Three weeks ago “a terrible thing happened”, says Taki in The Spectator. “I turned 85.” What really hacks me off is the big lie I was told 60 or 70 years ago – that if I lived to a ripe old age, “inner peace would take hold of me” and the “rage to live” would subside. It’s as big a lie as socialism, “or the one that says we’re all created equal”. The urge to chase beautiful young women never goes away. What does suffer is the performance, but that’s not such a bad thing. “The words also tend to come slowly.”
Costa Rica is a paradise for centenarians
In most countries, health requires wealth – but not in the small Latin American country of Costa Rica. Life expectancy in the US is 77.3 years (and dropping), but in Costa Rica – where per capita income is a sixth that of the US – it’s nearly 81, up from 55 in 1950. How? By getting doctors out of their surgeries to meet patients at home, says Atul Gawande in The New Yorker.
One man has driven the public health revolution in Costa Rica over the past three decades. Alvaro Salas Chaves qualified as a doctor, but threw himself into public health on the Nicoya peninsula, in the country’s northwest. The area is now famous for having one of the world’s largest populations of centenarians. Salas pioneered door-to-door medical visits, winning people’s trust because “I had a very nice uniform… green surgery scrubs.” The local hospital reported shorter queues and his outreach clinics multiplied. In 1990 Salas convinced the country’s president to roll out a nationwide policy.
Every Costa Rican was assigned a local health team and a roving healthcare worker-cum-paramedic who would visit a household at least once a year. The visits even grew trendy – showing off your enrolment “became like a fashion”. The health workers are now a familiar sight on their scooters and nearly 60% of Costa Ricans have “a current, geo-referenced file”. And it’s free, funded by national insurance contributions. The system isn’t perfect: secondary care is slow and there’s a dearth of specialists. But Sala’s “immensely popular and politically untouchable” vision is thriving.
Salt substitutes can save us from strokes
We eat far too much salt, according to a study published in The New England Journal of Medicine. We can’t do without it altogether, of course: our nerves wouldn’t be able to transmit impulses and our muscles wouldn’t flex. But switching to salt substitutes with reduced sodium and added potassium could save thousands of lives. For individuals, substitutes – which taste just like normal salt and are only a tiny bit more expensive – reduce the risk of having a stroke by 14%.