translated from Spanish: And if we lived 100 years? A debate between optimists and pessimists?

Sir: on 20 November Dr Hernán Sandoval at the counter the article published “increase (no limits?) life expectancy”which it describes as”futuristic imagery”to those who predict that the possibility of living 100 years by mid-21st century will be an event of high possibility.
Specifically, the academic says that “during the 20th century there was an enormous increase of life expectancy, from 50 to 80 years, to the populations of developed countries and even in our country, we reach a similar life expectancy”. Chile even passed a 31.5 year life expectancy in 1910, according to the INE, 80 years today.
In fact, as Dr. Sandoval refers to long delays, even halving that trend, surpass the age of life expectancy of 100 years at the end of our century. That might now be more difficult than what was the livelihood for the poor of the Chile in the last century?
The Dean of the Faculty of Medicine of the University of the Americas refers to a series of health problems that affect us in our days (obesity, flu epidemic, opiate overdose, drugs and alcohol, suicide, etc.). 100 years ago, some of the experts of the time, would have said life expectancy not may never reach 80 years by malnutrition, pests, alcoholism and wars. Dr. Sandoval claims where is the algorithm of the prevention of the consumption of opiates? How do the technocracy face epidemic of suicides? Or how will it address obesity?
It is worth placing algorithms compared prevalence of causes of death of the current situation and the beginning of the last century. While obesity reaches to today to about 60% of the population, on their part, child malnutrition even in 1960 reached 36% and probably exceeded 60% in the early 19th century. Suicides in Chile in 2014 according to Minsal represented 2% of the deaths is a worrying figure, but that does not influence significantly the life expectancy. WHO reported for the year 2009 in Chile 2.148 deaths by suicide and 2,220 deaths by traffic accidents. In Chile they die around 100,000 people a year, according to the INE.
Although inequalities in access to advances in health can even be higher than before, is also true that the current logic of technological processes makes the economic obsolescence of goods fast enough as to which they become economically affordable in short periods. A few years ago a cell phone was a good of elite by its price and scope. There are now more cellular than inhabitants in Chile. A laboratory test or x-ray can be paid by people even directly because they are “affordable” costs. The poor now have, nevertheless, more access to goods and services from health to the middle classes of just a half century.
Malnutrition, he said, could never be unresolved without recognizing that the poor suffered from it with greater severity. However, in our country the malnutrition decades that ceased to be a problem why can not move to reduce obesity? In fact, when the State acts in a way decided with regulations obtained achievements. This is how in the 1960s was the milk for infants reducing malnutrition and infant mortality. The decline in about 10% between 2009 and 2017 (survey ENS) smokers by combined and efficient regulations between prices and restrictions will have, by the way effects on the health of the population. The recent act of labelling showed according to an official study of the INTA which began to notice a reduction in the sale of sugary drinks.
From the point of view of innovation the own Dr Sandoval emphasizes the contribution of penicillin which reached an industrial and commercial development only from the 50’s of the last century (the cost of a penicillin dose fell from an unattainable price in 1940 US$ 20 per dose in July 1943 and $0.55 per dose in 1946). Thus, the expectations of life in the world rose rapidly. The idea that HIV-AIDS – recognized in 1981 – it would be the modern plague and that diezmaría to the world lasted very little. Just three years later the Institut Pasteur isolated the virus. The price of antiretrovirals, for example, was reduced by 90% in 15 years (Médecins sans frontière July 2016).
policy of the India of allowing competition between the producers of generic has involved the reduction of the price of treatments of first line of around 10 000 dollars a year per person, with close to $100 at present (ibid). The rapid decline in some prices opens the door to a greater universality of certain expensive treatments, all of which should influence longer life expectancy.
The changes are not as fast, but it is important to qualify the long-term trends. In 1910, according to the INE, in Chile the 33% of deaths occurred in less than one year; in 1950 still 32% belonged to this segment, but in 2000 only 3% of the deaths were of children under one year. Conversely, 72% of all deaths in 2000 were from people with more than 60 years and in 1910 only were 15% even though at that time life expectancy was only 31 years old.
The short term should not prevent us from seeing the forest for the long term. As with economic growth averages are displayed in long series. The article cited by Sandoval hinting a reversal in the average life expectancy with United States data is an alert, but it is still premature to establish it as a trend. The following chart of the life expectancy in a century in Spain realizes that there are moments in history that life expectancy back but everything continues on an upward trend. It is no exaggeration to think then, however, most developing countries have managed to increase life expectancy approximately 4 months per year after 1950. Spain did so at almost 5 months per year in the past century despite the massive problems that went through.
Even the article quoting Dr, Sandoval pointing in the U.S. life expectancy reduction indicates that when the total of the period (2001-2016) is parsed anyway life expectancy increases in all deciles of income, notwithstanding that it is useful to call attention to the inequalities that are embedded in this process. Furthermore, another article by Ana Best et to the. July 2018 in The Lancet Public Health, points out that the mortality rates in the United States increased from 2014 to 2015, but it expressly indicates that this only slows down the increase in life expectancy but does not change the upward trend.
Dr. Sandoval is right when it refers to social determinants as a decisive factor in the health of the people: “quality of life, education, income, housing, among others, and also by access to better medical techniques such as;” vaccines, drinking water, sewerage, and increase of the possibilities of curing conditions frequent and severe, using vitamins, hormones, antibiotics and access to surgical techniques of great impact, among other developments”, says Dr Sandoval. Now, even if increasing inequality in the countries (which is unjust and irritating) there is no doubt that the quality of people’s lives, education, housing and the absolute income of Chileans have increased.
obesity with its sequels is the biggest threat to the health of the populations of middle and high income countries. The paradox of history is that for thousands – or millions of years – famines were the main problem of humanity. It is not belief mythical or mystical abilities of science and the decisions of the elites to resolve this issue or let it advancing though still there is not enough awareness in families of this pandemic.
It is actually the basic logic of the reactions of the population what will push to make this change. Dr Sandoval notes referred to pejoratively as “algorithms technocrats dreaming of a world without people who annoy them them in their plans, but people is suffering, is sick and fight for not only a subject of the designs of the market”. Precisely, this is a biased view because these companies (the technocrats of algorithms?) are very attentive to the demands of the people and provide alternatives to those demands. Big drug companies do not cause obesity but have thousands of offers to fight it, and then to keep the weight of the “patient” “in shape”.
not contemplate huge ductility of transnational enterprises to adapt to the demands is an important error. They are their own tobacco having already developed the strategy for the sale of marijuana in cigarette packs. They are the great transnational suppliers of sugar-sweetened beverages for decades that now sell the same brands with a great “zero sugar”.
lowering the dose of salt in bread was relatively easy.
What always oppose big business is to bear the costs of the damage generated by the population. The tobacco companies always claim the taxes and regulations. Drug companies develop fierce lobbies to prevent competition from other countries such as Brazil or India. Health authorities are placed in sight when they subtly succumb to business pressures to the detriment of the population for a moment it seemed that it was a debate between pessimism and optimism to the lengthening of the life expectancy of the population but the (my) position that averages may be increasing in the expectation of life of the people, ends up being the vision pesimistto because if society is not prepared to assume this trend we will see increasingly more older adults with dementia, and many of them, abandoned and impoverished.
Rafael Urriola

Original source in Spanish

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