Elderly Japanese exercise in Tokyo to mark "Respect for the Aged Day" © Reuters
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Half the children born today in Japan could live beyond 100. That's the startling fact galvanising the debate about longevity and social change in a country where deaths have exceeded births for more than a decade.

FT Tokyo correspondent Leo Lewis examines the implications for finance, housing and technology as well as health spending. By 2025, when baby boomers turn 75, government expenditure will soar as patients become entitled to reduced medical costs as they get older.

Japan's experience is not universal. New data for 20 countries this week showed average life expectancy improved by 13.1 weeks per year for men and 9.4 for women between 2000 and 2011. But since then this improvement has slowed to 10.4 and 6.7 weeks respectively.

In the US it is clear the opioid crisis is taking a toll, while the UK has also experienced a stark slowdown in improvement. Possible causes range from government austerity measures hitting social care, poor lifestyle and obesity as well as seasonal flu. Earlier gains from treating cardiovascular disease and stopping smoking are also tailing off.

One sector is benefiting though: life insurers are bagging exceptional profits as their customers die sooner than expected.


Three questions

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine.

What do you think about the recent slowdown in Britain’s life expectancy improvements? 

This needs to be taken seriously. We are seeing a reduction in gains in life expectancy, which conceals reversals in some places and at some ages, notably for older isolated people most dependent on social care. It has been complicated by the NHS coming under unprecedented pressure. We’ve been warning on this since 2013 but it has been ignored and at worst dismissed.

Are you concerned about the growth in vaping in the UK?

England is a complete outlier in its approach to electronic cigarettes. There is no really good evidence that they are effective as quitting aids, and more and more evidence that they act as a gateway to smoking for young people. The long-term effects are completely unknown but there is enough evidence to be concerned. Nobody knows how safe vapes are. There is data from animal studies showing a link to cardio-vascular and lung disease.

Are you worried about the impact of Brexit on health?

Nobody is prepared. I have absolutely no idea what will happen and, more important, the government clearly has no idea. NHS colleagues tell me they have had no guidance. I’ve heard British researchers being asked to step aside from European research consortiums and excluded from funding applications. We have no idea how the UK will be able to participate in the next EU programme and government reassurances are completely worthless as they are based on nothing more than hope.


Chartwatch

Drug safety Recent safety scandals show the risk to international consumers from weak oversight in China, the world’s largest supplier of active pharmaceutical ingredients. The country’s manufacturers account for 40 per cent of global production. (FT)


FT conference

FT Digital Health Summit USA will explore the benefits, opportunities and complexities of digital disruption. Join the brightest minds from across the health spectrum in New York on October 17. FT Health subscribers can save 20% using the code FTHealth20. Register here


News round-up

Anti-vaxxers advance Medical experts attacked Italy's new government for removing legal obligations to vaccinate schoolchildren — despite recent outbreaks of measles. Headteachers are refusing to comply and barring unvaccinated children from nursery. Measles is also spreading through the Americas. “Anti-vaccine activists have taken vaccine science hostage,” remarks one commentator. (FT, Times, The Lancet, NYT)

Ebola in Congo Vaccinations began for the new outbreak of Ebola in the Democratic Republic of Congo, albeit hampered by armed conflict. Peter Salama is the Australian epidemiologist heading the response. (WHO, Nature, Science) 

Nutrition news Nigerian food companies plan to add nutrients to staples such as salt, flour and sugar to improve health, especially among children, seven per cent of whom die before the age of five. Chinese consumers are turning away from monosodium glutamate in food and embracing healthier products. (FT)

Coco Pops clampdown London's transport authority is counting the cost of its ban on junk food advertising. UK regulators, meanwhile, rejected complaints about the marketing of McDonald's “Happy Meals” but clamped down on ads for KFC and Kellogg's Coco Pops. Listen to our podcast on anti-obesity strategies and the food industry. (FT, Guardian)

DIY HIV tests Superdrug became the first large UK retailer to sell HIV self-testing kits. The BioSURE test gives a result from a finger-prick sample within 15 minutes and says it is 99.7 per cent accurate. (Guardian, company video) 

Virtual doctors Online medical consultations could save the UK's NHS time and money, especially given the current delays in gaining an appointment, but they also pave the way for a two-tier healthcare system. In Germany, IBM's artificial intelligence system for detecting cancer was found to be less intelligent than expected. (BMJ, National Health Executive, The Conversation, Der Spiegel)

Drug Deaths Drug-related deaths hit a new record in England and Wales and in the US use of illicit drugs could be higher than thought. Has the war on drugs been hopelessly lost? (The Conversation, Eureka, FT)

Mobility and health “Healthcare is obviously a critical need but if you can’t get to your appointment, it doesn’t matter how great the doctor or hospital is.” Philanthropy can play an important role in tackling transportation problems for patients in rural America. (Health Affairs)

Dental ding-dong Flourishing fluoride-free toothpastes with “natural” ingredients have been criticised by dental authorities. Gerodontology journal said oral hygiene without fluoride had “no impact” on cavity rates. (Trib) 

Doctors with disabilities Despite advances in equalities legislation, doctors with disabilities face an uphill struggle against perceived norms of medics as able-bodied and available for duty around the clock. Campaigners are fighting back. (NPR)


Podcast of the week

Climate change and health The planet could be approaching a tipping point on global warming. Does the same apply for its impact on our health? We speak to FT environment correspondent Leslie Hook and Laurie Laybourn-Langton, director of the UK Health Alliance on Climate Change. (FT, 8m)


Best from the journals

Preventable deaths Most advanced economies are experiencing a slowdown in preventable premature deaths. One exception is white Americans who are affected disproportionately by increased suicides, accidental poisonings and deaths from liver disease, while the decline in chronic disease deaths is slowing. Projections show 426,000 suicides among those aged 25—64 years between 2017—30. (The Lancet)

Pass the salt An international study suggests fears about the effects of salt on health should be focused on countries like China where intake is particularly high. (The Lancet)

Greek tragedy Austerity cuts in Greek health expenditure were probably responsible for steep changes in mortality trends and a rise in communicable, maternal, neonatal, and nutritional diseases between 2010 and 2016. (The Lancet)

Vaping and smoking A study showed vaping put teens at a higher risk of trying marijuana while another examined the role of Twitter bots — posing as real people — to swing public opinion in favour of ecigarettes. (Pediatrics, Journal of Health Communication.)

ADHD success Themost comprehensive study so far on drugs for attention-deficit hyperactivity disorder said medication was remarkably effective in treating the condition. ADHD is estimated to affect around 5% of school-age children and 2.5 per cent of adults worldwide. (The Lancet Psychiatry, FT graphic)

Exercise and mental health The largest study of its kind to date showed a link between exercise and improved mental health. Excessive exercise can however have the opposite effect. Audio discussion here. The public is also generally unaware that a lack of exercise is a cancer risk. (The Lancet Psychiatry, Journal of Health Communication)

Are women better doctors? Female heart attack victims are more likely to survive when treated by female doctors. But male physicians do improve the more they practice alongside female colleagues. (PNAS) 

News in briefs Men who wear boxer shorts rather than tight-fitting underwear are more likely to have higher sperm concentration and total count. For those who would rather avoid causing pregnancy, here are three male birth control products in development. (Human Reproduction, Vox)


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Final thought

Taboo-busting In the west at least, celebrity memoirs, film and TV are all helping dispel the reluctance to discuss mental health problems. The world's largest arts festival sees the issue take centre stage. (NYT)

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