Life Expectancy and Health Trends in Modern Society

To access the various sections of this article, just click on the following sub titles or scroll through the article.

Introduction

What is Wrong with Life Expectancy and Causes of Death Statistics?

Reliable Indicators for Assessing Public Health Trends

Health Trends in Modern Society

Heart Disease as an Indicator of Health Trends

Conclusion

Links and References

Addendum
2004 - 2006 And The Better Health Initiative

Life Expectancy and Health Trends in Modern Society

If we are to assess the effectiveness of our current health care system it is absolutely imperative that we accurately determine in which direction public health is actually progressing. Our ability and will to introduce appropriate health reforms, is clearly proportional to our awareness of the shortcomings of our current health care system as indicated by directional changes in health statistics over time. In which direction, we must determine, is the health of modern society actually progressing? Are we becoming healthier or sicker? Why is it that health experts cannot agree about the answer to this vitally important question? Who is right?

In order to answer these questions it is first necessary to establish the most suitable criteria to use to assess trends in public health. Although it is commonly thought that trends in average life expectancy at birth, and also causes of death statistics, accurately reflect changes in public health, these criteria, for reasons which I have briefly considered elsewhere (see But What about Efficacy? ), are misused, misunderstood, misleading, and totally unreliable as a means of assessing changes in public health. There are much more reliable means by which trends in public health may be assessed and this is the focus of this article. Although this discussion is based predominantly upon Australian data similar trends are also occurring in other Western countries.

The purpose of this article is to reveal the truth, according to current evidence, about directional trends in public health and in so doing to establish and define any need for changes in current medical training and practices. Since priority is given to truth, this article is not intended merely to condone or perpetuate our current health care system, but rather to establish positive directions for future changes.

1. Assessing Trends in Public Health

a) What is Wrong with Life Expectancy and Causes of Death Statistics?
To many, average life expectancy at birth has long been the hallmark for assessing health trends. However, since the infant death rate has been dramatically reduced over the past century, life expectancy at birth figures also show a corresponding improvement ( 29 ). Although statistically, the reduction in infant deaths suggests that people are living longer, this is merely an illusion bought about by the fact that less people are dying at or shortly after birth. If we eliminate the influence of changes in the infant death rate by examining life expectancy at age 65 or 70 years of age, it will be revealed that life expectancy over the past century has increased very little, in the order of 2 - 4 years in America ( 30 ), or around 5 years in Australia ( de Looper - pers. comm. ). Any suggestion that people are living longer merely because fewer infants are dying is merely statistical nonsense. After all, just imagine how long we would all be living if the infant and perinatal death rate was reduced to zero! It cannot be overemphasised that average life expectancy at birth is a hypothetical mathematical figure which, even if it has increased by 30 years, does not necessarily mean that even one person is living 30 years longer, or for that matter, even 1 year longer. 

In spite of the misleading nature of life expectancy at birth figures, it is indeed interesting to note that many "experts" prefer to make this figure much more prominent than figures for life expectancy at 65 - 70 years of age or any actual changes in longevity or life span, the latter figures, by comparison, being rather more difficult to obtain. This popularity of life expectancy at birth figures is perhaps related to the ease with which these figures may be misused to convey a false impression about the effectiveness of modern medical science. If we wish to honestly convey the full significance of such figures it is vitally important that the correct terminology is used and the limitations of the figures are fully explained, something which many authorities appear determined to avoid.

In spite of the limitations of life expectancy statistics it is interesting to observe the ways in which these figures are utilised by health authorities and media outlets. Dr. Wooldridge for instance, the former Australian Minister for Health, has recently stated that "there has been a 20-year gain in life expectancy" ( 31 ) in the past century. Of course there has been a 20 year increase in average life expectancy at birth, but are we living any longer? Similarly, in an attempt to demonstrate the effectiveness of modern medicine a prominent "media doctor" has recently claimed on a Sydney radio station that we are now living 25 years longer than we did a century ago. Although I have contacted the doctor concerned in an attempt to clarify the basis for his statements I have received no response.

Similar statements have been made by other experts and media outlets ( 32, 33, 34, 35 ). According to Ferrari for instance ( 34 ), "babies born in the closing years of this century can expect to live almost twice as long as babies born 100 years ago." Ferrari continues: "Australians are living longer, with the average life expectancy for men rising from 51 years at the beginning of the century to 75 years in the 1990's." Similarly, according to Recer ( 33 ): "human life expectancy has increased by three decades since 1900 and may reach 85 for babies born in this century." Additionally, according to Suter ( 35 ), "one of the greatest changes in our era is that people are now living longer – about 25 years longer than they were a century ago." Suter continues ( 35 ): "people in western countries such as Australia, have gained as much life expectancy in the last 50 years as they achieved in the previous 5,000 years." Although Suter also claims that genetic engineering may even result in "the next generation to be born" having a life expectancy of  "110 or 120 years", it seems that the reverse may be true since genetic engineering has been reported to cause accelerated ageing and premature death ( click here for more info).

A similar theme has been echoed by Humer of Roche Pharmaceuticals (152): "Looking back over the past century, it is clear that medical science has made breathtaking advances. This is shown, for instance, by the fact that life expectancy has risen enormously to around 80 years, compared with 55 in the late nineteenth/early twentieth century when Roche was established. Even so, it is still not possible to treat the causes of most diseases." To describe the inability to treat the "causes of most diseases" as "breathtaking advances" hardly seems appropriate, but even in spite of these breathtaking advances, Humer also emphasises the stark reality of some of the shortcomings of modern drug therapies (152): "

Today we are witnessing the fruits of the past century of medical advances, continuing breakthroughs, and developments in sophisticated medical technology. Deaths from heart disease have increased from 6.2% of total deaths in 1900 to 31.4% in 1997 while cancer deaths have increased from 3.7% to 23.3%. Medical experts now claim that we are also becoming increasingly obese, so much so in fact that obesity has reached epidemic proportions. But these same experts also claim however, as we become more obese and suffer more from cancer and heart disease, we are living longer and longer........and longer. In fact it is claimed that we are on the verge of reversing the ageing process. The past century has indeed been one of remarkable medical progress, but why the desperation for genetic engineering when immortality seems just around the corner?

So what does all this mean? Are we really living 25 years longer and on the verge of immortality? If this were true it would be good news indeed, but another explanation is possible since life expectancy at birth statistics are often misinterpreted. According to the Australian Bureau of Statistics ( ABS ) in this regard ( 29 ), "life expectancy at birth is often wrongly interpreted to mean that most people die at that age." Although average life expectancy at birth has indeed increased by almost 25 years over the past century ( 36 ), as is noted by the ABS this does not necessarily mean that people are living 25 years longer. We must be quite clear about this. It is a well known fact that most of this 25 year increase in life expectancy has, as I have previously indicated, resulted from a reduction in infant mortality and NOT because we are living longer into old age. In the words of the ABS ( 29 ): "the increase in life expectancy is mainly due to fewer deaths of young children, particularly in the first year of life ( infant mortality )." 

In spite of the repeated claims of experts from around the world that life expectancy is synonymous with longevity and total life span, this is the opposite of the truth. While average life expectancy at birth has increased through the 20th century, total life span on the other hand, has apparently remained static ( 80 ) and perhaps may even be decreasing.

According to Nesse and Williams (128): 

The oldest people in the world in recent times normally live until around 114 - 122 years of age ( 118, 119, 120, 121, 122, 123 ). However, 400 years ago the oldest person in the world was Thomas Parr who died at the age of 152 and was said to be healthy right up until his death ( 124, 125, 126 ). We have a long way to go before we get back to the 1600's!!

I believe that when it comes to public health and matters such as life expectancy the public is entitled to be correctly informed. Those who make public statements regarding health matters have a responsibility to maintain a standard of truth and accuracy which will not mislead or deceive the public. With medical issues especially, as we are frequently reminded, only the scientific facts will do. I am at a loss to understand why, if these statistics are as commonly "misinterpreted" as has been suggested by the ABS, steps have not been taken to ensure that the relevant authorities are educated about the correct interpretation and use of statistics. What is most disturbing about this matter is the unanimity of these apparent misinterpretations.

While claims that we are now living 25 years longer are clearly without any factual basis, recent claims by Oeppen and Vaupel ( 57 ) that life expectancy will continue to increase for the foreseeable future are also deserving of comment. Unlike many other workers whose focus involved total life expectancy changes over the past 100-200 years, Oeppen and Vaupel ( 57 ) have adopted a rather different approach which emphasises the regularity and consistency of annual changes in life expectancy over the past 160 years. From this point of view it is not the alleged 25 year total gain in life expectancy over the past 100 years that is important, but rather it is the average annual increase of 3 months over this period which this represents that is emphasised. Oeppen and Vaupel ( 57 ) not only describe this 3 month annual increase as perhaps the "most remarkable regularity of mass endeavour ever observed", but further, they claim that on this basis life expectancy can be expected to increase at this same annual rate for the foreseeable future. In fact, according to Duke University ( 58 ), this study indicates there is "no natural limit to life expectancy."

The importance of the study of Oeppen and Vaupel ( 57 ) is highlighted by the various media reports of this study ( 59, 60, 61, 62, 63, 64 ), typified by headlines such as "life expectancy to soar" ( 59 ), "will life expectancy ever stop rising" ( 61 ), "scientists: human lifespan has no natural limit" ( 61 ), "ever increasing longevity" ( 62 ), and "Japan leads way into new age of longevity" ( 64 ). These reports contradict earlier research which indicated "mankind nears its old age limits" ( 65 ), a view which acknowledges the misleading effects of large reductions in infant mortality ( 65, 66 ). In spite of these reports however, and in spite of the risk of becoming excessively repetitive, I am forced to point out yet again that reductions in infant mortality make the average life expectancy at birth data used by Oeppen and Vaupel totally invalid as a reliable means of assessing total life span or longevity ( 60 ).

In this respect it is indeed interesting to note that although Oeppen and Vaupel ( 57 ) acknowledge that "before 1950, most of the gain in life expectancy was due to reductions in death rates at younger ages", they nevertheless still include this data as a vital part of their evidence that we are living longer and longer. Once again it seems that the fewer infants that die, the longer we all will live. Oeppen and Vaupel have obtained mathematical life expectancy figures which are completely remote from the biological aspects of ageing and longevity ( 63 ). Quite clearly, Oeppen and Vaupel's life expectancy predictions also see the current epidemics of obesity and diabetes as correlating with continuing increases in life expectancy. Interestingly, the increasing incidence of these disorders is consistent with current theories regarding the effects of elevated cortisol levels upon ageing and longevity, theories which are probably of little interest to mathematicians.

When it comes to predicting life expectancy changes in the future it is generally acknowledged that reductions in infant mortality will level off and this will also cause a corresponding levelling off of life expectancy. In other words, life expectancy, which has been artificially elevated by reductions in infant mortality, will increase much more slowly, if at all. Since future changes in life expectancy will therefore be increasingly determined by genuine increases in longevity rather than reductions in infant mortality, this slowdown or reversal of life expectancy provides a considerable incentive for new ( more positive? ) ways of analysing life expectancy data. The study of Oeppen an Vaupel could be seen as answering this need by adopting an approach which may assist in concealing this expected slowdown in life expectancy rates.

I must admit I have found this research into life expectancy to be most informative. I have learned much of which I was previously unaware. The commonly employed technique of using reductions in infant deaths to claim a general increase in life expectancy and longevity has been most illuminating. It conjures up all manner of hypothetical scenarios. For instance, just imagine what could be achieved by deliberately lowering the birth rate. If we could prevent all births, and continue this for 10 years we could completely prevent all deaths ( forgetting immigration ) under 10 years of age. This would have an astonishing effect upon life expectancy. As a general rule in fact, the fewer children that are born, the longer they will live!! Furthermore, using currently accepted criteria for calculating life expectancy, this would be a scientific fact!!

Another difficulty with regard to life expectancy figures relates to claims that any years of extra life that have occurred are considered to be extra years with a disability rather than extra years of healthy life ( 37 ), however I shall consider this matter a little later.

Although many experts use causes of death statistics as a means of assessing trends in public health, as is the case with life expectancy figures, these figures are also frequently misused and misunderstood. Causes of death figures for instance, do not reflect the "incidence" of the various diseases which afflict the human race and therefore may be quite misleading. A person may suffer for example, from heart disease for 20 years and then because he/she dies as the result of an accident, this fact may never be statistically revealed. Similarly, as I have mentioned elsewhere ( see But What About Efficacy? ), cancer patients who die from aggressive medical treatment before succumbing to the cancer, would in effect, serve to lower the cancer death rate.

In view of the limitations of causes of death statistics it is interesting to note that these figures frequently seem to be very popular with health authorities. In fact, causes of death statistics commonly seem to be given a much higher and more public profile than disease incidence rates, especially when the latter figures may not be so positive. As is the case with life expectancy statistics, disease statistics seem to be used in a very selective manner. Statistics for heart disease probably represent one of the best examples of the misuse of causes of death statistics. I will consider heart disease statistics in considerable detail a little later ( see Heart Disease as an Indicator of Health Trends ).

b) Reliable Indicators for Assessing Public Health Trends 
Clearly, the most direct, and therefore the most accurate indicator of health trends is the incidence of various illnesses throughout the community. Unlike life expectancy and causes of death statistics, illness morbidity figures represent a direct measure of health trends in modern society. Given the importance of accuracy in determining health trends however, these figures should also be confirmed by secondary data such as the per capita consumption of prescription drugs and use of medical services. Additionally, since increasing numbers of people are consulting alternative practitioners, changing rates of the use of medical services should also include consultations with non-medical practitioners to give a more accurate picture of the use of health services.

By using illness morbidity figures as our primary source of information combined with this confirmatory data a more accurate and reliable picture of modern health trends may be obtained. While life expectancy and causes of death statistics are often claimed to indicate improving health trends in modern society, let us see what this alternative data reveals.

2. Health Trends in Modern Society

Comparisons between these two systems of health criteria are graphically illustrated by two recent conflicting studies of the health of Australians, namely the study of de Looper and Bhatia ( 45 ), and that of Walker ( 37 ). While de Looper and Bhatia ( 45 ) give prominence to life expectancy at birth and causes of death statistics as a means of evaluating health trends, Walker ( 37 ) on the other hand, refers extensively to chronic illness surveys which reveal the changing incidence of various diseases in Australia. The dramatically different conclusions reached by these workers, being a result of these different forms of public health criteria, are of fundamental importance to anyone who is interested in accurately assessing health trends in modern society. Of these two studies I will begin by considering the study of de Looper and Bhatia ( 45 ).

Probably the most conspicuous aspect of the study by de Looper and Bhatia ( 45 ) is the dramatic difference between the major conclusions publicised in their media release ( 47 ) and other statistical data which remains buried in the body of their report. It seems that prominence is given to those statistics which may be construed as indicating that public health is progressing in a positive direction. For instance, notwithstanding the fact that de Looper and Bhatia draw attention to the fact that Australians are becoming more overweight and are spending more ( per person ) on health, these workers make the following conclusion in their media release ( 47 ): "Australians lived longer and healthier lives in the 1990's" and "life expectancy continues to increase."

Especially in view of these positive conclusions of de Looper and Bhatia it is enlightening to examine other statistical data provided by these workers in the body of their report. As far as life expectancy is concerned for instance, these workers fail to mention in their media release that the life expectancy of 65 year old Australians has only increased by 1.9 years ( men ) and 1.5 years ( women ) during the period 1989 -1999 ( 48 ). More significantly however, de Looper and Bhatia acknowledge in their report that an increasing period of the life of Australians is characterised by a disability. In fact, of the predicted years of life expectancy of Australians "only 57.5 ( 76% - males ) and 63.3 ( 78% -females ) of these years" "are expected to be disability free" ( 49 ). Furthermore, the period of life which is disability free is actually declining as more people spend more years of their lives suffering from one or more disabilities. According to de Looper and Bhatia ( 49 ), the expected years of life with "core activity restriction" increased by 87% and 58% for Australian men and women during the period 1981 - 1998. It is absolutely astonishing that these vital figures were omitted from the media release of de Looper and Bhatia.

In summary then, according to de Looper and Bhatia, Australians are becoming healthier but yet they can expect to spend an increasingly greater period of their lives suffering from one or more disabilities.

It must also be emphasised, in spite of a very common misconception to the contrary, the increasing number of years of life Australians are spending with one or more disabilities or chronic illnesses is not due to an increasing life expectancy. This point is made quite clear by the fact that although life expectancy of 65 year old Australians increased by only 2.3 - 2.9% between 1989 - 1999 ( 48 ), during the period 1981 - 1998 the expected years of life with "core activity restriction" increased by 58% for women, and 87% for men ( 49 ). Quite clearly, the number of years of healthy life of Australians is declining very dramatically whereas any increases in statistical life expectancy are extremely small.

In total contrast to the conclusions of de Looper and Bhatia regarding the health of Australians, according to a detailed study by Walker ( 37 ), which is based upon the incidence of various illnesses, the health of Australians has deteriorated significantly over the past few decades. The data cited by Walker indicates that this deterioration in health is apparent across the entire spectrum of human illnesses, from less serious illnesses right through to more severe or terminal illnesses. Interestingly, as was also the case with de Looper and Bhatia, Walker ( 37 ) reported a significant increase in the per capita use of medical services during the study period.

Walker emphasises the fact that this deterioration in the health of Australians has occurred in spite of continuing medical breakthroughs and "heightened awareness and responsiveness of people to health issues." Walker continues ( 37 ): "the statistics show that many stopped smoking, adopted healthier eating habits and took up regular exercise. Also, the population had access to improved immunisation schemes and to cancer and other screening programs. In addition, health expenditures continued to rise as a share of GDP, suggesting improvements in and/or more frequent usage of medical services."

Walker also notes that her findings have been confirmed by various other studies, both in Australia and also in other countries. Other workers cited by Walker note, with regard to the alleged increase in life expectancy, that any years of life that have been gained are actually "extra years with a disability, not extra years of healthy life" ( 37 ). These trends have recently been confirmed again by the Australian Health Survey of 2001 which found that a staggering 87% of people over 15 years of age had "one or more long term medical conditions", an increase of 4% since 1995 ( 143 ). At this rate, in less than 20 years 100% of Australians will suffer from a long term medical condition.

If the findings of Walker are accurate then quite clearly they should also be confirmed by other data such as the sales of pharmaceuticals and prescribed drugs. Data published by the Australian Pharmaceutical Manufacturers Association (APMA) in their Facts Book ( 50 ) reveals that that the sale of pharmaceuticals is increasing at an astonishing rate, in total agreement with the research of Walker ( 37 ). While the world pharmaceutical market is worth around $US300 billion annually ( 51 ), Australian sales total around $6.04 billion ( 52 ), which represents an increase in sales of around 260% in ten years ( 52 ). In the past decade drug companies have developed in excess of 300 new medicines for the Australian market ( 53 ), correlating with a doubling in growth of the pharmaceutical industry between the years 1990 - 1995 ( 52 ). During this same period production from other Australian industries actually diminished ( 52 ).

In the six year period from 1992 -1998 there was a massive 117% increase in the number of prescribed drugs for "peptic ulcers/ reflux", while in the same period prescriptions for antidepressants increased by 60% ( 54 ). In spite of these massive increases, the Australian Institute of Health and Welfare makes the point that increases in the numbers of prescriptions for a specific drug are not an accurate indication of drug usage ( 54 ). This is because prescription numbers do not reflect increasing consumption due to increased dosages ( 54 ). To eliminate this error the Institute suggests that the "defined daily dose" ( DDD ) of a drug provides a more accurate picture of changes in drug consumption. If we examine the DDD of antidepressants we observe that the consumption of these drugs has almost tripled in only six years ( 54 ). This is a staggering increase, especially in view of the development of the supposedly more effective new generation antidepressants. Once again the same pattern emerges, the more drugs we take, the more we seem to need more.

The changes occurring in the use of health services within Australia are typical of changes occurring throughout the Western world. In Canada for instance, the sales of drugs increased by 11.4% in 1999 as compared to 1998, reaching a total of $8,306 billion ( 55 ). Canadians had an astounding 22 million more visits to the doctor in 1999 than they did in 1998 ( 55 ).

One reason why we need more and more prescription drugs is because succeeding generations are becoming sicker at younger and younger ages as compared to their predecessors. Throughout this web site I have expressed concern regarding the long term consequences of symptomatic medical treatments the aim of which is to conceal any underlying disease and encourage it to continue unchecked. The possible consequences of this type of symptomatic disease "management" strategy is especially important when it comes to genetic diseases which may be expected to become more rampant in the next generation if the underlying cause is not addressed. Increasingly it is being realised that this is precisely what is happening. Genetic diseases are becoming more severe and occurring at younger ages in succeeding generations, a phenomena which has been termed "genetic anticipation" ( 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142 ). Does this mean that even those who merely have (undiagnosed) subclinical disease may produce children with a fully developed genetic disorder? Does genetic anticipation also effect genetic nutrition (ie those who have a genetically increased need for certain nutrients - see Nutrigenomics and the Bold New World of Individualised Nutrition).

The onus is clearly upon those who claim we are becoming healthier to explain precisely why we are becoming sicker at younger and younger ages and why healthier people have an increased need for prescription drugs. They must also explain why, as we become healthier, we are becoming more obese and suffering increasingly from both the major and minor diseases of modern Western society. Paradoxically, it seems that those authorities who claim that modern medicine is so effective that we are on the verge of reversing the ageing process are also frequently the most ardent supporters of genetic engineering. The urgency and desperation with which genetic engineering is being embraced by the scientific community however, is a clear and confident admission that conventional medical therapies have not only failed in the past, but furthermore, they are expected to continue failing in the future. In this enlightened age it is becoming increasingly clear that diet and nutritional therapy may be more effective, especially preventatively, than all the dazzling medical technology that has emerged during the past century. Even doctors are describing many modern diseases as "lifestyle" diseases, a traditional holistic message which has long been ridiculed. The naturopaths and herbalists of the past, traditionally regarded as quacks by the medical profession, are leading the way into the 21st century!

Heart Disease as an Indicator of Health Trends

In spite of the numerous high tech medical advancements and breakthroughs which have occurred over the past century heart disease has become the number one killer in modern society. It is vitally important that we explore the reasons for this and examine directional trends in the incidence of heart disease. I should perhaps point out that the term "cardiovascular disease" includes heart disease, strokes and peripheral vascular disease ( 16 ). 

One hundred years ago, in 1900, both heart disease and cancer were virtually unknown. Both these diseases are an invention of the 20th century. The increasing prominence of heart disease or cardiovascular disease ( CVD ) parallels the development of scientific medicine in the 20th century. In 1900 deaths from heart disease and cancer represented, respectively, just 6.2% and 3.7% of total deaths ( see thumbnail ). By 1997 these figures had increased alarmingly to 31.4% and 23.3% representing increases of 506% for heart disease and 629% for cancer ( 68, 69, 71 ). After the past 100 years of advances and breakthroughs in scientific medicine, today, the sad truth is that heart disease and strokes claim the life of an Australian every 10-12 minutes( 42, 108 ). In America a person suffers a "coronary event" every 29 seconds while a fatal heart attack is experienced every minute ( 109 ). In the UK heart disease claims a life every 3 minutes ( 110 ).

(Note: the above graphic does not list deaths from iatrogenic diseases)

When it comes to death rates for heart disease and cancer, many health authorities are extremely selective about the data they use. Although many authorities quote life expectancy data for the past 100 years, when it comes to heart disease and cancer death rates this 100 year period is persistently avoided. Most authorities are very careful to utilise figures only for the past few decades or the latter part of the 20th century. There is a very good reason for this since if we compare heart disease and cancer death rates in 1900 with those in 2000 a very grim picture emerges.

The truth is that death rates ( per 100,000 ) for heart disease and cancer have increased, respectively, by a massive 237-322% and 332-359% from 1900 to 2000 ( 67, 70 ). Most authorities display a determination to avoid these figures and focus exclusively upon figures for the latter part of the 20th century which reveal a decline in heart disease deaths. It should be noted however, that not only is this decline in heart disease deaths diminishing ( 72, 73 ), and may even be reversing ( 72 ), but furthermore, the incidence of CVD is still increasing ( 16, 43, 74  ). Even if the current rate of decline in heart disease deaths were to continue it will take many years before we get back to where we were in 1900. With cancer the situation is even worse since there is still no significant and sustained decline in cancer deaths.

The facts relating to heart disease are of vital importance in assessing the effectiveness of modern scientific medicine since it has been repeatedly stated that the decline in heart disease deaths over the past few decades is one of the greatest of all the achievements of modern medicine ( 75, 76 ). However, when medical experts describe a disease which kills an American every 60 seconds and has a death rate which is still more than 200% higher than it was in 1900, as one of the greatest achievements of modern medicine there is clearly cause for considerable concern. There is no doubt what would have occurred if alternative medicine had boasted of a similar "achievement".

Even though health authorities often claim that CVD is declining in Australia, it must be emphasised that such claims are based upon the death rate rather than the incidence of CVD ( 41, 42 ). In reality, the incidence of CVD in Australia has increased from 17.4% in 1990 to 20.9% in 1995 ( 43 ). In this five year period the number of Australians suffering from CVD increased by 29% ( 16, 43 ). Furthermore, this increase is not due to the ageing of the population ( 16, 44 ). According to the ABS in this regard ( 44 ): "age-standardisation of the data indicated that over this period the ageing of the Australian population played only a small part in the increase in prevalence of cardiovascular disease." The ageing of the population, it should be noted, is due predominantly to the declining birth rate ( 27, 28 ). Australia is not alone when it comes to the increasing prevalence of heart disease since this is a trend which is occurring throughout the world ( 127 ).

In spite of these facts health authorities seem reluctant to mention the fact that the incidence of CVD is actually increasing ( 40, 41, 42 ). Even the Heart Foundation of Australia  seems to focus exclusively upon the death rate rather than the increasing prevalence of CVD ( 42 ). Similarly, although de Looper and Bhatia ( 45 ) supply data in their report for both the incidence and death rates for certain diseases, when it comes to heart disease they chose to include the death rate and omit the incidence rate ( 46 ). Quite clearly, most medical authorities seek not to give prominence to the increasing incidence of heart disease ( 16, 40, 43, 74  ) or the astonishing increase in heart disease deaths which have occurred over the past century ( 67, 70 ). Instead of acknowledging responsibility for this situation health authorities seek praise for the recent decline in heart disease deaths.

Although health authorities may suggest that heart disease is becoming less prevalent because of the declining death rate, it is interesting to note the astonishing increase in the use of emergency surgical procedures which has been required to treat heart disease patients over the past few decades. Heart bypass operations for instance, which only began in Australia around the late 1960's ( 81 ), increased to around 17,000 operations annually in 1998 ( 81 ). Bypass operations increased around 400% from 1980 to 1998 ( 81 ). From 1985 to 1999 the use of coronary angioplasty increased more than 1000% ( 81 ). Furthermore, in the 1990's coronary stenting was introduced to "reduce the risk of early closure of the coronary artery following coronary angioplasty" ( 81 ). Not only is their a high rate of reblockage following coronary angioplasty ( 81 ), which may incidentally be significantly reduced by vitamin therapy ( 82, 83, 84 ), but furthermore, the occurrence of reblockage is a feature of bypass operations also ( 81 ).

It cannot be overemphasised that the use of these surgical procedures represents desperate last minute attempts to save the lives of patients whom the health care system has failed. The need for such procedures is clearly proportional to the extent to which medicine has failed at the preventative level. Since such procedures are not cause based and play no role in prevention it is hardly surprising that the incidence of heart disease is still increasing. Are we content to continue to try and patch up our ailing hearts without addressing the cause?

Recognition that heart disease cannot be properly addressed by symptomatic interventionist techniques has eventually led to scientific medicine acknowledging the traditional holistic teaching that health is indeed influenced by lifestyle factors. Unfortunately this is a lesson which has been learned agonisingly slowly and in fact, has still not been fully learned. Although the connection between diet and heart disease, particularly the saturated fat content, is now generally acknowledged by modern medicine, the importance of optimum nutrition is still frequently disputed. Even when it comes to correcting excess dietary fat consumption, the medical solution is not necessarily dietary but rather involves the consumption of even more prescription drugs. Medicine it seems, will continue to cling to its symptomatic drug oriented interventionist approach to health care.

It is interesting to note for instance that orthodox medicine continues to display an obsession with drug treatment as a first option to reduce cholesterol levels. In 1998 for instance, Australian doctors wrote nearly 7 million prescriptions for cholesterol lowering drugs, an increase of more than 300% in only six years ( 54 ). In fact, Simvastatin had become the fourth most prescribed drug in 1997-98 ( 54 ). By 2000-2001 cholesterol lowering drugs had become the first and second most prescribed drugs in Australia ( 79 ).  Remarkably, this amazing achievement occurred in a medical environment which is highlighting the importance of lifestyle factors such as diet and nutrition. It seems that when there is a drug option this will automatically be preferred to lifestyle factors. However, in spite of the increased use of cholesterol lowering drugs the cholesterol levels of Australians has not changed in 20 years ( 78 ). Since the cause of excessive cholesterol levels is generally accepted as being dietary ( 78 ), cholesterol lowering drugs are being used in preference to dietary changes.

That this astonishing increase in lipid lowering drugs could occur at all, let alone when medicine is publicly espousing the importance of diet, is deplorable. What does this single fact say about the health of Australians? Why has it become necessary to medicate so many Australians to lower their cholesterol levels? While I acknowledge the fact that the health of Australians is deteriorating, is it really deteriorating at such an astonishing rate? At this rate of increase in another twenty years our consumption of lipid lowering drugs will have increased by almost 1000%. All this when we are having more and more heart surgery and are apparently becoming healthier. It is just as well medicine has changed its focus to emphasise the importance of lifestyle factors!!

While the influence of lifestyle factors upon heart disease was initially thought to be confined to such factors as dietary fat content, exercise, smoking and obesity, increasing evidence has forced modern medicine to acknowledge the importance of optimum nutrition for cardiovascular health. Perhaps the greatest breakthrough in this respect was the discovery that elevated homocysteine levels, caused by deficiency of vitamins, could cause arterial damage either by a direct toxic effect or by oxidising cholesterol deposits ( 85, 86, 87, 88, 89, 90, 111, 113 ), a fact which some authorities believe makes cholesterol levels per se relatively unimportant ( 93 ). With much reluctance, the medical profession has now generally accepted the fact that supplements of vitamins B6, B12 and folic acid may lower homocysteine levels and significantly reduce the risk of heart disease ( 86, 91, 92, 93, 111, 113 ). Conversely, large doses of B3 as are sometimes used by doctors to treat circulatory disorders, may actually elevate homocysteine levels ( 113 ). 

According to accumulating scientific evidence there are also many other nutrients that are necessary for a healthy cardiovascular system. These include vitamin E ( 90, 93, 94, 95, 112 ), vitamin C and bioflavonoids ( 90, 93, 94, 95, 112 ), beta carotene ( 90, 93, 112  ), magnesium ( 90, 98, 99 ), selenium ( 90, 97, 112 ), copper ( 112 ), zinc ( 112 ), manganese ( 112 ), carnitine ( 90, 96 ), chromium ( 90, 114 ), and essential fatty acids ( 90, 100, 101, 102, 103  ).

When it comes to nutrition and heart disease medical experts have yet to learn the lessons taught by Roger Williams  more than three decades ago ( 115 ):

In further confirmation of the nutritional cause of heart disease is the observation that dietary fat intake is not necessarily related to the occurrence of cardiovascular disease. It has long been known, from studying different cultures throughout the world, that people who consume up to 355 grams of fat daily and consume a diet in which 60% of the calories come from saturated fat have been shown to have virtually no heart disease ( see: Lowenstein, F.W., Am.J.Clin.Nutr., 15, 175, 1964; and other studies reviewed by Williams, 115 ).

In spite of overwhelming evidence of the importance of nutrition, medical research is still frequently characterised by a pronounced anti-nutrition bias ( see Medical Bias ). Medical researchers still resort to brief highly selective trials to discourage the use of nutrition and justify the use of modern symptom based surgical or drug therapies for heart disease ( 104, 105, 106, 107 ). These treatments continue to be recommended even though they offer no hope of cure. When it comes to heart disease I give absolute priority to one clinical trial - a trial which began in 1900, continued for 100 years and involved people throughout the world. 

The results of this clinical trial are absolutely conclusive. In spite of continuing "breakthroughs", increasing reliance upon surgery and drug therapy over the past 100 years has correlated with heart disease emerging from virtual obscurity to become the number one killer throughout the world. While heart disease deaths have declined in the past few decades, a fact which may be partly due to increasing interest in nutrition and nutritional fortification of foods ( 92 ), the increasing incidence of heart disease combined with the staggering increase in consumption of hypolipidemic drugs and heart surgery, is cause for alarm. If our hearts continue to fail at such a rapid rate not only will the use of such symptomatic patch up treatments soon reach epidemic proportions, but furthermore, there will also be an increasing need for artificial hearts and other heart "spare parts".

The medical profession's rejection of the importance of nutritional therapy and the processing of nutrients out of our foods has correlated with a constantly increasing incidence of chronic diseases such as heart disease, cancer, and diabetes. In fact, the past 100 years of scientific medicine has been characterised by an unprecedented deterioration in health due to chronic diseases. Paradoxically, the century during which vitamins were discovered is also the century during which more was done to process the vitamins out of our foods than ever before. While most health indicators over the past 100 years reveal that scientific medicine has had a decidedly negative impact there are some benefits. The triumph over certain infectious diseases is most notable in this respect. 

Additionally, modern scientific medicine has created a phenomenal world wide dependence upon pharmaceutical drugs which has resulted in the emergence of a brand new epidemic of diseases called iatrogenic diseases. It is this epidemic of iatrogenic diseases which is claimed to be largely responsible for the correlation between increased numbers of doctors and increased mortality. According to Richardson & Peacock in this regard (151) "an increase in the doctor supply is associated with an increase in mortality".

Richardson and Peacock continue (151):

As if this is not bad enough, Richardson & Peacock (151) further point out that "it is now known that nutrition has been the major determinant of mortality in the last 200 years" and people generally have "an erroneous and exaggerated belief in the efficacy of modern medicine." Clearly, the challenge is for health authorities to urgently address these erroneous and exaggerated beliefs. To this end the public should be immediately advised that modern scientific medicine is not equipped to diagnose and treat nutritional disorders. 

History shows that virtually every nutritional discovery, whether involving thiamine and beri beri, folate and birth defects, folate and heart disease, vitamin B6 and heart disease, vitamin E and heart disease or the many other nutritional discoveries, has been rejected and scoffed at by medical science, and eventually accepted only begrudgingly. Resort is repeatedly given to the use of clinical trials to justify medicine's drug oriented approach to health care ( or disease care ). Such an attitude is consistent with a belief that disease results from mysterious extraneous influences which arbitrarily inflict themselves upon the body rather than being the result of a deviation from the normality that results from optimum nutrition.

Yet, unlike drugs and surgery, nutrition is overwhelmingly safe and natural. Nutrients form the substance of every cell in our bodies and are required for every metabolic reaction. Unlike drugs and surgery, nutrition promotes health, vitality and normality. The natural function of nutrition is to restore to normal or optimum. Nutrition is an absolutely integral and inseparable part of health. Medicine however, prefers to use toxic foreign compounds which have absolutely no role to play in the healthy body. While the effectiveness of drugs depends upon their ability to conceal symptoms, nutritional supplements on the other hand, which have no symptom suppressing ability, rely on their ability to normalise or cure.

For obvious reasons, the truth about heart disease and cancer mortality in the 20th century has been carefully concealed. The appalling increases in these diseases necessitates that we urgently identify and change contributory factors within our "scientific" health care system. Modern medicine must explain why automatic preference continues to be given to toxic or invasive heart disease treatments which offer no hope of cure. Is it surprising that heart disease continues to be the number one killer when doctors are so determined to avoid utilising those substances which form such an integral part of normal health and well-being?

Conclusion

In spite of the fact that those who have a vested interest in our current orthodox medicine based health care system have a history of putting a spin on figures related to health trends, there is absolutely no doubt that the practice of orthodox medicine has coincided with a continuing deterioration in major public health indicators. The following health indicators confirm this simple fact.

• Heart disease and cancer death rates have increased by more than 200% - 300% in the past 100 years and the incidence of heart disease is still increasing.
• Health surveys reveal that an increasing number of people are suffering from one or more chronic illnesses.
• The incidence of various disorders, including diabetes and obesity, are increasing throughout the Western world.
• There has been no increase in total life span or longevity over the past century. Although we are managing to prolong the lives of many who are ill we are also becoming sicker earlier in life. 
• More people are spending a greater period of their lives suffering from one or more disabilities. This is not related to increased life expectancy.
• There is a continuing increase in the per capita use of medical services - although more people are going to the doctor more often, they are becoming sicker in spite of reductions in smoking and increasing use of diet and exercise programs.
• There continues to be an astonishing increase in the use of pharmaceutical products and prescription drugs - a fact which correlates with a deterioration in public health. The more drugs we take, the sicker we are becoming.
• The incidence of iatrogenic diseases is increasing alarmingly and has now become the third leading cause of death behind heart disease and cancer.

The direction in which public health is progressing under the influence of scientific medicine is made abundantly clear by the astonishing rapidity with which the three leading causes of death have skyrocketed to their current positions of ascendency. There is no cure in sight for the current epidemics of heart disease, cancer, and iatrogenic disease. If our health care system remains fundamentally reductionist, symptomatic and interventionist, all the available evidence indicates that these, and various other chronic diseases, will be the diseases of the future. Holistic therapies such as nutrition on the other hand, increasingly offer an effective solution.

As a patient, I must admit that I find it absolutely astonishing how little concern is shown by health care professionals regarding the current direction of our health care system as evidenced by the above facts. Many in the profession still seem to pretend, on the basis of life expectancy at birth figures, that we are living longer and becoming healthier. This is cause for real concern. Why is it, one may well ask, that so many medical authorities and other health care professionals prefer not to publicise the importance of life expectancy at 70 years of age? Why do so many experts prefer to publicise life expectancy at birth figures and ignore statistics which reveal spiralling increases in the incidence of chronic illnesses and disabilities? Why also do so many authorities refuse to publicise the appalling increase in heart disease and cancer deaths which have occurred over the past century?

To deliberately mislead or deceive the public by misuse of life expectancy and causes of death data is totally unacceptable and reflects very poorly upon the integrity and reliability of anyone who indulges in such practices. Yet, the consistency and apparent determination with which many "experts" avoid revealing the precise meaning and limitations of health statistics is amazing. Such persons also tend to display a preoccupation with a purely mathematical approach to life expectancy, an approach that is so remote from any consideration of the biological aspects of ageing and longevity that it is also completely detached from the real world. Such authorities also commonly display a determination to avoid real life data showing increasing disease rates in modern society. Instead of enshrouding life expectancy in a cloud of confusing and misleading figures, no effort should be spared in ensuring such figures are totally transparent.

Time and again we see that the actions of health authorities are consistent with a desire to abandon public health concerns in order to protect and perpetuate our current medical system.

Also disturbing is the current move towards corporatised medicine. Corporatised medicine of course, seeks to create an environment in which medical decisions will be increasingly dictated by profits, not patient care ( 56 ). Already, it has been reported that there are higher death rates at "for profit" hospitals as medical services may be restructured to suit the healthy rather than the sick ( 56 ). As medicine becomes corporatised  private hospitals are rejecting the more severely ill in preference for "easy fix" patients who are considered to be more profitable, a process which is described as "cherry picking" (144, 145, 146, 147, 148, 149, 150). One patient, who subsequently died, was initially admitted to hospital but was suddenly discharged and told there were "no beds" when it was discovered that she did not have private health insurance (145).

Medical decisions are increasingly being made by accountants, economists, and bureaucrats. The doctor of the future will be forced to spend an increasing amount of time being trained to juggle the conflicting interests of patient care and reducing costs. He/she will need to become more adept at minimising costs without sacrificing the life or well being of the patient. Patients with complex problems whom it is not considered cost-effective to treat will be placed well down the priority list. In fact, patients who are extremely ill may be seriously disadvantaged by a system which prefers to prioritise on the basis of cost rather than compassion. In spite of these facts, why is it that so few within the health care profession are seeking to alert the public to the dangers of corporatisation?

It seems amazingly incongruous that those who are concerned about the cost effectiveness of our health care system are also completely unconcerned about the symptomatic interventionist nature of this system. Although seemingly unpopular, the cost advantages of a cause based preventative health care system are obvious. Symptomatic treatments are inherently expensive, especially in the long run. Patients are forced to return to doctors time and again, perhaps for 40 or 50 years, simply in order to have the same symptoms suppressed. Cost effective preventative treatments, such as nutritional therapy, are avoided in favour of expensive operations with all their complications. Health funds often refuse to cover preventative nutritional tests and treatments, preferring instead to wait until expensive surgery becomes necessary. Is it just the lucrative human repair industry we are trying to promote rather than a compassion based preventative health care system? 

The evidence is clear. In spite of the ever increasing health budget, more and more visits to the doctor, and a huge increase in the consumption of prescription drugs, we are becoming sicker. Are we going to continue to ignore this evidence? Are we going to continue to pretend that eliminating infant deaths will somehow cause the entire community to live longer ( ie. increase life expectancy)? After 300 years of the application of reductionist science in the fields of medicine, nutrition, food technology, and agriculture, the health of mankind is deteriorating, even in spite of the triumphs of medicine in certain fields ( ie. the conquering of certain infections ). Perhaps when patients become more important than profits or perpetuation and protection of the medical system itself we will be in a position to initiate an evidence and compassion based health care system. Let us return the focus to patient care. 

Let us accept the need for fundamental change and move forward by creating a safer and more effective health care system Let us move forward with an urgency that reflects our concern about the needless suffering of patients. In doing so our health care system will also become much more cost effective - but for all the right reasons

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122.http://www.cbsnews.com/stories/2002/03/19/national/main504094.shtml
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124.http://healthy-natural-body.freeyellow.com/p48.htm
125.http://www.westminster-abbey.org/library/burial/parr.htm  See: Westminster Abbey, The Library and Archives, People Buried or Commemorated. 
126.Williams, R.J., Nutrition in a Nutshell, Doubleday and Co. Inc., New York, 1962.
127.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=Pub  See: Suter PM, Vetter W., Nutr Rev 2000 Oct;58(10):319-23.
128. Nesse, R.M., Williams, G.C., Why We Get Sick; The new science of Darwinian Medicine, Vintage Books, NY, 1996.
129.http://www.medscape.com/viewarticle/457974?mpid=15501&WebLog See: Thomas Heiberg Brix, et al, Thyroid 13(5):447-451, 2003.
130.http://www-east.elsevier.com/ajg/issues/9312/ajg678edi.htm  See: Theodore M. Bayless , et al, Amer. J. Gastr., 93, 2322, 1998.
131.http://hmg.oupjournals.org/cgi/content/abstract/8/13/2473  See: DG Monckton, et al, Human Molecular Genetics, Vol 8, 2473-2478, 1999.
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143.http://www.abs.gov.au/Ausstats/abs@.nsf/e8ae5488b598839cca2568  See: 4364.0 National Health Survey, 2001, Australian Bureau of Statistics, Canberra.
144.http://www.ama.com.au/web.nsf/doc/SHED-5EXHMG See: Dr Mukesh Haikerwal, President AMA Victoria, with Linda Mottram, Radio 3LO 'AM', 22 October 2001.
145.http://www.abc.net.au/7.30/s399640.htm  See: Mark Bannerman, Mayne Health denies selecting patients for profit, 7-30 Report, ABC TV, 24th Oct. 2001.
146.http://healthplus.com.au/pages/news.asp?NewsID=127  See: Corporatised healthcare rorts Medicare, Health Insurance Fund of WA.
147.http://old.smh.com.au/news/0110/24/national/national10.html  See: Mark Metherell and Mark Robinson, Corporate healthcare is bad medicine, says report, Sydney Morning Herald, October 24, 2001 .
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150.http://www.theage.com.au/cgi-bin/common/printArticle.pl?path=/articles  See: David Wroe, Ian Porter, Doctor anger savages Mayne, The Age, April 25 2002.
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ADDENDUM

 2004 -2006 And the Better Health Initiative

The Australian Institute of Health and Welfare (AIHW) has been busy once again repackaging and recycling the same old misleading statistics with their latest reports into the health of Australians (1, 2, 3, 4). They still claim, as infant mortality decreases and fictitious average life expectancy at birth increases, that we are all living longer and longer (1, 2). As fewer babies die we can all expect to live longer and longer. Although they admit that (4) "reductions in infant and child mortality have been the greatest contributors" to improvements in life expectancy this information is not highlighted. The Institute continues to try and mislead the Australian public by inferring this reduction in infant deaths and increase in average statistical life expectancy means we are living longer. For instance, the following passage and sub heading from their report is extremely misleading to say the least (2):

Okay this is all very interesting, but the subtitle suggests there is some evidence here that we are living longer. Why is the Institute once again seeking to link average life expectancy at birth with total life span when they admit elsewhere it has more to do with infant mortality? It is interesting to know that the health of people in many other countries is deteriorating more quickly than it is in Australia and their infant mortality has not improved to the same degree but how much longer are we actually living and why the misleading subheading? 

The Institute continues (2):

Once again, no mention here of the fact that life expectancy has improved predominantly through reductions in infant mortality and NOT because of increases in total life span. Once again (statistically speaking), according to the Institute, the fewer infants that die, the longer they will live!!

It would appear, according to life expectancy statistics cited by the Institute, that those who wish to maximise their life span should forget about adopting a healthy lifestyle and simply begin a campaign to encourage total birth control!!

As I have indicated previously, the Australian Bureau of Statistics (6) has warned about the misuse of average life expectancy figures to infer gains in longevity and it is absolutely despicable that this problem is being further accentuated and perpetuated by the AIHW. As has been noted by Goldhamer (7), "Mark Twain proclaimed that, 'There are lies, damn lies, and statistics.' Surely he is not alone in the conclusion that statistics don't lie, but liars use statistics."

I appeal to the AIHW to immediately clarify this situation, as has already been done by the Australian Bureau of Statistics (6), by including within every subsequent publication concerning life expectancy or longevity a clear warning about the misuse of life expectancy statistics to infer gains in total life span and longevity. Failure to do so is to encourage the perception that the AIHW is deliberately attempting to deceive the public.

But the Institute also claims, yet again, that we are not only living longer, we are also much healthier (1, 2). According to the Institute, increasing rates of diabetes, obesity, and mental diseases,  increasing expenditure on pharmaceutical drugs, and increasing use of emergency surgical intervention for heart disease, correlate with improved health and a longer life (1, 2). Given the Institute's claim however, that (4) "healthy people feel and function well in body and mind, and are in a condition to do so for as long as possible", it is interesting to observe their unsupported claims that (1) "Australians are living healthier as well as living longer", the (3) "2004 health verdict is very good to very good plus", and (2) "the overview that emerges is one of health status that is improving substantially."

It seems the future is rosy indeed. As (1) "Australians are living healthier as well as living longer"  total health spending in Australia has blown out to $72.2 billion or $3,652 for every person (8, 9) while increasing dependence upon prescribed drugs has resulted in the need for 158.5 million prescriptions in 2002-03 (4). With increasing rates of diabetes, obesity, mental diseases and a dramatically increasing need for emergency surgical procedures for heart disease, all correlating with improved health and a longer life span, it seems the Institute's claimed  improvements in health and longevity are equalled only by the ballooning size of the pharmaceutical and health care industries (8,9)!! In spite of all this the Institute assures us that our health system is "world class" (4). Presumably, if we were not so ill and not so dependent upon prescription drugs and emergency heart surgery it would not be world class.

Although the AIHW notes that the use of heart by pass operations in Australia increased by 400% in 18 years ( 5 ) while the need for coronary angioplasty increased by 1000% in 14 years ( 5 ), the Institute reassures us that we are living longer and becoming healthier. Remarkably, the Institute also claims that this increasing need for emergency heart surgery correlates with a significant reduction in the incidence of heart disease (2). Apparently, according to the Institute, as the incidence of heart disease declines the need for emergency surgical intervention to save our ailing hearts can be expected to skyrocket. Since the Institute claims that the incidence of heart disease has declined, then clearly, according to the AIHW, we are performing more and more heart surgery on fewer and fewer heart patients!! Just imagine how much heart surgery would be required if there was only one heart patient!! 

In another publication however, the AIHW draws attention to the fact that hospital admissions for cardiac disease are actually increasing (as we become healthier!) although they claim that this does not necessarily reflect the true incidence of heart disease (10). According to the AIHW in this respect (10):

The Institute attempts to explain these findings thus (10): 

In further support of the increasingly high incidence of heart disease is the fact that cardiovascular disease is responsible for the greatest expenditure on disease in Australia, amounting to $5.4 billion in 2000-01 (11).

In summary then, according to the AIHW, fewer people are dying from heart disease, fewer people are suffering from heart disease, but more and more people are being admitted to hospital for heart disease and more and more heart surgery is being performed, all as we become healthier and live longer. It's just as well our health is improving!!

Another curious aspect of data provided by the Institute is the fact that when statistics suggest negative health trends are occurring, or a particular disease is becoming increasingly prevalent, then the Institute often seems to question their own survey methodology and claim that any increase may not be real but may be due to statistical anomalies or improved diagnostic techniques etc. (2). This applies to increases in mental diseases (2), arthritic disorders (2), and, as I have noted above, heart disease (10) . Amazingly however, when the Institute claims a disease is reducing in prevalence, they never seem to suggest that this may be due to survey problems or statistical anomalies. Scientific evidence apparently reveals that survey problems and statistical anomalies always work in one direction to give a false negative picture of health trends!! 

A further amazing conclusion of the AIHW from the above data is that the health sector is becoming more effective. The Institute cites various statistics to confirm this increasing effectiveness of modern medicine. The following statistic cited by the AIHW is top of their list as an indicator of the increasing effectiveness of modern medicine (2): 

When such data provides the most notable evidence of the effectiveness of our health care system there is absolutely no question about the direction in which we are progressing.

Apparently, according to the AIHW, the health of Australians is wonderful, we are living longer and becoming healthier, and our high tech scientific medical system is becoming increasingly effective. So effective apparently, that heart surgery and pharmaceutical drugs can be expected to lead the way as growth industries well into the foreseeable future. 

Our health care system, and the health of Australians, are apparently considered to be in such dire straights in 2006, in spite of the above claims of the AIHW, that the Commonwealth government has finally decided to introduce a "better health initiative" (12,13). So although, according to the AIHW, Australians are living healthier as well as living longer", the (3) "2004 health verdict is very good to very good plus", and (2) "the overview that emerges is one of health status that is improving substantially", we now need a "better health initiative."

According to the Commonwealth government this "better health initiative" is necessary for the following reasons (12,13):

So although "Australia has one of the best health systems in the world, and one of the highest life expectancies" chronic illnesses are spiralling out of control due to the failures of modern scientific medicine and therefore we need a "better health initiative". The suggestion that this is occurring "as the population ages" is also interesting. Since total life span has not increased and the main reason for the "ageing of the population" is that there are proportionately fewer younger people, the government is suggesting here that as the proportion of younger people declines the incidence of chronic illnesses can be expected to increase significantly!

So what is a "better health initiative"?

It seems this so called "better health initiative" is simply an attempt to acknowledge, implement, and incorporate within modern medicine, natural forms of health care which have traditionally been taught by naturopaths and other natural health care practitioners but which have previously been rejected as quackery by modern medicine. In the words of the government (12,13):

So there is an agonisingly slow recognition that the tools of modern medicine, namely drugs and surgery, have been a dismal failure when it comes to prevention, optimum health, and chronic diseases. It is indeed interesting to note that Tony Abbott, the Minister for Health and Ageing, gave a speech on 20th September 2006 on the following subject (14):

"What if We Could Start Again? Elements of an Ideal Health System"

So the better health initiative is occurring within the context of a failing medical system and talk of "starting again" and forming an "ideal health system". Of course, as I have pointed out elsewhere (see Integrated Medicine, Australian Government Inquiry into Complementary and Alternative Medicine), it is ridiculous to speak of significant changes to our health care system until we first identify in detail the exact faults in our current system. Simultaneously, as attempts are being made to restructure medicine and include within medicine many traditional practices and beliefs of alternative or natural medicine, there is also a drive to take control of the alternative medicine industry (see Alternative Medicine, Pan, and Codex, Australian Government Inquiry into Complementary and Alternative Medicine ).

So though we are living longer and becoming healthier, it seems our health care system has failed us so badly we must "start again". Perhaps our "next" health care system will be based upon caring, compassion, and prevention, and not profits. And perhaps it will be based upon honesty (see Medical Bias) and treating patients as humans (see Medical Rationing, Do Not Resuscitate) - but I guess we should not expect too much.

References

1.  http://www.aihw.gov.au/media/2004/mr041209.html See: Media Release, Australians' health getting better but there is room for improvement, AIHW, Canberra, 9 December 2004. See also Ref (2)
2.  http://www.aihw.gov.au/publications/index.cfm/title/10085  See: National Health Performance Committee 2004, National Report on Health Sector Performance Indicators 2003, AIHW cat. no. HWI78, Australian Institute of Health and Welfare, Canberra.
3.  http://www.aihw.gov.au/media/2004/mr040622.html See: Media Release, 2004 health verdict 'very good to very good plus', AIHW, Canberra, 22 June 2004. See also Ref (4).
4.  http://www.aihw.gov.au/publications/index.cfm/title/10014 See: Australia's Health 2004, AIHW, Canberra, 2004.
5.  http://www.aihw.gov.au/publications/aus/ah02/ah02-c02.pdf  See: Australia's Health 2002, Section 2, Australian Institute of Health and Welfare, Canberra, 2002.
6.  http://www.abs.gov.au/ausstats/abs@.nsf/94713ad445ff1425ca25682000 See: Australian Social Trends 1995, Health Status: Life Expectancy Trends, Australian Bureau Statistics.
7.  http://www.healthpromoting.com/Articles/articles/expect.htm See: Alan Goldhamer , Life Expectancy: Separating the Facts from the Myths.
8.  http://www.aihw.gov.au/media/2004/mr040929.html See: Media Release, Health spending grows to $72.2 billion, AIHW, Canberra, 29 September 2004. See also Ref (9).
9.  http://www.aihw.gov.au/publications/index.cfm/title/10043 See: Health Expenditure Australia 2002-2003, Health and Welfare Expenditure Series No. 20, AIHW, Canberra, 29 September 2004.
10.http://www.aihw.gov.au/publications/index.cfm/title/6807 See: Monitoring the Incidence of Cardiovascular Disease in Australia, Cardiovascular Disease Series No. 17, AIHW, 21 June 2001
11.http://www.aihw.gov.au/publications/index.cfm/title/10006 See: Health System Expenditure on Disease and Injury in Australia 2000-2001, Health and Welfare Expenditure Series No. 19, AIHW, 11 May 2004.
12.http://www.health.gov.au/internet/wcms/publishing.nsf/Content/feb2006 See Australian better health initiative: Promoting good health, prevention and early intervention, Commonwealth Department of Health and Ageing.
13.http://www.health.gov.au/internet/wcms/publishing.nsf/Content/8F84093 See Fact sheet 3, Australian better health initiative: Promoting good health, prevention and early intervention, Commonwealth Department of Health and Ageing, 2006.
14.https://www.sslcis.org/secure_policymakers_abbott_form.htm Minister for Health and Ageing , t he Honourable Tony Abbott MP
‘What if we could start again? Elements of an ideal health system’ Wednesday 20th September 2006, The State Library of NSW , Metcalfe Auditorium , Macquarie St , Sydne y, The Centre for Independent Studies.