Through the last view lectures, we learned many aspects of end of life care, such as being in the intensive care unit, in nursing homes, and in hospice care. The main overall view we can get from these aspects is we need to change our view of death, and make sure the patient gets what they want or deserve. Maybe they would not prefer treatment and rather die in the hands of their loved ones or near them, therefore sending them not to ICUs but rather to hospice facilities or just the comfort of home. Maybe the old would rather be living their own lives, like those in the neighborhood for the elderly, instead of being monitored for their own health. This would lead us to believe that we need a change in how we view death and aging.
Whereas death may be viewed as a terrible thing and prevented, we should treat is as an inevitable situation and have the patient be the one in control when it is their own death. Death should not be a taboo subject, but again it should be embraced when the time has come. In this state, the most optimal thing to do would be allowing the patient the most comfort they can afford. Aging should be viewed in a similar fashion. People who are aging should not be viewed as feeble or fragile and have to be looked for (unless they have to due to a condition such as Alzheimer’s) but rather looked as capable individuals who have their own wants or needs. Rather then confine them because they are close to death, allow them to do whatever they want because they almost have no more life to live. There is a shift toward this view, but a lot more thought would be needed to fully push the view toward the main picture and have it embraced by everyone. At this point, will we be able to actually conquer death: when we accept it and gain a sense of comfort from it.
In the article “Does Exercise Slow the Aging Process?” Gretchen Reynolds explores the scientific data behind exercise and aging. A new study published this month showed that exercise routines are correlated with people having shorter telomeres. In the article Reynolds explains a telomere as a plastic cap on a shoelace, except the shoelace is our DNA. As we grow older our telomeres shorten and research has recently shown this may be the cause of aging. In this latest study the data showed that the people who can benefit most from exercise were in the 40-65 age group.
I thought that this article was particularly appropriate to write on because of our recent discussion of health and different SES groups. We know that SES and life expectancy are intertwined and this data on telomere length is part of the answer as to why that is. Most people who are employed are most likely not getting much exercise at their job whether they are sitting at a desk or standing at an assembly line. The major difference between the two is the amount of freedom each job allows. The high powered executive is able to take vacation days to go hiking, skiing, or running and there may even be an office gym, while the factory worker probably does not have as many freedoms or resources. Every part of being in a higher SES group gives advantages that someone in a lower groups does not have. There should be programs started to give these disadvantaged workers a chance at a healthier lifestyle. If routine exercise becomes a luxury that not only the rich can afford then the entire population would see benefits from higher life expectancy to improved levels of mental health. We saw in class that Seattle is setting a good example for this by making the lower income neighborhoods safer, bringing communities together, and starting farming programs.
Another interesting result of the data mentioned above is that it may shed some light on the “hispanic paradox”. The group of people who this paradox applies to may be seeing the unforeseen benefits of labor intensive jobs. If a worker is out on a farm 8 hours a day doing manual labor for most of their life then they have to be in good shape. Could it be that migrant workers are living longer because they are taking the physical jobs that US natives see as undesirable? This could be an interesting direction to take research studying the hispanic paradox. Are the life expectancies of workers who undertake a physical job higher than those who do not even if they are in the same SES group? Whatever the answer, I think that exercise and physical health promotion will contribute to shrinking the differences between health and SES.
I would love to think biology was the sole reason some people live longer than others. However, countless research projects and case studies reveal that there are other underlying factors at hand. The discrepancy between male and female life expectancies was not surprising to me. There exists a social stigma that men “naturally” die younger than women due to “natural” causes. For a long time, I accepted the principle as a fact and failed to question the implications of the trend.
It is true that there are many biological aspects that can explain why men die significantly younger than women. For example, genetic deficits are often the causes of many mutations that lead to lifetime diseases and cancers. The difference in chromosomes suggests men can potentially have weaker immune systems and are more vulnerable to such illnesses. Yet, what I found simply fascinating were the social reasons proposed by Professor Guseva. I was bewildered to discover the consequences of how society views men can dramatically change something as important as life expectancy. An abnormally high 15% of males who die at ages 20-24 is due to suicide. With the overall empowering feminist movement, I failed to realize there are social problems for men as well. The lectures were truly eye awakening, especially as we compared the discrepancies in developing countries and developed countries. The conclusion that male-female life expectancy gaps were smaller in poor, developing countries was completely unexpected.
As we delve deeper into the conversation and discuss what can be done, I feel much more indeed can be done in my lifetime. However, these social matters will not be recognized and accepted easily. The idea that a strong man should never get ill or be depressed has been present since the dawn of time. Even evolution explains that female look favorably upon males who are the strongest and healthiest of the breed. I believe the most efficient way to handle this social crisis would be to continue discussing the matter. In doing so, these archaic perceptions would begin to fade and the newer generations would then be responsible for how these inequalities are handled.
On the very first day of lecture, we learned in class that there is a difference between sociology in medicine and sociology of medicine. The former means that we accept the basic principles of medicine, but the latter means that we are analyzing medicine from outside the medical system and challenging accepted beliefs and ideas claimed in this complex field. In this article titled “Income Inequality Grows With Age and Shapes Later Years,” the writer tells a story of two senior women who both grew up in frugal households but lived very different lives throughout their adult and elderly years. Continue reading “Income Inequalities With Old Age”