Why use time on managing your behaviors?
Before digging into why we could benefit from using time on managing our (health) related behaviors, let's start by appreciating our situation.
How fortunate we are
We are, through evolution, designed to be concerned and worried, it has helped us to survive, and we will – luckily – never escape that. Being worried is a part of being a human. There are many things to worry about, but compared to earlier generations and our ancestors hundred of thousands years ago we are extremely privileged.
From an evolutionary perspective our living standards and life expectancy, are unprecedented. We have been incredibly innovative: Even though we make all the bad unhealthy choices we can think of to maximize short-term pleasure, we can still expect, on average, to live longer than previous generations. We are not necessarily happier, more satisfied, or less worried, but we can live longer in better health. We should be thankful to our very innovative and hardworking ancestors.
Since 1900 the average life expectancy across the world has more than doubled from approximately 30 years in the beginning of the early 20th century to approximately 73 years in 2023. In some countries it is much higher. A part of this improvement comes from reduced child mortality, but life expectancy has improved significantly for all age groups due to public health measures, medical advances, improved nutrition, and social and economic development. A comfortable sedentary lifestyle entertained by social media, YouTube / TikTok shorts and streaming and fueled by ultra processed food can, when combined with all the innovative medications (statins, blood thinners, GLP-1, insulin, blood pressure medications etc.), keep us alive for quite many years.
So why bother?
Let us start by looking at the numbers.
The biggest health risk we face is getting older. Our risk of experiencing health problems, and our mortality risk, dramatically increases as we age. Historically, Japanese women live longer than most, but eventually they die just as the rest of us.
|
Age |
Japan |
Spain |
Den. |
Eng. |
US |
|
40 |
1.4% |
1.4% |
1.7% |
2.3% |
4.1% |
|
50 |
3.9% |
4.2% |
4.4% |
5.1% |
7.9% |
|
60 |
9.9% |
10.9% |
12.0% |
11.7% |
16.1% |
|
70 |
24.9% |
24.3% |
28.5% |
27.1% |
31.7% |
|
80 |
58.7% |
57.2% |
65.6% |
63.4% |
65.4% |
Table 1: Men's risk of dying within the next 10 years.
Table 1 illustrates the risk of dying within the next 10 years at a given age in Japan, Spain, England, Denmark and US. The numbers will be different in other populations, but these five nations illustrate the differences across developed nations. Japan and Spain are in the top (so is e.g. Switzerland), US is at the bottom (so is e.g. some countries in eastern Europe). England and Denmark are somewhere in the middle.
At 40 men’s risk of dying from any cause within the next 10 years in US is approximately 4%. As we can see , the risk of dying within the next 10 years is more than doubled for every 10 years. Getting old is dangerous.
Table 2 illustrates the similar risk for women.
|
Age |
Japan |
Spain |
Den. |
Eng. |
US |
|
40 |
0.9% |
0.8% |
0.8% |
1.4% |
2.3% |
|
50 |
2.1% |
2.2% |
2.6% |
3.3% |
4.9% |
|
60 |
4.3% |
5.1% |
7.8% |
7.7% |
10.3% |
|
70 |
11.6% |
12.8% |
19.9% |
19.3% |
23.2% |
|
80 |
38.3% |
43.14% |
53.4% |
52.7% |
55.2% |
Table 1 and 2 are based on Period Life Tables from 2021-2023 from the five countries.
As we can see woman have better survival odds than men, and Japanese women has, at least in the past, survived longer than most.
The numbers are population averages, so there are a lot of individual variations. The difference in average mortality risks across these five is large, and they are also large within each individual country as illustrated in table 3.
P25, P50, and P75 are the ages by which 25%, 50%, 75% of people have died (based on period life tables). So, 25% of US men dies before the age of 66.7 years, while another 25% lives beyond 87.3 years.
|
Country |
Sex |
P25
|
P50
|
P75 |
|
United States |
Men |
66.7 |
79.2 |
87.3 |
|
Women |
74.1 |
84.0 |
90.8 |
|
|
Denmark |
Men |
73.5 |
82.4 |
88.8 |
|
|
Women |
78.2 |
86.2 |
91.7 |
|
England |
Men |
72.9 |
82.5 |
89.0 |
|
Women |
77.9 |
86.1 |
91.9 |
|
|
Spain |
Men |
76.3 |
85.5 |
91.4 |
|
Women |
81.9 |
89.8 |
95.0 |
|
|
Japan |
Men |
74.6 |
84.0 |
90.3 |
|
Women |
83.0 |
90.0 |
96.2 |
In the relatively small town I live in (in Denmark), the difference in life expectancy is more than 10 years for citizens living in different parts of the city just a few kilometers apart, even though we all have free access to worldclass healthcare.
The stunning differences in table 1, 2 and 3 are caused by a range of factors (including the genetic differences between men and women), but the differences both within and across nations illustrates how modifiable our mortality risks are. The differences between the 25% that dies first and the 25% that live the longest are staggering. These numbers include all causes of death, including accidents, but the differences are very much driven by our health related behaviors.
