Welcome! Welcome! Let me give you a hug. Your being here just lit up this dreary winter’s day for me. As you know, as much as I’ve tried to quiet my constant recollections about your dad, David, here I am a year later, still actively grieving. That’s why I took your advice and went to a grief support group.
Sitting in a circle with other mourners, I glanced at the impossibly young woman next to me. When she spoke, she said, “Just six weeks ago, I lost my brother, Raol, age 21.”
I girded myself.
“I took care of him during his last year,” she continued, bemoaning all the failed attempts to extend her brother’s life as he grew hairless, chronically dizzy, and shit his pants. “He loved to mess with people. In this final week, all he wanted was to taste whiskey since he’d just turned legal age, and to drive his truck which he was far too feeble to do safely. “Finally, we let him take his little spree, with me in the passenger’s seat, white knuckled. That outing made me love him more than all the medical turmoil we’d gone through together.”
I held my tears until I got to the parking lot, then, barely able to get out, “hello”, I called you. And here you are, sweetie. Thank you. I felt so helpless and sad for that poor sister and so grateful that you are well. But her story put fear into my heart about you and your chance of dying prematurely. I keep wondering, “Are we all so fragile and impermanent?”
Between then and now, I’ve pulled out the tissues, scoured my physician-epidemiologist brain, and revved up my Search Engine. Here’s what I found out.
Your chance of premature death in your 30’s is tiny.
At ages 25-44: Your odds of dying are like the chance of being killed by my cooking (just kidding ). Really though, it’s like being the only one of two to suffer some freak event in your high school class of several thousand.
At ages 65-74: Your chances of mortality (no surprise) go way up. Still, 60 is the new 40, and you have a 50-50 chance of reaching 90 (fingers crossed – I’m in this group and rooting for us all).
Age 85+: You’re not a goner but it’s time to get those papers in order. As a female, you have about a 20% shot of getting to 95, and as someone with a healthy lifestyle, you may well live to be 100 – or at least so says my accountant in working out my long-term budget.
What's most likely to get you? The four devils.
The devil most likely to off you is heart disease – accounting for over 700,000 U.S. deaths per year -the leading cause of fatality abroad and at home. Yet, for reasons that escape me, you probably won’t walk around feeling anxious about your ticker stopping until you land in the hospital because something’s gone wrong. While you know that eating a hot fudge sundae every day is going to clog up your plumbing, what the heck, it’s right in front of you. Thus, 40% of Americans are obese (that’s a 5’5” woman weighing more than 180 pounds). And severely obese people (5’5” and over 240 pounds) take 10 years off their lives. New miracle drugs can reduce weight by up to 30% but even if you take these meds forever, only by changing eating habits will you keep weight off and reduce your chances of developing diabetes.
Cancer holds second place in the underworld of devils, and together with heart disease, the Big Two account for nearly half of all deaths. Cancer remains Americans' most feared diagnosis, partly because it can strike at life's peak and because treatments—despite advances—still largely involve a brutal duo of poisoning and burning.
The risk of an accidental death lags well behind but still holds the number three spot. When you think of accidents, you probably imagine (rightly so) a young person speeding their souped-up car down the highway, or worse, becoming a transplant in the making on a motorcycle. But since you survived your teens and don’t hotrod, your chance of dying in a crash is about one in 2000 – the same odds as killing yourself with a gun. Moreover, half of accidental fatalities are due to an elder falling and breaking a hip.
Finally, in 2023, just over 60,000 Americans died from Covid, putting it well behind the death rates for stroke, lung diseases, diabetes, Alzheimer’s, and kidney and liver diseases. If you were fully vaccinated or vaccinated at least once and had the disease, that number dropped to only 6-12,000 deaths - even less than that risk of suicide by firearm. Just using a mask in a crowd or airplane, cut transmission by half.
What’s most likely to save you? The four angels.
Mankind has found the miracle mix that provides hope. Oddly, it’s a similar brew for both heart disease and cancer. I know you’ll find this shocking but here it is:
Eating a nutritious diet – the easiest to stick to is the Mediterranean diet
Avoiding tobacco smoking (the verdict on e-cigarettes is still out)
1-2 alcoholic drinks a day - my mother-in-law enjoyed a nightcap every night until she succumbed at age 101
30 minutes of exercise five days a week - personally I find a brisk daily walk in the park healing for both body and soul
The shocking part? The degree to which this reduces risk. Research tells us that you can prevent 90% of heart disease by adopting this overall lifestyle. Similarly, this lifestyle recipe works to prevent all the major cancer killers. It’s estimated that we can slay as much as half of these diabolical demons with the magic potion of eating, exercising, not smoking, and drinking right. You may have already adopted this lifestyle, if so, you’re in the elite 10%.
In contrast, I’ve read more books about ultra-processed food, secondhand smoke, radon, and electromagnetic waves, than I can count. But research tells us that stuff accounts for a tiny fraction of deaths. So, stop obsessing about walking under that high power line and stick to the Four Angels.
Other spiritual life guides.
A short list of diseases that can be prevented with other potent potions:
Melanoma: Use sunscreen regularly (avoids 40-50% of melanomas)
Colon cancer. Colonoscopy three times in your life: from age 45 to age 75 every 10 years (reduces colorectal cancer deaths by 65%)
Breast cancer: Mammograms every 2 years (guidelines recently changed) from age 40 to 74 (risk reduction 25-30%)
Cervical cancer: Pap smears every 5 years until 70 (cancer reduction 70%). Even better, vaccination (pretty much eliminates risk).
Now for a bit of fun. When you combine prevention strategies, the impact grows exponentially. For example:
If you’re a sedentary smoker who becomes active and quits tobacco your cancer risk declines by up to 65%
If you’re an older adult who combines balance exercises, removing slippery rugs, and avoiding sedatives, you can lessen your fall risk by over 70%
If you get vaccinated and simply wash your hands regularly, you shrink your COVID risk by over 85%
And even more fun. I always read about “eating well” and “a healthy diet” and thought, “What the *expletive* does that mean?” So here is a Mediterranean diet menu stolen from the Good Housekeeping website.
Breakfast: No sugar granola topped with Greek yogurt and berries
Lunch: Canned salmon mixed with capers, lemons, and fennel atop whole grain or sourdough bread.
Dinner: Chicken breasts sautéed with cherry tomatoes and garlic atop couscous sprinkled with feta cheese.
Snack: Humus with whole grain crackers.
Any time of the day: Unlimited veggies and several servings of fruit.
My editorial comment: Yum! But if you order my famous baconburger and fries every day for lunch, it may seem overwhelming to get religion. For you, I suggest:
Pick a start date, like a birthday – anything but New Years.
Go cold turkey with red meat, white carbohydrates (bread, potatoes, tortilla chips), sugar, and all oils except olive oil.
Yes - that first month will be hard, but as the months go by, the taste of meat and fries will become yucky. You’ll have to trust me, but I can tell you that when recently offered (very expensive) Wagu Beef, I found it so unappealing I spit it out.
Pay attention to recommended portion sizes and restaurant calorie counts. A single order of large fries, Double Cheeseburger, or medium milkshake will use up half your recommended calorie intake for the entire day. Even a salad doused with blue cheese or French dressing can do the same!
The Bittersweet Math of Living Longer
A word for women. We outlive men, and the implications go beyond what you might imagine. I witnessed this firsthand after my father passed. My folks had been inseparable for 65 years. Mom’s response to being alone? A whirlwind of panic-driven reinvention – facelift, crash diet to her wedding weight, and a deep dive into online dating. The results were sobering. The few octogenarian men on dating sites seemed to be searching for either a Sugar Mama or a personal nurse. As my mother wryly concluded, "I'd better learn to balance the checkbook on my own."
On average, American men live to 75 while women reach 80. Even with healthy lifestyle adjustments boosting both numbers, the gender gap persists. By age 90, women outnumber men two to one. This longevity advantage comes with hidden costs: 15% of single elderly women live in poverty, compared to just 5.8% of their married counterparts. Depression rates are higher among older women than men and get worse as women age, particularly for those facing chronic illness without a partner's support.
But don’t despair. If you’re looking ahead (as a widow, I’m already taking heed), here are five research-backed strategies to avoid becoming a sad shut-in:
Nurture Family Bonds: Whether it means relocating closer to loved ones or maintaining regular video calls, family connections become invaluable lifelines. Get closer now - think of it as an investment in your future.
Find Your Tribe: Seek out groups aligned with your interests – bridge clubs, book discussions, quilting circles, political forums. The activity matters less than the connections you forge.
Expand Your Daily Orbit: Whether through religious communities or simply chatting with local shopkeepers, create opportunities for regular social interaction.
Embrace Nature's Rhythm: A daily walk is profoundly therapeutic. Turn off the headphones and watch the unfolding of spring buds; the dazzling colors of autumn leaves. Research suggests that connecting with nature can be as effective as some antidepressants.
Focus on gratitude: This one may sound trite but it’s true, according to good studies. Regularly counting your blessings will make you happier and live longer. It’s free - try it - you may like it.
TAKE HOMES. As your friendly neighborhood number-junkie, I’m relieved that at age 66 I’ve got a reasonable chance of seeing mid-century. Yet, I live every day as though it may be my last. To improve my chances of seeing 2026, I walk daily with the Four Angels and hope not to get hit by lightning. Life is unpredictable, but friends who hold similar beliefs seem to be Ever Ready Bunnies into their 80’s and (especially among women) 90’s. I appreciate every moment I’ve been gifted.
Bottom line: you live in a magical world of longer life that is there for the taking. Might as well make the most of it.
Join the conversation—I look forward to hearing your thoughts in the comments. And don't forget to check-out visit Fully Informed Conversations (https://www.fullyinformedconversations.org/)
Livingly yours,
Mom
(Roberta Ness, MD, MPH)