What's the price of living longer? New mortality data from the Centers for Disease Control and Prevention (CDC; Atlanta) reveal that human life expectancy is at an all-time high and death rates have reached new lows. But quality of life for those extra years was not assessed.

"There are two implications of living longer. One is the extra life – which everyone sees as so valuable – has to be financed," Richard Suzman, PhD, director of Behavioral and Social Research for the National Institute on Aging (Bethesda, Maryland), told Medical Device Daily. "People can work longer, save more, consume less or there can be larger [government] payments. Second, people have to have a long view that they will be around for longer than they expect and that health habits in early life will affect what happens in later life. It's very difficult to get people to think that far ahead."

The CDC reported that U.S. life expectancy reached nearly 78 years (77.9) and the death rate has dropped to 760.3 deaths per 100,000 population. Both of these figures are new records for the U.S.

"Life expectancy has been increasing at a fairly steady rate for the last 150 years," Suzman said. "It shows no evidence of leveling off to any plateau. But the U.S., especially in the case of white women, has been lagging behind almost all other high-income countries for the last two to three decades. So, there's plenty of room for catching up. There's good evidence, as the smoking generation dies out, the tempo will increase. The increase in life expectancy is a crowning achievement of the last 150 years. The good news is that, in the older population, for a period that went from around mid 1980 to 2000, disability levels dropped quite significantly."

"The question is whether that trend will continue or whether it will be interrupted by the increase in obesity," he said. "The answer is, we don't know. We're not sure."

In addition to living longer, mortality rates dropped between 2006 and 2007 for eight of the 15 leading causes of death. Declines were observed for influenza and pneumonia (8.4%), homicide (6.5%), accidents (5%), heart disease (4.7%), stroke (4.6%), diabetes (3.9%), hypertension (2.7%) and cancer (1.8%).

Death rates increased for Parkinson's disease, chronic liver disease and cirrhosis, and Alzheimer's, although the CDC reported that those increases " are not statistically significant," which could be translated into the fact that more people are actually suffering from these diseases that strike the elderly but they're still living longer.

Suzman noted the increases in the number of people with cognitive disabilities associated with increasing age, saying "It's becoming more important to find ways to postpone, prevent or cure the various dementias."

But he added that the problem is a global phenomenon and there needs to be a global response.

"It may be too big an issue for just one country, even the richest and largest biomedical behavior research institutions," he said. "It's going to require collaboration with other countries because science knows no boundaries. It's not just drugs and medical devices, it's ways of changing individual behavior that's critical. The science of behavior change is an area that needs development. The National Institutes of Health [Bethesda, Maryland] is doing a wonderful job. We've just been the beneficiary of stimulus funds to push things faster, but here's always more that can be done."

Suzman acknowledged that there have been enormous improvements in treatments, especially for cardiovascular disease and some cancers. "But there's less progress in stopping people from getting diseases earlier," he said. "It's important to also consider well being and quality of life. We are developing new ways to measure well being. There is some evidence that pain is inadequately treated. Treating that would certainly raise well being and quality of life. Clinical trials are also focusing more not just on quantity of life but more on quality."

And as the world continues to address disease cures and treatments, Suzman returns to the issue of obesity, saying advances in treatment of various diseases that help us to live longer are, "to some extent balanced by increases in obesity" and the health complications brought on by being overweight.

"We need a better basic science of behavioral change," he said. "The NIH has started an initiative that encompasses 17 institutes to try to understand better ways of changing behavior. We've begun to think in new ways."

Suzman said there are some promising signs emerging already in the behavioral change landscape.

"Behavioral economics and default opt-out options have been adopted within pension areas and 401(k)s so people are automatically enrolled with options to opt out and that leads to higher savings," he said, referring to the need to finance longer lives. "There are ways to nudge people. There are ways to arrange the architecture of environments so people can do what's probably best for them with the option to opt out for those who are independent minded. If it could be adapted to health behaviors it would be a great idea."

But assuming most common diseases are cured and the obesity problem is conquered, what's next? Just how long can humans live?

"There are divisions in the research community," Suzman said. "Some argue that age 75 or 85 is a limit. But then there are sub groups that have exceeded those limits. Others think there is no clear stopping point that they can see. We don't know. Some who think along evolutionary lines say there's no mechanism to pass on increased life expectancy at very late ages to children because procreation has ended well before that. So there may be other processes going on. Others have argued that having parents that live a long time somehow relates to fitness of the individual. There are also attempts and research underway to slow down the aging process. It's happening slowly, so there's time to adapt social institutions. There are biological limits, but we just don't know what they are."

Other interesting facts that emerged from the CDC's latest mortality statistics include:

• While the gap between male and female life expectancy has narrowed since the peak gap of 7.8 years in 1979, the 5.1 year difference in 2007 is the same as in 2006.

• For the first time, life expectancy for black males reached 70 years.

• Heart disease and cancer, the two leading causes of death, accounted for nearly half (48.5%) of all deaths in 2007.

• There were an estimated 11,061 deaths from HIV/AIDS in 2007, and mortality rates from the disease declined 10% from 2006, the biggest one-year decline since 1998. But HIV remains the sixth leading cause of death among 25 to 44 year-olds.

Lynn Yoffee, 770-361-4789; lynn.yoffee@ahcmedia.com