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December 21, 2005

On the Preservation of Health

JAMA. 2005;294(23):3024-3026. doi:10.1001/jama.294.23.3024

Health is intrinsically unstable and is subject to erosive forces across the life trajectory, from intrauterine life to old age. As a result, few individuals achieve idealized versions of the lifespan (ie, good health and functional status into very advanced years, with compression of morbidity toward the end of life).1

Each person may be thought of as having, at birth, a certain quantum of health expectancy, determined by the characteristics of the individual genome and the biological quality of the intrauterine environment in which the fetus has developed. The quantum is affected over time as the biological, psychosocial, and behavioral characteristics of the individual interact with environmental, socioeconomic, and educational factors, and with the amount and quality of the health care received over the life course.