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  • Writer's pictureRyan Allen

What takes years of life away?

A couple months ago, I discussed the topic of “rare” diseases, the number one leading cause of years of life lost (YLL) worldwide. Many were curious to know what some of the other leading causes of YLL are and, particularly in the U.S., the answers are rather devastating. To me, it’s incredibly upsetting to see that so many of these harms are heavily human-induced: automotives and accidental death, self-injury, violence, alcohol-related diseases.

I may have discussed on the blog in the past that it pains me to see things like this, because I just find it morally wrong that any human being should die from something that should, in theory, be preventable or controllable. It’s one thing to die of an infectious disease that one just unfortunately contracted. We do all the best we can to save that person’s life, but if we can’t, that is simply the sad reality. However, it’s quite another thing when a person takes their own life, perhaps as a result of significant bullying or social hardship they have faced. In that latter example, I just always agonize to myself: what are we doing? That is a human life, years of valuable life, that we have stripped away. It was not of a “natural cause;” it was preventable. We brought it upon that person. It was a man-made death. In the midst of my frustration with these situations, there are a few takeaways I have from these top, human-caused contributors to YLL.

First, maybe it is my emotional reaction to these kinds of deaths that drives me to combat issues like social determinants of health. I am struck by the injustice of scenarios where someone so committed to their health and wellbeing can end up so off-track due to socioeconomic factors, which influence their health far more than their best efforts ever can. Logistically, ethically, however we want to view it, this is a failure of society. We have the resources, the knowledge, the capacity to ensure that person’s wellbeing, but for whatever reason, the bridge of access between that person and good health has been worn down. It may be due to educational barriers, which hinder that person from fully comprehending their conditions, treatment strategies, or day-to-day health management. It may be due to geographical obstacles, where the closest grocery store and urgent care clinic are miles away. It may be due to systemic discrimination, which not only can underline these other factors, but can also be present in the hospital or clinic and lead to medical errors or mistreatment. Resolving these issues will require significant policy efforts across several realms of society, in addition to significant alterations in the healthcare field.

My second extrapolation from these YLL causes is a point Nick and I have made previously, which is that for all the chronic disease prevention we can preach and practice, the threat of acute health incidents cannot be ignored. It is crucial that we put ourselves in the best position possible to avoid these. For example, insufficient sleep is strongly correlated with automobile accidents, not to mention several other chronic health issues. For your long-term and short-term health, get your 8 hours. If you cannot or you feel at all drowsy, it is much safer not to drive; each individual occasion when you do is playing the odds, and clearly these odds are high enough to kill so many. The same goes for drinking any amount of alcohol. While chronically, any one mild drinking occasion is not likely to harm you, the acute toxicity–either from alcohol poisoning or subsequent car accidents–can be severe.

Lastly, I can’t help but notice how many of these things that take the most years off of our lives contain some element of despair: self-harm, alcohol and drug abuse, violence to others. We are undoubtedly living through a mental health crisis at the moment, not just due to the pandemic, the economy, or global turmoil, but aspects of our society which are here to stay, like the rampant social comparison we put ourselves through every day online and on social media. I’ll briefly reemphasize the point that I made in our most recent newsletter, which is that studies show that much of our stress is a product of our perceived status, not absolute. In many cases, if we can harness the power to reframe our circumstances, we can lessen the impact of trauma and mental health harms. This is just one important aspect of mental health management that we will repeatedly hammer home to address such issues, and potentially preserve some years of life.


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