Aging’s New Path Forward

A toolbox of options for delivering more appropriate care to older people already exists, but it is not being utilized.

A fundamental fallacy in understanding American longevity has been the belief in the primacy of medicine as its cause. Even though modern medicine’s triumph over many infectious diseases in the first half of the 20th century enabled more people to survive childhood, it was developments in the second half that created a new epidemiologic era, one characterized by extended chronic conditions instead of acute or infectious episodes. Such innovations include the concept of “risk factors” introduced by the Framingham longitudinal study, the chlorination of drinking water, the reduction of smoking, the recognition of the benefits of exercise, tort reform that punishes anyone who creates avoidable risk, stair lifts, Velcro shoes, and many other options. The miracles of modern medicine continue, but rather than providing short-term cures, tend to turn former fatal diseases into chronic conditions.

The belief that medicine deserves all the credit for our increased longevity, when it is also due to many societal factors, is problematic because it assumes that the Industrial Era institutions created to cure infectious diseases will also serve to cure chronic ones. But they don’t. Our health…