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Chapter 1. The State of Health

 – An ‘Invisible’ Epic Health Crisis

What are the most pressing issues facing humankind? Apart from wars and hunger, most would say climate change – a subject constantly in the news and political discourse. Sadly, an unfolding epic health crisis has been receiving too little attention – the medical establishment and the media have turned a blind eye on the dire situation. For the last 70 years, especially the last 30 or so, the prevalence of chronic or incurable diseases has been skyrocketing, inflicting immeasurable human suffering – more and more toddlers can’t talk because of autism, increasing number of young women are diagnosed with cancer, and mental health is in a downward spiral reflected by the relentless gun violence, just to name a few.  

Nearly one in every five dollars of GDP (gross domestic product) is spent in healthcare and 90% of healthcare expenditures goes into chronic disease treatments.1 In 2020, health spending per person in the U.S. was $11,945, twice the average of other high-income nations ($5,736).2 If the dollars are too abstract, let’s just look at some concrete facts.

Heart disease was largely unnoticed until the 1920s when suddenly and mysteriously deaths from heart attacks skyrocketed. Relatively young otherwise healthy people including businessmen and doctors dropped dead at an increasingly alarming rate.3 The calamity reached the peak in the late 1960s. Thanks to the advances in cardiac care, the mortality of heart diseases has declined substantially for the last 50 years. However, the number of people suffering from heart diseases is still staggering – according to the latest AHA (American Heart Association) report, about 92.1 million US adults have at least one type of cardiovascular disease (CVD), which amounts to 37%; by 2030, 43.9% of the adult population estimated will have some form of CVD.4

Many are misled to believe the soaring chronic diseases are a result of the aging population. For sure aging plays a role, but how about the jump of heart diseases from 1920s to 1960s even after adjusting for age? And is the skyrocketing of autism also due to aging? According CDC statistics, there was a 417% increase in 20 years from 2000 to 2020. For boys, the odds are much worse: Four times more common than girls. If you have a baby boy who isn’t autistic you should consider yourself lucky.

Well, “that’s due to more awareness and diagnoses rather than actual incidence,” the high-flying pontificators love to tell us. Talk to those doctors who treat autism patients to see how many more patients they are seeing for the last 10-20 years. I’m not saying awareness and more accurate diagnosis don’t play a role, but just look around to see how many adults 30 years or older suffer from autism. 

Don’t forget other mental health disorders such as depression and early onset dementia. Researchers from Johns Hopkins University find the prevalence of major depressive episodes among adolescents jumped 30% during the decade from 1995 to 2014.6 According to the Alzheimer’s Association, more than 5.7 million Americans are living with Alzheimer’s, and by 2050, the number is projected to reach 14 million.7

Needless to say, how many adults and even children these days aren’t struggling with being overweight, having high blood pressure, and diabetes? And how many of our kids aren’t suffering from the 4-A diseases (autism, ADHD, asthma, and allergy)?

Other ills have gone up fast too although they are ‘hidden’ from the public. There’re now more than 100 autoimmune diseases, according to American Autoimmune Related Disease Association (AARDA), and over 50 million Americans suffer from them. A recent study revealed worldwide autoimmune disease prevalence jumps 12.5% every year.8 Not surprisingly, the “awareness and better diagnosis” argument has been played here too. But I’d ask how about type 1 diabetes inflicting young children? Type 1 diabetes is an autoimmune disease causing the immune system to produce antibodies killing the beta cells in the pancreas. An earlier study published in JAMA found the type 1 diabetes rate increased 30% from 2001 to 2009,9 and another 30% jump from 2017 to 2020 according to the latest CDC report.10 I wonder how could these interest groups and the medical establishment sell the ‘awareness and better diagnosis’ argument in the face of the increasing type 1 diabetes, which literally can’t be misdiagnosed. 

Let’s look at cancer, which has been touted as a bright spot by the government agencies and the cancer industry for the downtrend of the cancer mortality rate since early 1990s which is credited to advances of treatment. But the reality isn’t that rosy. In many cases, patients with cancer die of other diseases (e.g., pulmonary fibrosis, kidney or liver damage) caused by chemo and radiology therapies. In fact, a metanalysis of randomized controlled trials revealed conventional chemotherapy was only contributing 2.1% to 5-year survival for adult cancer patients.11

In fairness, progress has been made in treating some cancers. For instance, the survival rate of leukemia has improved dramatically. But for other cancers such as lung, liver, pancreas, and brain, little progress has been made. And the toll of chemo and radiation therapies on cancer patients including those who survived continues to be horrendous.   

The trend of the cancer incident rate or prevalence is much worse. According to the National Cancer Institute,12 cancer incident rates have been going up, not down. From 1975 to 2017, the number of new skin cancer cases per 100,000 people skyrocketed by 228% from 7.9 to 25.9; liver cancer also jumped by 228% from 2.64 to 8.66; kidney cancer rose by 120% from 7.1 to 16.6; female breast cancer went up by 27% from 105 to 133. All these cancer rates are age adjusted and therefore the aging population can’t be blamed. Most strikingly and sadly, the cancer rate among children (age 0-19) who did nothing wrong increased by 39.2% from 13 to 18.1. In totality, a picture is worth a thousand words:   

Despite the rampage of this merciless disease and all the suffering from it, the government agencies and professional organizations love to see everything through rose-colored glasses and offer us illusory promises. For instance, in 2003, the former president-elect of American Cancer Society, Director of National Cancer Institute (2002-2006), Commissioner of the FDA (2006–2009), Andrew von Eschenbach, pledged “to eliminate suffering and death due to cancer by 2015.”13

What’s the reality today? Based on the American Cancer Society’s own data, 40% of men will get cancer in their lifetime and 38% of women will.14 Researchers from Queen Mary University of London concluded, 1 out of 2 in the UK will get cancer in their lifetime (54% of men and 48% of women).15 Worldwide, “The number of new cases is expected to rise by about 70% over the next 2 decades,” according to the World Health Organization.16

We don’t need statistics to show us the enormity of the suffering. Just look around to see how many of us don’t have a friend or relative inflicted by cancer and how many Cancer Centers have popped up like mushrooms across the country.

If this isn’t an epic health crisis, then what is it? The suffering inflicted by chronic diseases is also well reflected by how much we spend on prescription drugs. According to Health System Tracker, during 1990 – 2017, prescription drug spending per capita increased by more than 6-fold; after adjustment of price increase, it’s still nearly 4-fold from $266 to $1025.17 In 2018, 17.6 prescriptions (30-day equivalent) were filled per person on average in America.18 How many of us aren’t taking prescription drugs?

The greatest tragedy is there’s very little public outcry demanding answers – most suffer in the dark and isolation – if you’re sick, that’s because you have bad genes, you’re in a certain age, gender, and ethnicity group, or bad luck – you are a perfect candidate for the disease and no complaint is merited.

Regrettably, despite all the sufferings, the medical establishment continues to turn a blind eye to the epic calamity except for admonishing us to quit smoking, reduce fat as well as sugar intake, and exercise more. The admonishment is of course the right advice, but more and more people are getting sicker and sicker. It’s time to ask WHY.

 

References

  1. National Center for Chronic Disease Prevention and Health Promotion. Health and Economic Costs of Chronic Diseases https://www.cdc.gov/chronicdisease/about/costs/index.htm.
  2. Wager E, Ortaliza J, Twitter CC. How does health spending in the U.S. compare to other countries? https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries-2/#Health%20consumption%20expenditures%20per%20capita,%20U.S.%20dollars,%20PPP%20adjusted,%202020%20or%20nearest%20year.
  3. Fanu JL. The Rise and Fall of Modern Medicine. 2012. Basic Books. New York, NY 10107.
  4. Heart Disease and Stroke Statistics –2017 Update: A Report From the American Heart Association Circulation. 2017 March 07; 135(10): e146–e603. doi:10.1161/CIR.0000000000000485.
  5. CDC: Data & Statistics. https://www.cdc.gov/ncbddd/autism/data.html.
  6. Mojtabai R, Olfson M, Han B. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. Pediatrics, 2016; DOI: 10.1542/peds.2016-1878.
  7. https://www.alz.org/alzheimers-dementia/facts-figures.
  8. Lerner A, Jeremias P, Matthias T. The World Incidence and Prevalence of Autoimmune Diseases is Increasing. International Journal of Celiac Disease. 2015;Vol: 3(4): 151-155.
  9. Dabelea D, Mayer-Davis EJ, Saydah S, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014 May 7;311(17):1778-86.
  10. National Diabetes Statistics Report. CDC. 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
  11. Morgan G, Ward R, Barton M. The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies. Clin Oncol (R Coll Radiol). 2004 Dec;16(8):549-60.
  12. https://seer.cancer.gov/csr/1975_2017/browse_csr.php
  13. von Eschenbach AC. NCI sets goal of eliminating suffering and death due to cancer by 2015.
  14. https://www.cancer.org/cancer/cancer-basics/lifetime-probability-of-developing-or-dying-from-cancer.html.
  15. Ahmad AS, Ormiston-Smith N, Sasieni PD. Trends in the lifetime risk of developing cancer in Great Britain: comparison of risk for those born from 1930 to 1960. Br J Cancer. 2015 Mar 3;112(5):943-7.
  16. http://www.who.int/mediacentre/factsheets/fs297/en/.
  17. https://www.healthsystemtracker.org/chart-collection/recent-forecasted-trends-prescription-drug-spending/#item-start.
  18. Brooks M. US Prescriptions Hit New High in 2018, but Opioid Scripts Dip. May 10, 2019. https://www.medscape.com/viewarticle/912864.
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