This audiobook is narrated by a digital voice.

Public health statistics that are routinely celebrated as evidence of medical advancement often mask a more complex reality where chronic diseases have reached epidemic proportions, life expectancy gains have stagnated or reversed in many developed countries, and quality of life indicators suggest that despite enormous healthcare spending, populations are becoming sicker rather than healthier. This disconnect between medical technological progress and actual population health outcomes reveals fundamental problems in how health is conceptualized, measured, and addressed in modern healthcare systems.

Life expectancy, long considered the gold standard measure of population health progress, has stagnated or declined in many developed countries over the past decade, with the United States experiencing three consecutive years of declining life expectancy before the COVID-19 pandemic. These declines cannot be attributed solely to external factors like drug overdoses or suicides, but reflect broader patterns of chronic disease, environmental health problems, and healthcare system failures that suggest systemic issues with current approaches to population health.

Chronic disease prevalence has increased dramatically across virtually all categories of non-communicable diseases, with conditions like diabetes, heart disease, cancer, autoimmune disorders, and neurological diseases affecting larger percentages of the population than ever before. While improved diagnosis and longer survival may explain some increases, the magnitude and consistency of these trends across different diseases and populations suggest that environmental and lifestyle factors are creating genuine increases in disease incidence.