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Why do we write about, talk about, meet about and in general complain about children’s chronic illnesses in the U.S. when statistics show that, year by year, we Americans are living to an ever riper old age?

That’s a favorite gotcha question, intended to squash or at least minimize the impact of the damage we describe, usually employed by defenders of the right to pollute. Sometimes, though, it can be an honest question posed by someone really wanting to learn. So it’s worth thinking about.

Mostly, the steady increase in age expectancy results from modern hygiene that prevents the terrible contagious epidemics of past generations that cut us down in childhood or in the prime of our lives.  The thanks goes to Pasteur who discovered germs and their bad behavior, and to public health activists who figured out how to deliver clean food and water to the masses. The decline in mortality started in New York City in the 1880s when the Croton reservoir was built.

Modern medicine must also receive our thanks. I was about to die at age 13 from blood poisoning (an infected paper cut), but was saved by a shot of penicillin just made available to the public toward the end of World War II (until then it had been reserved for military use).  Modern technologies and diagnostic techniques, such as MRIs and CAT scans, are able to find potentially deadly illnesses and intercept them.   Modern medicine also brought (some) medical care to the nation’s poor who before that used to drive down life expectancy rates.

But, though it seems reassuring to hear that we will now live until our 80s or so, there are three catches.  First, the U.S. has not all that much to crow about: among the industrialized nations of the world, we rank 49th in life expectancy.   That we are among the richest nations but with such a poor standing puts us to shame.

Second, the oldest of the old are our nation’s most rapidly growing age group, thereby skewing the statistics.  But living longer does not necessarily mean really living. It can be more a factor of aggressive medical technology putting off death.  Such as pacemakers inserted into the bodies of elderly with dementia. Read My Father’s Broken Heart,

The third catch is, however, the most important.  The age curve doesn’t matter.  The death rate doesn’t matter.  What matters is the health rate.  And as a nation we are not healthy.  We suffer from a “new morbidity,” as environmental pediatrician Dr, Philip Landrigan calls it –new ways of living sick.  Among adults, it’s obesity, high blood pressure, diabetes, breast cancer, Parkinson’s, etc., serious chronic illnesses that debilitate even if they do not kill us right away.

Among our children, one out of three is living sick.  Our children may not die, and thus bring down the life expectancy rate, but they are not healthy.  A lot of children with cancer now survive.  But we should not be proud, because childhood cancer was once a rarity.   The roster of illnesses, besides cancer, is well-known: asthma, birth defects, lead poisoning, the declining ratio of boys to girls, infertility, Down syndrome.  All of these are on the rise, and all can be traced back to exposures to toxins that were unknown one or two generations ago.

So to those who ask why we kvetch, we answer, children have the right to health.  If you’ve met a child who has lived through chemotherapy or the dozen operations it takes to fix a cleft palate, or a child with autism who has lost the ability to speak, you know that there are measures more important than the statistic of extended life expectancy.

We’ll stop kvetching when the epidemic of chronic childhood illnesses stops.

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Alice Shabecoff is the co-author with her husband Philip of Poisoned for Profit: How Toxins Are Making Our Children Chronically Ill, just released in paperback.

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