Monday, January 8, 2001
Holding Off the Grim Reaper
By Pat French

The New Year is a time when many people will take stock of their lives: what has happened over the last year, how they're doing on achieving goals, and what they hope to do in the future. Many will decide that this is the year that they improve their state of health. Their first step will be to determine their current health.

Some will turn to the World Wide Web for help. There are hundreds of sites that can help people calculate an ideal cholesterol level, see whether they're depressed or sleep-deprived, or find out whether they should reduce (or increase) their alcohol intake. But the real bottom line is life expectancy--how long a person is going to live.

The best tool to calculate life expectancy would take into account the most common causes of death for people of different ages. The National Center for Health Statistics, under the Centers for Disease Control and Prevention (CDC), is the place to go for this information. The table below shows the 10 most common causes of death for people under the age of 65.

Age 25 to 44 Age 45 to 64
Accidents and adverse events Cancer
Cancer Heart disease
Heart disease Accidents and adverse events
Suicide Cerebrovascular disease
HIV Diabetes mellitus
Homicide, legal intervention Chronic lung disease
Chronic liver disease Chronic liver disease
Cerebrovascular disease Suicide
Diabetes mellitus Pneumonia and influenza
Pneumonia and influenza HIV

The following table shows information from 8 Web sites that offer a calculation of life expectancy. No site asks questions that account for all common causes of death among adults aged 25 to 65, although 2 come close.

Web Sites (see below for links)
  1 2 3 4 5 6 7 8
Accidents and adverse events X   X X X X   X
Cancer X X X X X X X X
Cerebrovascular disease X   X   X X   X
Chronic liver disease X   X   X X X X
Chronic lung disease X X X   X X X X
Diabetes mellitus X   X   X X   X
Heart disease X X X X X X X X

HIV

 X X X X X X X  
Homicide, legal intervention           X    
Pneumonia and influenza X X X X X X X X
Suicide         X   X X
Total number of questions 52 8 38 14 45 34 25 44
Life expectancy* 81 58 81 79.5 83.4 73 82.6 80
*Entering identical data for each calculation. Note: the sites measure only the risk of death only, not of disability, and they do not address other factors that would affect health, such as vaccinations.

All of the sites ask questions about major risk factors: age, sex, smoking, and lack of exercise. Most also measure a person's driving habits (the primary cause of accidents), race, height, weight, and seat-belt use. Only 1 site asked about depression, though, and only 2 about sexual behavior/HIV exposure, even though suicide and HIV infection are the fourth and fifth most common causes of death, respectively, among younger adults. Guns are involved in accidents, homicides, and suicides (#1, #4, and #6), but only 1 site asked about gun use. Finally, even between the 2 most comprehensive sites (#5 and #6), the calculated life expectancy varied by 10 years. Where does that leave the person hoping to get a handle on his or her overall health?

All of the sites do let people see how changes in their risk factors would affect life expectancy. Clearly, people can't do anything about how old they are, or about their families' medical history, but many other risk factors can be changed to result in longer life, all other things being equal. These sites let people change some of their answers, retake the test, or consult the summaries or charts at the end of the test.

Perhaps the best strategy would be to take a few of the tests, get an average, and then see whether it's worth it to lose the 5 pounds (0 months gained), get a pet (2.4 months gained), stop eating so many hot dogs (6 months gained), increase exercising from 15 minutes to 60 minutes a day (8 months), or even quit smoking (3+ years gained immediately).

1. WebMD - http://my.webmd.com/special_event_article/article/2755.242
2. datewithdeath - http://www.datewithdeath.com/deathframes.html
3. healthscout - Select "Measure Your Health" on the left menu bar.
4. UPenn1 - http://diskworld.wharton.upenn.edu/mortality/form.html
5. UPenn2 - http://gosset.wharton.upenn.edu/~foster/mortality/
6. thespark - http://test.thespark.com/deathtest/death.cgi
7. livingto100 - http://www.livingto100.com
8. MSNBC - http://www.msnbc.com/modules/quizzes/lifex.asp