The Secretary of Health and Human Services wants to return America’s public health to a simpler time – you know, the good ole days – back when Americans were healthier. Kennedy, whose uncle became president 65 years ago, has often claimed people were much healthier back then. The following was reported by The New York Times:
Robert F. Kennedy Jr., the health secretary, often says that when his uncle was president in the early 1960s, Americans were much healthier than they are now. People were thinner and had lower rates of chronic disease, he recalls. Fewer children had autism, allergies or autoimmune diseases.
Supposedly, fewer people were dying of chronic diseases 65 years ago, obesity was lower, and Americans were more active. However, does that really mean people were healthier? Or is it nostalgia for a bygone era, that never really existed except in the minds of old people remembering history wrong?
“If R.F.K. Jr. makes the statement that more people are dying of chronic diseases now than in Jack Kennedy’s era, that’s undoubtedly true — we’ve got twice as many people, and a much larger chunk are old folks who have much higher chronic disease rates,” said Kenneth Warner, dean emeritus of the University of Michigan School of Public Health.
“Does that mean we’re doing worse than back then?” he added. “Absolutely not.”
Going back to the era when John F. Kennedy was President America was younger. Not just the nation, but also its population. The Baby Boom generation ended in 1964. Baby Boomers, the largest cohort in American history, were born between 1946 to 1964.
The U.S. population was much younger in the 1960s, at the tail end of the Baby Boom, which complicates comparisons. Only 12.4 percent of the population was 65 or older in 1963, compared with 17.7 percent now. Rates of chronic diseases generally increase with age.
The average age of Americans over the age of 64 is also higher today than it was in the 1960s, due to better medicine and longer life expectancies.
Americans have also gained a lot of weight in the last 65 years. Americans eat more packaged foods and foods away from home where taste is more important than healthy ingredients. Obesity rates have driven higher rates of diabetes, which impacts America’s health, but I doubt if Kennedy can do anything about overeating tasty snack foods.
Mr. Kennedy has pointed to unhealthy diets, pesticides, food coloring and seed oils as the culprits. Recently he has also begun targeting sugar-sweetened beverages, which experts like Dr. Manson agree are closely linked to the development of Type 2 diabetes, even apart from weight gain.
Obesity may be higher than in 1960, but smoking rates are down. In 1965 nearly half of American adults smoked (42%), compared to only 12% today. As a result, the death rate from heart disease has fallen by 71% since the 1960s. Moreover, cancer rates have been declining in the past few decades, partly driven by lower rates of lung cancer.
Yet the apparent increase in chronic disease rates is also driven to some extent by earlier detection, said Kate Lorig, professor emerita of public health at Stanford University School of Medicine.
Public health experts point to blood pressure as an example. Hypertension is greater than in decades past. Obesity likely is partly the cause but so is the fact that the threshold of high blood pressure has been lowered in recent years.
A 1965 report recommended referrals for patients only when their systolic pressure exceeded 160. By 2017, treatment was recommended at a systolic pressure of 130 and diastolic pressure of 80.
Some types of deaths are more common in the US than elsewhere. Deaths from heart disease, guns, and auto accidents are higher than other countries, which is related to lifestyle and culture. Chronic diseases are largely a condition of old age. Yet not all chronic diseases are things you die from. As life expectancy increases, so does the years of living with chronic disease. The same is true with cancer. People are increasingly living long enough to get cancer. That is a good thing (longer life, not cancer).
Despite Kennedy’s assertion that people were healthier 60 years ago, life expectancy has risen by nearly a decade during that time. America is also a wealthier society, which can afford to overeat and treat related health conditions. Furthermore, conditions that would have been dismissed 60 years ago are now recognized as chronic conditions rather than merely getting old.