The secret to living well and longer is: eat half, walk double, laugh triple and love without measure. ~ Tibetan Proverb
I wondered last week, as I was writing How I Alleviate Back Pain and Avoid Surgery, if back problems are more prevalent today than they used to be. And, if so, why?
I found some answers in a massive study funded by the Bill and Melinda Gates Foundation called the 2017 Global Burden of Disease Study.* The goal of the study is to document patterns and trends of healthy life expectancy (HALE) and disability-adjusted life-years (DALYs). HALE quantifies the number of years expected to be lived in good health. DALY quantifies health loss due to specific diseases and injuries. (Find a full analysis of this study at The Lancet)
HALE provides a snapshot of overall population health, however, from a business and policy perspective, DALYs are much more interesting and useful because they point to the leading causes of health burden on society. Think of DALYs as the amount of time you lived a healthy life without the need for medical care. It is calculated by adding the number of years of life lost to the number of years lived with disability for a certain disease or disorder. (National Institute of Mental Health),
Let’s now return to the two questions at hand. That is, are back problems more prevalent today than they used to be. And, if so, why?
According to figure 6 in the article, which I’ve included below, one might observe that over time, low back pain has become more prevalent.
Note that in 1990, lower back pain was the 17th leading cause of DALYs and by 2017 it had risen to the 10th leading cause. Further, these are global numbers so it appears that back issues are not confined to high-income regions.
So what’s going on?
While the paper doesn’t explicitly answer this question, it does point to one possible reason; namely, that we’re living longer – a lot longer.
Between 1990 and 2017 global life expectancy increased 7.4 years, from 65.6 years in 1990 to 73.0 years in 2017. That’s a remarkable jump that one would reasonably expect to be accompanied by an increase in age-related DALYs such as lower back problems, Alzheimer’s, hearing loss, and diabetes.
If you note how much each of those particular DALY’s have already jumped and take these other factors into consideration:
- the number of Americans ages 65 and older is projected to more than double from 46 million to over 98 million by 2060 (source), and
- the 65-and-older age group’s share of the total population will rise to nearly 24 percent from 15 percent (source)
- US health care spending already at $3.5 trillion**
I’d predict there are some dangerous fiscal roads ahead. Of course, thanks to another great infrastructure week, we should all take heart knowing that at least those roads will be paved with the best of intentions.
On that note, before I check out for the week, how about some music?
Today, I leave you with the incredibly talented Rhiannon Giddens with her song “I’m on my way.” I was first introduced to Giddens via her band the Carolina Chocolate Drops and their song “Cornbread and Butterbeans” (off of their Grammy Award-winning folk album Genuine Negro Jig). I don’t typically listen to folk music, but this one had me after the first two lines:
Cornbread and butterbeans and you across the table
Eatin’ beans and makin’ love as long as I am able
Her new piece is from There is No Other, a recently released collaborative effort with the Italian jazz musician Francesco Turrisi which The Guardian labeled a stunning folk landmark.
Here’s to hoping your week includes some cornbread and butterbeans!
Cheers…xian
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*An epically massive collaborative research project funded by the Bill & Melinda Gates Foundation that involves over 1,800 researchers from 127 countries assessing mortality and disability factors around the world (Wikipedia).
** This translates into $10,739 per person and represents a staggering 17.9 percent of our economy as measured by GDP (NHEA).
