How long will I live? About forecasters

23 Mar
Joan MV Pons

The robustness and solidity of a science (which is why informally we sometimes talk about “hard sciences” and “soft sciences”) depends on its capacity to predict.

A science does not only need to explain what is happening in a very plausible way but also needs to be able to predict what will happen, with as great precision as possible.

In the same way that econometric models (mathematical, full of formulae and equations) want to demonstrate, in numbers, how closely they approximate to reality and therefore how by modifying initial parameters a calculation will produce a result that we would expect, so-called “life expectancy calculators” or “death clocks” also abound these days. You can find quite a few on the internet, some more serious while others more entertaining.

Asking oneself how much longer we have to live is in any case a good question.

We know a lot about the factors that have an influence on disease and which bring death closer to us and we also know how progress (it is not clear in what, as it is not exclusively medical) has increased our life expectancy (which should not be confused with longevity even though this is often the case), at least in developed countries.

We also know that health professionals despite their experience, are not as accurate in predicting as are the predictive statistical models that can include a multiplicity of variables. A comment in the BMJ recently spoke about these prognostic factors and life expectancy calculators. I have included several, of the more serious ones, in the bibliography.

Forgive me for taking the liberty for doing so, but today I will share with you, with irony, a cruise I took on the internet while searching for some of these prognostic tools that want to predict how long we have left to live in this world.

Abaris is one of these mathematical prognostic tools, developed by “professors” at the University of Pennsylvania with the support of The Times and The Wall Street Journal and which seems to be one of the most accurate. It factors in sex (it might be more accurate to refer to “gender” but “sex” is the nomenclature used in the application), weight and height (beware! You need to choose the metric system because if not the information given is in pounds and inches), to get to the body mass index, a well-known prognostic factor with a U-shaped curve in relation to the probability of dying, level of education, marital status (married, widow or widower, divorced, never married, separated – I am unaware of the difference between the third and last), if you are already retired, level of income (in dollars), the amount of exercise you do, what your general health is like, whether you have diabetes and what vices you have in general (alcohol, tobacco).

You choose from all this presented with colourful computer graphics and then, if you press the button, it performs all the calculations for you but if you want the results you have to give them your email address where they will send them. Someone might be inclined to do this but at this stage, I’m not giving anything away (and less on the network; they already take without asking).

Let’s move on to another forecaster sponsored by an insurance company (what more could you ask for?). The nice thing about Lifespan calculator is that as you answer questions it starts showing you your life expectancy and so you can see how it increases or decreases depending on what you answer. However, it does not ask you about your marital status or your level of income or studies but it does ask you about your family history, blood pressure, level of stress, the exercise you do, diet, whether you use a seat belt or not while in the car and toxic habits, among other details. On this one you also have to convert height into feet and inches.

The social security in the United States also offers a calculator but it is a lot more impersonal and does not take risk factors or protective factors into consideration. It only asks you for your sex and date of birth and provides you with your life expectancy according to your current age and your birth cohort. So, as I am 58 and 8 months, I can expect to live 24.4 years longer until I reach 83.1 as estimated for my cohort. It must be said that this calculator also estimates your age of retirement.

Another forecaster, a little less sophisticated created by a physician on his own initiative, Living to 100, includes a lot more elements than the others: nutrition, social relationships, level of anxiety, sleep and common habits but also includes the intake of coffee and tea, air pollution, exercise and family history. Unfortunately, it also sends you the results via email.

There is yet another way of looking for forecasters of this type: typing in ”death clock”, never better said.

There are some very entertaining ones with their humoristic screens (death and its scythe waiting for you at the tomb which is already prepared). The The Death Clock asks you for your date of birth, sex, height and weight (in centimetres and kilos in this case), your country of residence, whether you smoke, how you see yourself (pessimist, optimist, neutral, suicidal) and how much alcohol you drink. This “clock” calculates quickly and accurately and it even goes so far as to tell you the day on which you will die (comically foreseen derived from the fact that the date is engraved on the tombstone). However, it seems too simple.

Finally, whilst I am certain that more can be found, I have found another. This other, called The Death Clock, is very similar to the one before and also contains gloomy images to make it clear that we are entering very dark terrain. This forecaster also asks you for your sex and date of birth and like the others it asks you to work out your body mass index. Instead of alcohol, it asks you about tobacco (smoker or not, outright, no subtleties) and in terms of your state of mind it considers being normal, pessimistic and optimistic (like in the previous one), but it adds sadistic which is very surprising. It also asks you for your weight and height to calculate your body mass index. If all turns out well, it also tells you the day, month and year in which you will die and within seconds shows you the countdown.

It is precisely this calculator which, very elegantly, I having put pessimist (by nature) said: I’m sorry but your time has expired. Have a nice day.

Post written by Joan MV Pons.

Wishing you all a Joyous Festive Season from the AQuAS blog

29 Dec
Marta Millaret

From the blog AQUAS we hope you are having a good festive season and would like to thank you for reading and following us.

We publish weekly in Catalan, Spanish and English on subjects related to the projects that are being carried out at AQuAS and we also publish contributions from guest authors. The editorial line of the blog includes a focus on assessment from different points of view and areas of the health system.

Along these lines, we have dealt with healthcare and quality results presented by the different agents who make up the healthcare system, the whole range of observatories of the Catalan Health System (including that which deals with the effects of the economic crisis on the health of the population and innovation), qualitative research, integrated care, the assessment of mHealth, inequalities in health, patient involvement, doctor-patient communication, shared decisions, patient and citizen preferences, variations in medical practice, the prevention of low-value clinical practices, the impact of research, information and communications technology, data analysis in research, tools for the visualisation of data, innovation and health management, the gender perspective in science, statistical issues, clinical safety with electronic prescriptions, chronicity (not forgetting chronicity in children), the effects of air pollution in health and current topics.


The most read articles in 2016 have been:

However, we have published many more texts, 51 posts to be precise, without counting this one, with the aim of sharing knowledge and generating a space for reflection, open and useful for everyone.

Thank you very much, a joyous festive season and see you in the new year!

Post written by Marta Millaret (@MartaMillaret), blog AQuAS editor.



The Great Escape

21 Jan
Joan MV Pons, Head of Evaluation AQuAS
Joan MV Pons

A few days ago, Anna Garcia-Altés in a previous post referred to the Nobel Prize in Economics, which Alfred Nobel never granted – that was awarded in 2015 to Angus Deaton and his work on inequality. This is not the subject that I wish to talk about today but another that also features in the recent book from this Nobel proze winner which is titled “The Great Escape” (The Great Escape). Yes, just like the movie, set in a German camp for prisoners of war starring Steve McQueen and recalling a real fact of World War II. Unlike reality, the book predicts a better ending. For Deaton, the greatest escape in human history was in overcoming poverty and ageing.

For centuries, those who did not die at a young age could face years of misery. Beginning in period called the Enlightenment, with its scientific revolution and subsequent later industrial revolution, some people in certain countries began to escape this meagre fate.

Meanwhile, germ theories founded in the late nineteenth century surpassed the paradigm of the miasma theory in explaining contagious diseases. The key was and still is scientific knowledge and its dissemination. This point in history marks the extraordinary increase in life expectancy, initially for the better-off and then for the rest of the population.

This higher life expectancy, manifested especially in the developed countries, is largely due to the remarkable reduction in infant mortality and, more recently, to the epidemiological transition to chronic non-contagious diseases, the improvement in life expectancy in adulthood (increased life expectancy ≥ 50 years from 1950), but without a substantial improvement in longevity. Deaton shows us all this with data and graphics.

To illustrate it, Deaton mentions the progress in combating smallpox with a vaccination of smallpox (initially using matter from infected people and later the much safer vaccine Edward Jenner introduced in 1799). The public health measures introduced in the last few hundred years, including sanitation, water supply, nutrition and better hygiene, have led to a significant reduction in infant mortality.

Here, it was due to not only the knowledge but also the determination of the authorities in improving the conditions of the population. The improvement in life expectancy in adulthood is explained largely by reducing cardiovascular mortality through diagnostic and therapeutic advances in this field.

As mentioned before, we witnessed not only increased life expectancy but also a significant increase in the world population, an authentic explosion starting in the second half of the twentieth century. Malthusian alarms re-emerged but they were fortunately overcome by improvements in agricultural productivity, without excluding initiatives – for better or worse – for controlling the birth rate in developing countries; again, examples of scientific knowledge and its dissemination.

Deaton is very critical about the operating methods in which help flows from developed countries to developing countries. From the times of imperialism and colonization where (natural) resources were moved from poor countries to rich ones (Nineteenth century) and since the end of World War II we’ve also seen a flow of resources from developed countries to developing countries.

This external help, whether from governmental or NGO sources and despite the illusion that might it create if it continues as usual, may end up doing more harm than good. There’s no shortage of examples in the book of wasted resources by governments and corrupt politicians, granting donations or grants to countries (government to government) without these ever reaching the people. Not to mention situations where these grants are part of the geopolitics of the former colonies or contemporary powers.

Contrary to what an engineered hydraulic vision (communicating vessels) may show, we must invest in projects and programs that promote conditions for economic development to make external aid unnecessary, as is the reality in Africa, where paradoxically, the more external help yields the least growth in GDP per capita.

Health aid, without underestimating its achievements (vaccination campaigns, infrastructure construction, drugs against HIV / AIDS, mosquito nets), continues to be in most cases, vertical health programs with a very specific focus. This contrasts with the horizontal programs aimed at strengthening local health care systems, especially a good network of primary and community care.

Often foreign aid and the development of local capacity are not aligned; on the contrary, often one damages the other. Rich countries’ subsidies to their agriculture – consider the famous European PAC – is detrimental to farmers in poor countries where most of the workforce still works the land. There are more effective ways to help.

(It notes that another Nobel laureate in economics, Robert Fogel (1926-2013), had already written about the great escape in “The Escape from Hunger and Premature Death, 1700-2100” (2004), Deaton and had revised appointment. Thank Anna Garcia-Altés to call me about this)