that treat infectious diseases must have also played a huge role in these changes.  Even deaths due to AIDS seem to have peaked, even though they remain at a level that is too high globally.  The world is now dying of “rich country” illnesses that include cancer, heart disease and diabetes.  Again, this would seem to be a challenge our industry is ready to accept given the progress we have made over the last couple decades in the US treating these diseases.

Perhaps the biggest challenge in the article has do with the slow progress in the United States, especially women in the US.  Much of this has to do with the fact that a lot of the diseases being eliminated and cut down around the world were already low in the US in 1990.  Women in 1990 were already seeing an average life expectancy close to 80 years old and although it improved in 2010 the change was only slight.  Despite this, it might be worthwhile to determine with all the money we spend on healthcare why the results were not even better.  Smoking seems to come into play for women as does obesity.  It seems that as women are becoming more similar to men in their lifestyle the gap of life expectancy has shrunk somewhat.  It should be a concern that the US women fell to 36th place in global life expectancy down from 22nd two decades before.

As we enter the year end break there are certainly things to consider.  We should celebrate the progress that has been made and firmly dig in for the challenges ahead.  Although much progress has been made in developing countries around infant mortality and infectious diseases there is still significant work to be done, even in the more developed world.  We need to duplicate the effort we made around the world treating infectious diseases with treatments for heart disease, diabetes and cancer.  This is where the next jump in life expectancy will come from.  Finally, we need to really dig in to this issue with both women and men in our country to try to catch up with the rest of the more developed world.  We need to really quit thinking our healthcare system can’t be improved when there is this gap in life expectancy and it seems to be getting larger not smaller.

What is needed so much now in our healthcare world is that spark of imagination that leads to innovation.  Isn’t it imagination that makes this season so special?  Let’s make a resolution to challenge everything, to think big and really drive change in the coming year.  After all, isn’t our industry really all about innovation?  We also love a challenge and because of that the next couple years should really be fun.  Peace.

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