Does Chiropractic ‘Add Years to Life’?

Abstract

Résumé

Does Chiropractic add ‘Years to Life’?

“Chiropractic adds Life to Years, and Years to Life”

Introduction

Imbued within our culture are clichés, or sayings, that many accept as truisms without examining their validity. We often repeat clichés not realizing they are often contradictory. Some examples might include: “Look before you leap” vs. “He who hesitates is lost”; or “Absence makes the heart grow fonder” vs. “Out of Sight, Out of Mind”; or, for those in health care, “Above all do no harm” vs. “To Err is Human”.

Chiropractic has its own cliches, and with repetition and time they take on a life of their own. Some common clichés in chiropractic include “When Your Spine’s in Line, You’ll Feel Fine” ; or “Find it, Fix it, and Forget it”; or (as a technique criticism) “It’s just Push, Poke, Pop, and Pray”.

This paper will examine a common chiropractic cliché: “Chiropractic adds Life to Years, and Years to Life”. This cliché reflects a common assumption that chiropractic care has a definable positive effect on overall human health and longevity.

Few would argue that the twentieth century brought dramatic improvements in human health and longevity. At the beginning of the twentieth century life expectancy for a U.S. male at birth was 27.2 years.¹ By the year 2000 that male life expectancy had risen to an all time high of 76.9 years.²

Never before in recorded history has such a dramatic change in human health and longevity occurred. The greatest relative improvement has taken place in younger ages with the control of infectious diseases.¹

At the turn of the 20th century the major causes of death were respiratory, infectious, and gastrointestinal diseases that together accounted for 40% of all mortalities. Today the leading causes of death are heart disease and cancer. As diseases are controlled, especially childhood diseases, human longevity and population increase. Obviously, if a disease that kills people is controlled, then people will not die from that disease and will thus live longer. The dramatic increase in world population in the past century is the direct result of this declining mortality, not increased fertility.³

Even before the 20th century improvements in longevity during the Industrial Revolution resulted from improvements in public health, food supply, sanitation and living standards. By the early 20th century further increases in longevity came with the control of smallpox, cholera, tuberculosis and other infectious diseases. Looking to the future, if further improvement in human lifespan is to be made it will come by controlling cancer and heart diseases, today’s biggest killers.³ Can chiropractic demonstrate a measurable effect on either of these ailments?

Within the phrase “Chiropractic Adds Years to Life” lies a certain presumption. If the cliché is valid, and not just marketing hype, then chiropractors themselves should be exemplars of it. If anyone benefits from living the “chiropractic lifestyle” it should be chiropractors themselves. Who else would be the best living examples of the health and longevity benefits of chiropractic care if not chiropractors themselves?

To answer the question: “Do chiropractors live longer?” a survey of chiropractic mortality in the U.S. was done and the data compared with national databases.

Methods

Because no nationally recognized database tracks chiropractic mortality, per se, it was necessary to derive this data from other sources. One publication, Dynamic Chiropractic, is a trade paper with wide circulation in the chiropractic community. Dynamic Chiropractic periodically lists the passing of certain chiropractors, typically in a “Moment of Silence” or “In Remembrance” column.

Other sources of chiropractic mortality data was the text “Who Was Who in Chiropractic – A Necrology,”⁴ college publications and individual websites, and other sources. Most of the chiropractic mortality data used in this study were derived from Dynamic Chiropractic and “Who Was Who in Chiropractic – A Necrology.”

Dynamic Chiropractic was the primary data source for the period from 1990 to mid 2003. “Who Was Who in Chiropractic – A Necrology” was the main source of data for an earlier decade 1969–1979. These two data sets were compared with each other and with similar data on medical doctors and the general U. S. male population.

Because of data limitations the study was restricted to male doctors who were presumed to be Caucasian and who died from natural causes. Because this study sought to determine natural longevity deaths from accidents or other than natural causes were excluded where such could be determined. Also excluded were those names where all the necessary death data was not available.

Where known the specific cause of death is listed, otherwise the deaths are considered as being from “natural causes.”

The deaths listed in Dynamic Chiropractic and “Who Was Who in Chiropractic – A Necrology” reflect a cross section of chiropractors, including educators and association leaders, and many general practitioners from all parts of the U.S. and some from Canada. Even still, it is uncertain whether the deaths appearing in these publications represent a valid sample of all chiropractic practitioners in general.

Further, the amount of chiropractic mortality data available was limited. Nationally there are approximately 2 deaths per 1,000 for people aged 25–44, 7 deaths per 1,000 for people aged 45–64, and 50 deaths per thousand for people over age 64.⁵ Thus with over 60,000 chiropractors we can assume many hundreds of doctors pass away each year. Only a few of these deaths will be noted in Dynamic Chiropractic or other chiropractic publications.

The chiropractic data reflects deaths occurring over several years in order to acquire sufficient data. The medical and general population data reflect single years.

Results

Table 1 provides chiropractic mortality data collected for this study for deaths occurring after 1990 and is derived largely from past issues of Dynamic Chiropractic. It is grouped by doctor name, age at death, year of death, and brief notes about the doctors’ contributions to chiropractic. Cause of death, where known, is designated at the bottom of the chart.

A total of 55 doctors who died during or after 1990 are presented in Table 1. The mean age at death of these 55 doctors is 73.4 years, with a standard deviation of 12.8.

The causes of death, where known, are most commonly heart disease and cancer, consistent with the general population. Life Colleges had the unfortunate circumstance of having three of their faculty pass away from cancer at relatively young ages: Doug Thorpe at age 44, Ian Grassam at age 57, and John Grostic (46, age est.).

Table 2 lists 67 doctors who died during the decade of 1969–1979. Their mean age at death was 74.2 years with a standard deviation of 10.5. Data for this table was derived primarily from “Who Was Who in Chiropractic – A Necrology”.

The British Medical Journal (BMJ) published a similar study in 1995 of medical doctor longevity based on obituaries published in the BMJ during that year (Table 3). The mean age at death of medical doctors in the United Kingdom was 75.2 years, SD of 13.4. In the rest of the English-speaking world, including Canada and the U.S, the mean age at death for medical doctors was 81.5, with a SD of 9.8.⁶

The BMJ study did not differentiate by gender, which may bias the reported mean age at death slightly higher.

Discussion

For chiropractic care to increase human longevity, i.e., “Adds Years to Life”, it would have do so by significantly reducing those systemic diseases that limit life span. Chiropractors have frequently claimed relief from systemic diseases as diverse as chronic pelvic pain,⁷ Parkinson’s Disease,⁸ myasthenia gravis,⁹ chronic otitis media,¹⁰ pediatric asthma,¹¹ pediatric epilepsy,¹² duodenal ulcer,¹³ infantile colic,¹⁴ high blood pressure,¹⁵ and numerous other disease conditions.

Unfortunately, such claims, even those made in refereed journals, are often typified by single case reports, poor study design, or over-interpretation of results.

If chiropractic is going to claim it advances life span it must demonstrate, among other things, long-term changes in the immune system to fight cancer, and relief of high blood pressure for heart disease.

Chiropractors often claim immune system benefits of chiropractic by citing the study by Brennan, et al., which demonstrated increased respiratory burst of polymorpho-nuclear neutrophils (PMNs) following spinal manipulation.¹⁶ PMN bursting, however, is a common rapid bodily response to any number of potential outside events unrelated to spinal manipulation.^17–20

For chiropractic to demonstrate that it increases life span it would have to show that it effectively manages high blood pressure. While Knutson found a temporary drop in systolic blood pressure following a chiropractic adjustment,²¹ similar drops in blood pressure are also found after drinking tea,²² taking a red clover food supplement,²³ meditation,²⁴ and restricting dietary salt intake.²⁵

In a study from Life Chiropractic College West treatment for high blood pressure with chiropractic care showed no long term benefit compared with non-treatment controls.²⁶ Similarly, a larger study by the Berman Center for Clinical and Outcomes Research also found chiropractic treatment offered “... no advantage in lowering either diastolic or systolic blood pressure compared to diet alone.”²⁷

To date no single quality study has been produced that shows chiropractic spinal care is the treatment of choice, or is even influential, in the long-term management, prevention, treatment, or cure of cancer, heart disease, or any other systemic disease. If chiropractic care cannot materially change the course of these diseases then it is unlikely chiropractic care can be successful in increasing human life span

Because no nationally recognized mortality database categorized by profession exists such data must be derived from other sources. Interpretation of findings in this paper must include consideration that the chiropractic mortality data reported is limited in not including all chiropractic deaths, reflecting as it does only those names that appeared in certain publications.

Conclusions

This paper assumes chiropractors should, more than any other group, be able to demonstrate the health and longevity benefits of chiropractic care. The chiropractic mortality data presented in this study, while limited, do not support the notion that chiropractic care “Adds Years to Life ...”, and it fact shows male chiropractors have shorter life spans than their medical doctor counterparts and even the general male population. Further study is recommended to discover what factors might contribute to lowered chiropractic longevity.

By contrast, the claim that chiropractic care “Adds Life to Years ...” does seem reasonable. Any service that significantly increases a patient’s mobility, function, sense of well-being, and relief from debilitating symptoms represents a valuable contribution to health care. That combined with exceptional patient rapport and chiropractic fills a valuable health care niche.

Footnotes

References