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March 28, 2012

Accelerated Aging of US Presidents—Reply

Author Affiliations

Author Affiliation: University of Illinois, Chicago (sjayo@uic.edu).

JAMA. 2012;307(12):1254. doi:10.1001/jama.2012.357

In Reply: Dr Goldbaum is right that the perfect comparison group would be people matched to the exact risk profile of deceased presidents who died of natural causes. As indicated in the article, these data are unavailable for the United States or any other population prior to the late 20th century. However, I disagree with Goldbaum that the only conclusion to be drawn from my analysis is that presidents outlive men without the advantages they had. No one knows precisely what relative advantages or disadvantages men of their era had because they cannot be measured. In fact, without the assumption of accelerated aging, US presidents lived on average about as long as other men their age. We do know with certainty one critically important attribute men in the comparison group all had in common: survival to the same age as each president when inaugurated. This advantage was relatively rare during the late 18th and early 19th centuries given very high death rates before age 55 years, making US presidents and their contemporaries at that time perhaps closer in socioeconomic advantage than one might think.