Expectancy

“ Life expectancy at birth is also a measure of overall quality of life in a country and summarizes the mortality at all ages. It can also be thought of as indicating the potential return on investment in human capital, and is necessary for the calculation of various actuarial measures. ”

“ The New York City tables for the period 1909 to 1911, for example, indicate that the probable span of life for children under five has been extended by about ten years since the earlier tables for the period 1879 to 1881 were prepared. The improvement in life expectancy continues until about age 35. From this age onward the expectation becomes reduced. In Massachusetts, the reduction in the expectation of life has occurred at an even earlier age. ”

“ In 1924, in his report to Congress, Surgeon-General Cumming, of the Public Health Service, said fifty-six years was now the average span of life in America, and contrasted it with the sixteenth century when the average life was between eighteen and twenty years. So, you see, every time you celebrate your birthday you can also celebrate the improved sanitary conditions and new conquests of disease that mean you should live longer than you thought you would when you celebrated your birthday a year ago. ”

“ I said no more; but, a few days afterwards, I went to him and very gravely told him that I had discovered the law of human mortality in the Carlisle Table, of which he thought very highly. I told him that the law was involved in this circumstance. Take the table of expectation of life, choose any age, take its expectation and make the nearest integer a new age, do the same with that, and so on; begin at what age you like, you are sure to end at the place where the age past is equal, or most nearly equal, to the expectation to come. ”

“ American experience in tables of mortality shows that of 100 persons at the age of 20, 53 will reach 65; 12, 70; at which time the average expectation of life will be 81⁄2 years. If we take 100 people at the age of 30, 53 will live to 65; 48 to 70. But this table was compiled half a century ago, although it is still used—to the great profit of insurance companies as expectation has greatly increased. Ten to fifteen years of life over sixty-five are assured to more than half all wage workers. ”

“ In every period of life in the child, in the adult, in the middle-aged and in the old we meet with conditions which were not present at earlier periods. There is no definite period at which the changes which we are accustomed to regard as those of old age begin. This is true of both the external appearances of age and the internal changes. One individual may be fully as old, as far as is indicated by the changes of age, at fifty as another at eighty. ”

“ These tables were satisfactory in the evidence they gave of a material improvement in the average duration of life. In forty years so great a change had taken place in the condition of the people, that the decrease of mortality was from 1 in 40 to 1 in 56. They proved, also, to demonstration, the extraordinary difference between the longevity of men and women, a circumstance not hitherto known to a certainty, but one which was most important to the granters of annuities. ”

“ To be tending towards death from five-and-forty seems to them ridiculous. So it would be as a matter of sentiment, among people who think about death in such an exaggerated way as we, of this age, do. But I am here speaking of the natural facts which bear upon the condition of old age; and that is my concern with forty-five. In a rough way, the physiological distribution of our life is set down as including five-and-twenty years of growth, five-and-twenty of decline, and twenty of maturity between them. ”

“ These more marked nodes in the unity of man’s individual existence are: (1) childhood, (2) adolescence from puberty to full nubility, (3) middle life or the prime, when we are at the apex of our aggregate of powers, ranging from twenty-five or thirty to forty or forty-five and comprising thus the fifteen or twenty years now commonly called our best, (4) senescence, which begins in the early forties, or before in woman, and (5) senectitude, the post-climacteric or old age proper. ”

“ This, in a large degree, is due to the diminished amount of infant mortality. The improvement is shown more conclusively in the increased commonness of vigorous and active old age, [Pg 332] in the multitude of new contrivances for economising and therefore increasing time, in the far greater intensity of life both in the forms of work and in the forms of pleasure. 'Life at high pressure' is not without its drawbacks and its evils, but it at least means life which is largely and fully used. ”

“ Zeitschr., 1861, 348 ff.) But the inference which may be drawn from a high or a low average of life is altogether ambiguous. A high average may as well be produced by a great mortality among children as by a favorable mortality among those of mature age; and a low average as well by a relatively small number of births as by a relatively short duration of life. (Meyer, loc. cit., 23, 24.) ”

“ Let us glance briefly at the public and private provisions in different lands for the care of the aged, another large topic with a literature of its own. Here, too, we find great diversity of method and theory which it would be premature to attempt to harmonize. Indeed, so limited is our present knowledge of old age that the available data here also open rather than close most of the great questions about it, although we do seem to be at the beginning of a new era regarding this stage of life. ”

“ If we were investigating the longevity of twins, or of persons with supernumerary toes, or indeed of persons possessing any quality which one could detect in new-born infants, and if we could determine the average life-period of this class of persons and find that it markedly exceeded the average of the entire community, we should be entitled to conclude that twins, or persons who have supernumerary toes, are blessed with a greater longevity than the average man. ”

“ Wherever the pressure of the causes of death has yet been observed to be very great, there the line of mortality, or the average age of death, is below, what may be called, the line of vitality constituted by the average age of the living ”

“ Let the ripe age be supposed of twenty-one years, and their period of life thirty-four years more, that being the average term given by the bills of mortality to persons of twenty-one years of age. Each successive generation would, in this way, come and go off the stage at a fixed moment, as individuals do now. ”

“ Although no period of life, from infancy to old age, is exempt from Consumption, but all are liable to its attack, yet at a particular age, it is observed to appear more frequently than at any other. This period commences about, or soon after the age of puberty, and terminates at thirty-six ”

“ It can scarcely be doubted that the most critical period in the life history of the individual is the first ten months—the nine months of intra-uterine life and the first month after birth. Good care, then, during this critical period is indispensable in the building of a healthy race. ”

“ Abundant evidence shows that physical development is most active from thirteen to seventeen years of age; this manifests itself clearly by increase in weight. Hence this period of life is of great consequence. If at this age a boy or girl is subjected to undue physical strain, the development may suffer, the growth be retarded, and the foundation laid for future ill health. ”

“ The outline of this law is, indeed, clearly defined, and can be traced in every table—a high rate of mortality in the first year of life, decreasing until the minimum is reached somewhere near the age of puberty, then rising very gradually, until with old age a very rapid increase takes place. But, while these general traits are well established, the details are subject to continual deviations.
We must assume that there is a fundamental law of life accompanying the organization of the human being, but that it is
English Life Table No. ”

“ While the average age at death of the gentry and of professional persons and their families is forty-four, the average age at death attained by you and your families in many instances is only twenty-two, just one-half,—that is to say, comparing your condition with that of the professional persons, you and your families are deprived of one-half of your natural term of life. ”

“ THE RATE OF GROWTH.—When we recall the definite and often marked differences in the physical character of women, such as weight and height, it is surprising to learn that the prenatal development of their children proceeds with uniform speed. One very practical result is that the physician is thus enabled, at the birth of a premature infant, to estimate accurately the period of its development. ”

“ The whole period of growth is important; but, since from birth to about the age of seven years the growth and development of bodily and mental functions are immensely more rapid than at any period of after-life, it follows that greater care is required during these early years, when the consequences of a step in a wrong direction are more injurious than at any other time. ”

“ From long study of the lives of the patriarchs of great age—who, according to evidence, sometimes legal, and acknowledged also by such authorities as Professor Pflüger [382] and Pel, [383] have attained an age much over 100, and in some cases even of 160—we have come to the conclusion that, by following the hygienic rules we have laid down in the various chapters in this book, we certainly can preserve our youthfulness till 50 or 60, and our life to 100 or over. ”

“ Arthur Hunter, actuary of the New York Life Insurance Co., in a paper read before the National Conference of Charities and Correction in Indianapolis in 1916, presented a survey of this material in which he claimed that the American statistics, many of which were then only recently available in published form, corroborated the English data in indicating that total abstinence decidedly increased longevity. ”

“ An early bloom is too apt to presage an early decay; and though our mortuary statistics, thanks to the advance of medical and sanitary science, do undoubtedly show that [Pg 79] the average duration of life is becoming more and more extended, and that the Golden Age, in this respect, is before us rather than in the past ”

“ Insurance companies and benefit societies keep close watch of their members and they report that a person ten years old may now count on living to be sixty years of age. That is the average age, whereas a hundred years ago the average expectation [Pg 271] of life at that age was only fifty-three years. ”

“ We shall thus have a third rate of increase, viz. a theoretical rate, which might be expected to have a real existence, were not only food always abundant, but also all wars, all diseases, and other causes in any way tending to diminish fecundity, or to extinguish human life before the completion of the natural term of longevity, to be utterly removed. ”

“ They increase in the following order—liver, digestion, apoplexy, nerves, heart, kidneys. One’s enjoyment of food is greater perhaps than discriminative. Many reminders of age are overcome by warming up. Skin emanations may be offensive. Traits of a mature mind are poise, deliberation, economy and the largest output of judgment, like the Roman senators or seniors. Irritability is common. Youth wants to know; age wants to be.
* * * * *
C. A. Ewald,162 one of the most eminent of German professors of biology, gives us one of the most condensed statements on the subject of old age. ”

“ After the critical transition age of six or seven, when the brain has achieved its adult size and weight, and teething has reduced the chewing surface to its least extent, begins a unique stage of life marked by reduced growth and increased activity and power to resist both disease and fatigue, which suggests what was, in some just post-simian age of our race, its period of maturity. ”

“ THE VITAL PERIOD.—The physical condition of parents at the vital period of transmission of life should be a perfect condition of health in both body and mind, and a vigorous condition of all the animal organs and functions. ”

“ There is a very pregnant sense in which a man is as old as the glands that dominate this phase of life. Laymen, including most physicians, know very little of and find it hard to credit the devices that may be resorted to to retard this atrophy or often to conserve and even enhance the vestiges of this function, the excessive activity of which is the surest preventative of a happy old age. ”

“ He published a table of mortality, in which a distinction was made between the different ages, and the probable number of years of life for each given. The rate of mortality assumed for the middle ages approximates to that probably prevalent previous to the seventeenth century. ”

“ And if you consult the table when you are seventy-nine you’ll see you have an average chance of living four and three fourths years longer, which will make you eighty-four years and three months old. And when you are eighty-four the table says you still have an average expectation of living three years longer. That ought to be almost long enough for anybody, I should think, but even when you reach the rather mature age of eighty-seven, there’s no need of celebrating your birthday with a grouch, because the table gives the eighty-seven-year-old boys an average of two and one sixth years more. ”

“ For another group of five hundred, an average life-span of nearly sixty-five years was found, as against a life-span of fifty-one years for all classes of people who pass the age of twenty. In the case of still another group, studied by a third investigator, an average of seventy-one years was established. ”

“ III. I shall enumerate its peculiar diseases, and the remedies which are most proper to remove, or moderate them.
I. The circumstances which favour longevity, are,
1. Descent from long-lived ancestors. I have not found a single instance of a person, who has lived to be 80 years old, in whom this was not the case. In some instances I found the descent was only from one, but, in general, it was from both parents. The knowledge of this fact may serve, not only to assist in calculating what are called the chances of lives, but it may be made useful to a physician. ”