I bring up this vignette because an analysis of the Global Burden of Disease was published 2 days ago in JAMA looking specifically at the state of our country's health from 1990 to 2010. What's striking is that while all-cause mortality has decreased over this 2 decade period of time w/concomitant 3yr increase in healthy life expectancy, the number of years lived w/disability actually increased. In other words, while our quantity of life has increased, our quality of life has decreased. Even more striking is that while US life expectancy has increased, increase in life expectancy in other countries has outpaced ours such that we're slipping backwards on a global scale.
Which brings me back to my new patient who is well aware of hypertension's reputation as a silent killer. And despite this knowledge in a well educated patient, she couldn't explain why she wasn't doing more to maintain her current level of function & quality of life. This is why our national health is circling the proverbial drain. We know what we need to do but we don't have the collective conscience to act upon our knowledge.
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