Living Sick and Dying Young in Rich America

Chronic illness is the new first-world problem.
Dvortygirl/flickr

We were standing at Target in an aisle we’d never walked down before, looking at things we didn’t understand. Pill splitters, multivitamins, supplements, and the thing we were here to buy: a long blue pill box—the kind with seven little doors labeled “S M T W T F S “ for each day of the week, the kind that old people cram their pills into when they have too many to remember what they’ve already taken.

My husband, Joe Preston, shook his head. “Do I really need this?”

I grabbed it off the shelf and threw it in our basket. And when we got home, Joe—then a fit and fairly spry 30-year-old man with a boss-level beard—stood at the kitchen counter, dropping each of his prescriptions with a plink into the container.

I guess it’s true that life is full of surprises, but for the three years since Joe’s crippling pain was diagnosed as the result of an autoimmune disease called Ankylosing Spondylitis, our life has been full of surprises like this one. Pill boxes, trips to the emergency room, early returns from vacation. Terms like “flare-up” have dropped into our vocabulary. We’ve sat in waiting rooms where Joe was the only person without a walker or a cane. Most of our tears have been over the fact that these aren’t the kind of surprises either of us thought we’d be encountering at such a young age.

But here’s the thing: We recently realized we weren’t alone. Almost all of our friends are sick, too. When we met our friend Missy Narrance, Joe found solace in talking to her about his health. She’s 29 and has been battling lupus and fibromyalgia for the past 10 years. She’s been through chemotherapy twice, and her daily symptoms are so extreme that she was granted federal disability status when she was just 23 years old. In our close group of friends—who range from 25 to 35 years old—we know people with everything from tumors to chronic pain. Sometimes our conversations over beers on a Friday night turn to discussions of long-term care and miscommunication between doctors.

I thought this would be the time when we’d be preparing for the rest of our lives: earning money, going on fun vacations, having families, building our careers. And we are, but at the same time, we’re doing it while we’re trying to manage pain symptoms, chase down prescriptions, and secure stable health insurance. When I was in college, I remember being prepared to survive in the workforce, but I don’t remember a class that told me how to do that if half of your household is in so much pain on some days that they can’t get to work. I’m barely over 30. I thought I had so much more time before I had to think about this stuff.

I wondered if this was normal. Do we know so many people who are dealing with pain because people are just getting sicker in general?

I found out that they kind of are. It turns out that chronic conditions like what Joe and my friends are dealing with are one of America’s biggest health emergencies. And it’s one that many people say we’re not prepared to deal with.

Despite the fact that America shells out more money on healthcare than any other country in the world, according to a report by the Centers for Disease Control and Prevention—and a hefty 75 percent of those dollars are going toward aiding people with chronic conditions—almost half of American adults had at least one chronic condition in 2005.

Not surprisingly, the CDC says cancer is still the second leading cause of death for Americans. But not only do chronic conditions—a category that includes everything from autoimmune diseases like arthritis and lupus, to obesity, heart disease, and diabetes—claim the number one spot, they’re compromising Americans’ quality of life and disabling people for long periods of time. Take arthritis for example: Right now, the CDC says it affects 1 in 5 adults, and is the most common cause of disability in America.  “As the U.S. population ages, the number of adults with doctor-diagnosed arthritis is projected to increase from 46 million to 67 million by 2030, and 25 million of these individuals will have limited activity as a result,” the CDC report reads.

But it’s not just that Americans are getting sicker—it’s that young Americans are getting sicker. A 2013 report by the National Research Council and Institute of Medicine (NAC/IOM) echoes the shock of that fact. “The panel was struck by the gravity of its findings,” it reads. “For many years, Americans have been dying at younger ages than people in almost all other high income countries.”

Steven Woolf, director of the Center on Society and Health at Virginia Commonwealth University, helped prepare the NAC/IOM report and brought the findings before the U.S. Senate last month during a discussion on what is ailing Americans. In particular, Woolf points at how data is painting a bleak future for American women.

“Women are less likely to live to age 50 if they’re born in the United States than other high income countries,” he says. “I have a chart where we show this pattern going back to 1980. Back then if you looked at the survival of women to age 50, the U.S. was in the middle of the pack. Over time, not only has the U.S. fallen down in the ranking, they’ve fallen off the chart. That’s something we’re trying to understand.”

And don’t be mistaken, Woolf says: The United States’ outlook isn’t skewed from other countries’ because of its diverse people and massive disparities in socioeconomic status. “We analyzed the data by a variety of social classes and have found that the problem is pervasive. Rich Americans die earlier than rich people in other countries. College-educated people die earlier than college-educated people in other countries,” he says. “It’s misguided for people who are better off and doing well to think that this is someone else’s problem.”

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Leah Sottile is a writer based in Spokane, Washington.

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