[Paleopsych] Sex, Booze, and Getting Old - Welcome to the Human Nature blog. By William Saletan

Thu Jan 6 15:08:42 UTC 2005

Sex, Booze, and Getting Old - Welcome to the Human Nature blog. By William 
Saletan
http://slate.msn.com/id/2111786/
5.1.4

    You and I are cultural and political creatures living in an age of
    science and technology. From sexuality to liposuction to surveillance
    to cloning, we're being overrun by technologies full of implications
    about who we are and how we should live. The purpose of Human Nature
    is to expose and discuss those implications. In the weeks to come,
    what you'll find here is a steady diet of news updates and quick
    takes, coupled with longer columns exploring some topics more
    thoroughly.

    Let's start with a few updates.

    DEATH

    Item: We're going to live longer than Social Security administrators
    expect.

    Source: "many population experts"

    Outlet: [28]New York Times, Dec. 31

    Gist: Life expectancy at birth rose 21 years from 1900 to 1950 (47.3
    to 68.2) and another nine years from 1950 to 2002, reaching 77.3
    years. The Social Security Administration assumes life expectancy will
    now grow more slowly, increasing only six years by 2075. Longevity
    experts say this assumption is too low. Why? 1) Life expectancy has
    increased by three months per year pretty regularly for 160 years. 2)
    Government projections have historically underestimated increases in
    longevity. 3) After 1950, although the rate of increase declined for
    the general population, it increased for the population over age 65.
    4) Our average life expectancy is far below any biological "ceiling."

    Financial implication: We're doing such a good job of keeping people
    alive that we're going to bankrupt ourselves.

    Critique: Three of the four "expert" arguments are social science
    dressed up as natural science. They're just demographic extrapolations
    from the past to the future, with no biological theory to explain why
    we could increase the longevity of old people as easily as we
    increased the longevity of young people. The fourth argument is
    biological but tells us only about a ceiling. It doesn't matter how
    high the ceiling is if we don't have a ladder to get there--and that's
    the argument on the other side. As the token skeptic puts it in the
    Times, "There are no lifestyle changes, surgical procedures, vitamins,
    antioxidants, hormones or techniques of genetic engineering available
    today with the capacity to repeat the gains in life expectancy that
    were achieved in the 20^th century."

    Buried political story: Read down to the 10^th paragraph of the Times
    article.

      For the American population as a whole in the last century, most of
      the gains in life expectancy at birth occurred from 1900 to 1950.
      But most of the gains in life expectancy among people who had
      already reached age 65 were seen after 1950. Last year an expert
      panel advising the Social Security Administration found "an
      unprecedented reduction in certain forms of old-age mortality,
      especially cardiovascular disease, beginning in the late 1960's."

    In other words, as old people increased their share of the country's
    economic and political power, they consumed more of the country's
    medical attention. Further down, the Times adds, "Nor do economists
    generally foresee a reversal of the trend toward early retirement.
    Though researchers have observed a significant decline in chronic
    disability among the elderly, most workers retire and begin drawing
    Social Security benefits before they reach 65."

    Disability down. Cardiovascular disease down. Longevity up. Social
    Security benefits earlier. This isn't a biological problem. It's a
    political problem.

    Punch line: Two other problems may solve this one. One expert observes
    that obesity is proliferating and lethal infectious diseases are
    thriving in our increasingly connected world. Human self-destruction
    may spare us the financial cost of human self-absorption.

    SEX

    Item: More adult women are having unprotected intercourse.

    Source: [29]National Center for Health Statistics

    Outlet: [30]Washington Post, Jan. 4

    Gist: From 1995 to 2002, the percentage of sexually active adult women
    not using contraception rose from 5.2 to 7.4. This could increase
    unintended pregnancies by more than 20 percent.

    Liberal spin: This is the tragic result of insufficient sex education,
    too much abstinence-only curriculum, more people without insurance
    coverage, and lower federal funding of family planning relative to
    inflation. One liberal complains that drug companies "have cut way
    back" on free samples and tells the Post, "It is absolutely
    unconscionable that women have a co-pay of $20 or $25 [a month] for
    contraceptives and men are getting off scot-free."

    Critique: 1) If erosion of sex ed is the problem, why is contraceptive
    use [31]increasing among teenagers? 2) Before you blame health
    insurers and drug companies, ask how safe, reliable, and expensive
    birth control was before they got into it. 3) Doesn't "co-pay" mean
    we're socializing some of the cost, and nobody's getting off
    scot-free? 4) Have we really been relying on free samples to get birth
    control to poor women? If so, shouldn't we make that subsidy public
    and stop leeching off greedy drug companies?

    Conservative spin: Women are rejecting birth control because they want
    to get pregnant or don't like birth control's side effects. An
    abstinence proponent tells the Post, "The women making these choices
    are making a conscious choice. They are not stupid."

    Critique: We'll quote you on that next time you propose
    legislation--like, say, [32]S. 2466--to regulate women's choices on
    the grounds that they're dupes of the abortion industry.

    FAT

    Item: There's no evidence that commercial weight-loss programs work.

    Source: [33]Annals of Internal Medicine

    Outlet: [34]New York Times, Jan. 4

    Gist: 1) Virtually no commercial diet program has "published reliable
    data from randomized trials showing that people who participated
    weighed less a few months later than people who did not participate."
    2) Since there's no good evidence, maybe you should avoid the most
    expensive programs. 3) The most expensive programs are supervised by
    doctors. 4) "Doctors could do as well as these programs" just by
    telling people to diet and exercise. 5) All diet programs fail because
    "they're fighting biology."

    Critique: Thanks for the help.

    VICE

    Item: Medicare will pay for alcoholism screening and for counseling to
    quit smoking.

    Source: [35]Medicare administrators

    Outlets: New York Times, Dec. 24; [36]Los Angeles Times, Jan. 2

    Gist: Alcoholism screening begins this week. Coverage of smoking
    cessation counseling begins in March. Both will cost a lot of money
    but save more by preventing cancer, heart and liver disease, and other
    maladies.

    Cultural analysis: We're socializing treatment of smoking and drinking
    because we now view them as diseases, not vices.

    Economic analysis: We socialized treatment of the consequences of
    smoking and drinking when we created Medicare 40 years ago. Now we're
    just cutting costs.

    William Saletan is Slate's chief political correspondent and author of
    [37]Bearing Right: How Conservatives Won the Abortion War.

References

   28. http://www.nytimes.com/2004/12/31/politics/31benefit.html
   29. http://www.cdc.gov/nchs/data/ad/ad350.pdf
   30. http://www.washingtonpost.com/wp-dyn/articles/A45599-2005Jan3.html
   31. http://www.cdc.gov/nchs/data/series/sr_23/sr23_024.pdf
   32. http://www.nrlc.org/abortion/Fetal_Pain/S2466.html
   33. http://www.annals.org/cgi/content/abstract/142/1/56
   34. http://www.nytimes.com/2005/01/04/health/nutrition/04fat.html
   35. http://www.cms.hhs.gov/
   36. http://www.latimes.com/news/nationworld/nation/la-na-medicare2jan02,1,1081095.story?coll=la-headlines-nation
   37. http://www.bearingright.com/