In December, the Los Angeles Times reported — very briefly — that from 2007 to 2008, life expectancy in the United States declined by 0.1 year. It should have been the lead story of every newspaper in the country with the largest possible headlines (“LESS LIFE“). Did 9/11 reduce life expectancy this much? Of course not. Did World War II? Not in a visible way — American life expectancy rose during World War II. I can’t think any event in the last 100 years that made such a difference to Americans. The decline is even more newsworthy when you realize: 1. It is the continuation of trends. The yearly increase in life expectancy has been dropping for about the last 40 years. 2. Americans spend far more on health care than any other country. Meaning vast resources have been available to translate new discoveries into practice. 3. Americans spend far more on health research than any other country and should be the first to benefit from new discoveries.
Maybe I’m biased (because my research is health-related) but I think this is the biggest event of our time. It is the Industrial Revolution in reverse — progress grinding to a halt. For no obvious reason, just as the Industrial Revolution had no obvious reason. Health researchers have been given billions of dollars to improve our health, the whole system has been given tens of billions of dollars, and the result is … nothing. Worse than nothing.
No journalist, with the exception of Gary Taubes, seems the least bit aware of this. It is a difficult story to cover, true. But several journalists, such as health writers for The New Yorker (Atul Gawande, Michael Specter, and Jerome Groopman) are perfectly capable of covering it. They haven’t. With a few exceptions, they write about progress (e.g., Peter Provonost’s checklists). It is like only reporting instances when Dirk Nowitzki missed a free throw. Each instance is true but the big picture they create — he misses all free throws — is profoundly false.
Among academics, the stagnation has received a tiny amount of attention. In a recent paper (gated), two University of Southern California professors, considering a wider time period, point out that there has been some improvement in how long you live after you get sick, but no improvement in how long you live before getting sick. Here is how the discussion section of their article begins:
There is substantial evidence that we have done little to date [meaning: from the 1960s to the 1990s] to eliminate or delay disease or the physiological changes that are linked to age. For example, the incidence of a first heart attack has remained relatively stable between the 1960s and 1990s and the incidence of some of the most important cancers has been increasing until very recently. Similarly, there have been substantial increases in the incidence of diabetes in the last decades.
Here is my explanation of the paradox of: 1. Enormous and increasing health care costs. 2. Vast amounts spent on research. 3. No better health. Health researchers, such as medical school professors, shape their research to favor expensive treatments, such as expensive drugs. In fact, the best treatments would cost nothing (e.g., the Shangri-La Diet). To make the expensive treatments seem worth studying, they invent utterly false theories and claim to believe them. For an example (research about depression), see The Emperor’s New Drugs by Irving Kirsch. Because health researchers are forced to worship absurd theories, they are incapable of good research. Absence of good research is why there is no progress. The health care supply chain — everyone between you and the research, such as doctors, nurses, drug company employees, hospital employees, alternative medicine practitioners, medical device makers, and so on — is happy with the situation (useless research) because it ensures that little will change and they will continue to get paid. They are the supposed experts — and remain silent.
It is human nature that everyone in the supply chain remains silent. They are protecting their jobs. But the silence of the journalists is The Emperor’s New Clothes writ large. To explain why smart journalists fail to notice the stagnation, I think you have to go back to studies of conformity. When everyone you talk to — people in the supply chain — says black = white (i.e., that progress is being made), you say the same thing.
Why is personal science, the main subject of this blog, important? Because it is a way out of this stagnation.