Why Isn’t Donald Trump Dead?

No, don't worry, I am not about to get all political.  Rather this is a consideration of morbidity versus mortality.

Donald Trump, in spite of what he may claim, is unhealthy.  He is obese and by all accounts pursues an unhealthy diet of Coke and fast food.  He doesn't exercise much and famously goes around his golf courses on a buggy.  Of benefit to him is that he neither drinks alcohol nor smokes, but no doubt he is taking medication to counteract highly probable diabetes, high cholesterol and high blood pressure.  But he is one of the millions who live into old age (he is 74) without walking 10,000 steps a day and following a healthy lifestyle based around nutritious foods.  Is it all a con?  Do we need to exercise and eat healthily to live a long life?

Ultimately we all die of something and that includes all those who exercise and generally follow a healthy lifestyle.  Indeed, despite being recommended to exercise, more and more inactive people like Donald Trump are living longer and in better health today than ever before.

This brings us to the relationship between death (mortality) and illness (morbidity) and actually focusing not just on life span but on health span - the length of time spent in good health without morbidity.  What is observed is that those who are 'unhealthy' have only a slightly lower life span than those who are ' healthy' (remember we are talking statistical averages here).  Somebody who is generally healthy is at nearly 100% functional capacity until very late in life, despite occasional temporary illnesses.  However, those who are considered unhealthy see a much earlier reduction in their functional capacity and have a period of chronic illness for many years prior to mortality.

The figure below paints the picture quite clearly.

Additionally, what is being observed is that the mortality gap between the healthy and unhealthy is actually converging rather than diverging - we have better medicines and are getting better at treating people and keeping them alive.  On the other hand, the morbidity gap is getting bigger of course.

So, whether you exercise or eat healthily may not significantly impact your life expectancy (say 82 v 85), however it can significantly impact your health span by 30 or more years.  I know what I aspire for and it is not to be Donald Trump - for oh so many reasons!