Influencing Longevity--"flat of the curve?"
By Arnold Kling
In a review of Robert Fogel’s Escape from Hunger, Angus Deaton writes,
Today, movements in life expectancy in rich countries are driven by trends in chronic disease among those over 50—infant and maternal mortality rates are no longer important—so that, if the “womb with a view” stories are even partly correct, it is not nutrition today that is important for population health today, but nutrition before 1950. Indeed, the consequences of the nutritional improvements of the first half of the last century, not only in quantity of food, but in the increased availability of fresh produce throughout the year, and in a better understanding of nutritional requirements, have still to deliver their full payoff in reductions in morbidity and mortality.
Deaton distances himself from what he regards as Fogel’s extreme focus on nutrition at the expense of other factors affecting health.
My own view is that, at least since 1970, medicine has been much more effective and important in prolonging life than Fogel gives it credit for. At the same time, and perhaps paradoxically, much of medical expenditure is driven by suppliers, not by patient demand, and carries little or no benefit, “flat of the curve medicine,” or worse, iatrogenic medicine, medicine that actually hurts people.