A double load of bad news this week: Sabrina Tavernese reported in the NY Times that the birth rate in our country has fallen for the fourth straight year. In fact, the decline in birth has been 15% since 2007. Whether it’s the result of economics, political turmoil or other reasons, an increasing number of young people are opting out of -or perhaps are physically unable to take on- parenthood. Apparently the only thing keeping our population numbers level is immigration.
The second depressing report comes from Joel Ashenbach, writing in The Washington Post, citing what he chillingly calls “the U.S. longevity reversal”: there has been a relative jump in death rates between 2010 and 2017 by a horrifying 29% among people ages 25 to 34. The demographics cut across all racial and ethnic groups. Apparently -and appallingly- it’s individuals generally regarded to be in their prime who are opting out of life. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University who authored a report on the increase of deaths among young people commented that the increase in death is not only due to the obvious causes like the opioid epidemic, obesity and its complications, or driving accidents. He believes there is a deeper, “root cause” that is specifically affecting working class adults. Comments from experts who read the report speculate, like Ellen Mearn, Professor at the Dartmouth Institute for Health Policy and Clinical Practice, that people are increasingly more depressed, whatever the cause, about themselves and their futures. In fact, as Achenbach points out, the average life expectancy in this country fell behind that of other wealthy countries in 1998 and since then the gap has grown steadily. It’s so striking that it’s called the US health disadvantage.
One hopeful effort at combatting illness in the young is the report in Science that the US Centers for Disease Control and Prevention (the CDC) thinks that a synthetic form of Vitamin E oil added to many e-cigarettes may be at least one responsible agent for the deadly lung disease felling young vapers. The noxious substance was found in the lung fluid of all 29 patients who had suffered lung injuries. Vaping injured more than 2000 and killed at least 39 individuals since March.
Happily, this week’s issue of Science reports another weapon against premature death from another important killer: alcoholism. Dr. Bernd Schnabl, a gastroenterologist at the University of California has discovered an unexpected reason why heavy drinking affects some tipplers more than others. 30% of patients hospitalized with alcoholic liver disease harbored a toxic-making strain of the bacterium, Enterococcus faecalis, in their intestines. When mice experimentally infected with the deadly bug were treated with a virus that targeted E. faecalis, they had less severe disease than untreated animals. Clinical trials on treating humans with severe alcoholic liver disease with the virus will be the next step.
In short, the news of this week is bleak, but intense efforts to protect and defend human life, even for the millions afflicted by life styles and habits that are killing them in their prime, go on. It is an amazing fact that we can be recklessly abusive of our bodies, but science continues to find ways to help us survive in spite of ourselves. But the underlying reasons for the disturbing trends of a plunging birth rate and increasing death rates among young adults demand intense and focused consideration.
Dr. Marianne Legato, Professor Emerita of Clinical Medicine at Columbia University is an internationally known academic physician, author, lecturer, and specialist in gender-specific medicine. She is founding member of the International Society for Gender Medicine and also the founder and director of The Partnership for Gender-Specific Medicine at Columbia University and its next iteration, The Foundation for Gender-Specific Medicine. These enterprises are the first collaborations between academic medicine and the private sector focused solely on gender-specific medicine: the science of how normal human biology differs between men and women and of how the diagnosis and treatment of disease differs as a function of gender and sex. Her ground breaking textbook on Gender-and Sex Specific Medicine has been published in 2017 in the 3rd edition.
She has published extensively on Gender and Sex Specific Medicine, both scientifically and for the lay public. She is also the founding editor of the journal Gender Medicine, and the Journal Gender and Genome, published for the scientific community. In 1992, Dr. Legato won the American Heart Association’s Blakeslee Award for the best book written for the lay public on cardiovascular disease. She is a practicing internist in New York City and has been listed each year in New York Magazine’s “Best Doctors” since the feature’s inception in 1993.