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08
Letter from the Dean

Leslie Williamson
PHILIP A. PIZZO, MD
Philip Pizzo with a portrait of Levi Cooper Lane, The Founder of Cooper Medical College, which became Stanford Medical School.

dear friends and colleagues

Just 100 years ago, when the Stanford School of Medicine was being founded, life expectancy in the United States was 47. Now it’s 77, and the elderly population is exploding. In 2000, 12 percent of Americans were age 65 or older. By 2050, we can expect this segment to reach 20 percent. And the elderly in rapidly developing nations such as China and India will likely experience even greater growth.

This global expansion of longevity is evidence of medical and social progress, yet daunting challenges remain. Most nations have barely begun to shift policies to adjust to the burgeoning elderly population.

Here in the United States, many baby boomers have begun retiring. Their safety net is fraying. In February, federal analysts announced that over the next decade Americans are likely to spend nearly twice as much on health care, and the costs will shift from private insurance to Medicare as the boomer generation ages. Indeed, the Medicare trust fund is currently projected to become bankrupt by 2019 or sooner. But few political leaders want to face the difficult issues that lie ahead. Possible solutions — rationing health care, later retirement ages — take them into rocky terrain with the American electorate.

Here at Stanford, an urgent call to action comes from the director of the university’s Center on Longevity, Laura Carstensen, PhD. A psychologist, Carstensen delineates the mental block many have when it comes to planning for our later years and urges us to break through. The center, founded two years ago, aims to use science and technology to advance the quality of life for people living longer. Carstensen is making it her priority to speak to scientists across many disciplines to inspire them to work toward improving life for older people.

One of the center’s first projects is to commercialize a shoe designed by professor of mechanical engineering and of orthopedic surgery, Tom Andriacchi, PhD. The shoe’s structure reduces peak load on the knee to help prevent osteoarthritis, a common disease of older people, which results from the deterioration of joint cartilage.

Ideally, we would wear such shoes as a preventive measure, long before signs of trouble emerge. But will we? And even more important, will we maintain the level of physical exercise and lifestyle changes needed to sustain and even promote health as we age?

Some demographers predict that today’s epidemic level of obesity, especially among children, heralds a reduction in life span — because with obesity comes increased risk for arthritis-related disabilities, diabetes, heart disease, high blood pressure and some cancers. Research published in 2005 by Jay Olshansky, PhD, et al. in the New England Journal of Medicine predicts a drop of four to nine months in life expectancy in the United States in 2050 due to obesity. It would mark an end to the steady rise in life expectancy that began in the mid-19th century.

Parents, teachers, policy makers and, last but not least, medical professionals must take the long view and step up efforts to keep children healthy and fit. A return to a physical education requirement in public schools would be a start. And the same challenge applies to adults. As a long-time distance runner, I readily appreciate how hard it is to set aside the time. But exercise and other healthy habits must be a goal for each of us throughout our lives. A focus on well-being coupled with advances in the science of aging can promote a long and fulfilling future for all of us.

Sincerely,
Philip A. Pizzo, MD
Dean
Stanford University School of Medicine
Carl and Elizabeth Naumann Professor, Pediatrics, Microbiology and Immunology

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