For a better tomorrow, the time to act is now, futurist says

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Human nature thrills at the prospects facing the newborn -- a new life fat with opportunity, technological breakthroughs, cures for deadly diseases, longer lifespan, advancements in civilization and steps toward world peace.

But, oh, how reality can undercut hopes and dreams. Futurists also cast a pall over optimism, with discomforting predictions that past mistakes will extend and compound themselves into a darkened future full of tug-of-war politics; bad public policy; international, cultural and religious clashes; war; epidemics; and a growing population that heightens the competition for dwindling resources.

As Mark Twain wrote in his novel "Pudd'nhead Wilson," "Why is it that we rejoice at a birth and grieve at a funeral? It is because we are not the person involved."

PG graphic: The next generation
(Click image for larger version)

The big question is, what challenges will the 4 million babies expected to be born in 2013 encounter?

The Institute for Alternative Futures, an Alexandria, Va., think tank that focuses on health and health care issues, foresees advances in health, but it does not anticipate any major breakthrough treatments for major diseases. Medical advances will continue creeping rather than leaping forward, sometimes taking decades before they are developed fully and proven effective. Worries include surging obesity and diabetes reversing potential steps forward.

The U.S. Census Bureau says the world population of 7 billion will top 9 billion in 2044, when next year's newborns turn 32. That alone will heighten demand for food, water, energy and health resources, with added uncertainties about the impact of climate change.

Fewer people are marrying and at older ages, and more couples are divorcing. Will such trends affect newborns, darkening their outlook and making it more difficult to deal with stress, change and challenges?

In this day and age, it sounds crazy, but census data reveal that life expectancy declined in 1,000 U.S. counties -- nearly a third of the nation's 3,033 counties -- with the 2010 U.S. Census expected to reveal a drop in life expectancy for African-Americans and a widening gap when compared with whites.

In 2008, life expectancy for white Americans was 4.1 years longer than African-Americans -- 78.4 vs. 74.3 years -- with white males having a five-year advantage over African-American males. Early results from the 2010 census show that life expectancy will drop for African-Americans by a half year and about seven months for black males. That means life expectancy for white males likely will be 6.3 years longer than African-American males.

Where resources go

Public policy devotes a large portion of tax dollars to the elderly rather than the young, especially regarding children living in poverty.

"Health status is going to be determined more by ZIP code than genetic code," said Jonathan Peck, IAF president and senior futurist. "There are more minorities today, and it's equally important to think about the growth of the number of children in poverty rather than [more affluent] 'yuppie puppies.' "

Rewind history to 1968, Mr. Peck said, when society devoted the large balance of resources to children with antipoverty programs, Women and Infant Children and Headstart, causing a struggle for the elderly.

"There's been a shift in public dollars to support the elderly and a decline in the dollars for the younger part of the demographic," he said. The funding imbalance promises to grow with 10,000 baby boomers turning 65 each day.

The WIC program has shown a drop in constant dollars for children. Many programs have either been cut or eligible families and children are not receiving the services. Other programs don't have sufficient funding.

"More children are facing poverty and millions are facing deep poverty," according to the Children's Health Fund. Children living in poverty are more likely to be uninsured, have fragmented health care access, do poorly in school, experience food insecurity and are more likely to experience poverty as an adult.

Declines in health care, healthy food and a safe environment for children, especially those in poverty, increase the odds they will develop health problems earlier in life. Unchecked, those ailments can turn chronic and reduce the person's life span.

For now, American health care focuses on late-stage treatment rather than prevention, making medical costs "unaffordable," soon to become "desperately unaffordable," Mr. Peck said. "What if we improved health for children? They would do better in school. They would earn higher lifetime incomes. Sick kids are in trouble and disadvantaged at school."

The United States Centers for Disease Control and Prevention says, "Type 2 diabetes in children and adolescents already appears to be a sizable and growing problem among U.S. children and adolescents." Other health problems on the rise include asthma, which affects 10 percent of children in the U.S., with the greatest rise in black children that have experienced a 50 percent increase in prevalence from 2001-09, the CDC reports.

Children face huge obstacles in education and employment, leading to notable disadvantages in health and income. Those lacking education will compete for fewer jobs as technology, particularly robots, perform more routine, repetitive and laborious tasks.

In the meantime, educational costs continue to skyrocket. The cost of room, board and tuition has risen since 2000 by an annual average of $566 a year for four-year institutions. If the rate continues, the cost of a four-year college degree would climb from the current average of $83,000 to $129,000 in 2034, when the 2013 crop of newborns graduates. That would represent a 55 percent increase in the cost of a college education, based on data from the National Center for Education Statistics.

Cure vs. control

There's persistent hope for a cancer cure and treatments to reverse or eliminate cardiovascular disease.

"Rather than think of cancer being cured, it's more likely that it will be controlled more effectively," Mr. Peck said, noting that the likely scenario will follow advancements in treating HIV with drug cocktails.

Better health policies and campaigns could do a better job at reducing obesity, smoking and diet-induced diseases, Mr. Peck said. The result would be lower health costs and longer lives. But are people and government willing to tackle such issues to reverse current trends?

Government, for example, could encourage vegetable and fruit crops rather than sugar, corn and soybeans that result in products laden with empty calories and fat. "There is not a single grocery store in urban Detroit," Mr. Peck said. "Kids there are growing up without ever having seen a fresh fruit or vegetable. It's now a food desert."

How will climate change affect food production, hunger, availability of potable water, poverty, epidemics, jobs, income, and population shifts worldwide? And how will pollution continue to affect health?

"Most of the world's population will be subject to degraded air quality by 2050 if human-made emissions continue as usual," the World Health Organization said based on a European Geosciences Union study. "Air pollution is a major health risk that may worsen with increasing industrial activity. At present, urban outdoor air pollution causes 1.3 million estimated deaths per year worldwide."

Is pandemic ahead?

Mr. Peck, citing various studies including the Robert Wood Johnson Foundation, said the world and nation likely will face a major viral or bacterial pandemic in coming years, similar to the 1918 Spanish Flu epidemic that claimed 50 million lives, or 2.5 percent of the world's population at the time of 2 billion people. Only then will governments devote sufficient resources and develop better plans to address pandemics.

"We may have to learn the hard way by going through a pandemic that takes out a larger portion of the population," he said. "We will get smarter, but we are slow on the learning curve here."

But he said he's optimistic that people can live healthier lives and fulfill their potential if people and government adopt better strategies. It remains controversial, but the Affordable Care Act -- so-called Obamacare -- does attempt to shift the focus from treatment to prevention.

"We can screw it up -- and we have with obesity, smoking and lung cancer being higher than they should be," he said. "But we have reversed some of that."

So we still can have optimism, hope and high expectations for babies born in 2013, as long as they are tempered a bit by the realities of a complex world faced with enormous problems. Problems can be solved. Diseases can be treated. Lives can improve.

The big question, as Mr. Peck notes, is whether our actions will boost or reduce the prospects for the new generation.

mobilehome - health

David Templeton: dtempleton@post-gazette.com or 412-263-1578.


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