Presidential Health: Do We Know Enough About the Candidates?

Uniformed Secret Service officers keep watch outside the White House. (Reuters/Carlos Barria)
The White House. How healthy is the next occupant of this house? (Reuters/Carlos Barria)

The nation is poised to elect one of its oldest presidents, and while age doesn’t determine health, it begs the question: How much do we know — and should we know — about how physically fit Donald Trump and Hillary Clinton are for the job?

“Age always matters” when it comes to risk for disease, said well-known aging researcher S. Jay Olshansky of the University of Illinois at Chicago, but he cautions that it shouldn’t be a litmus test for the presidency. There are plenty of unhealthy young people.

On his election day 70-year-old Trump would be months older than Ronald Reagan – the oldest president to assume office – and Clinton will have just turned 69.

Age aside, releasing at least some medical information is an election-season ritual.

Clinton has revealed more of this usually intensely private data than Trump. Each had their own doctor write a letter last year attesting that they are in excellent health. Clinton’s was nearly two pages and included standard lab test results. Trump’s was four paragraphs with few details.

That’s a far cry from 2008 when Republican Sen. John McCain, then 71, released more than a thousand pages of medical records to show he was cancer-free and fit enough to serve as president.

The letter approach isn’t enough for some experts, who say an independent panel should assess would-be presidents’ health, sort of like the fit-for-flight physicals pilots take. After all, history shows presidents have been pretty adept at hiding frailty: Woodrow Wilson’s secret stroke; Franklin D. Roosevelt’s severe heart disease during his final campaign; Grover Cleveland even sneaked onto a boat for cancer surgery.

“What have we done to help independently vet those who would lead the most powerful nation on earth? Nothing,” bioethicists Arthur Caplan of New York University Langone Medical Center and Jonathan Moreno of the University of Pennsylvania wrote recently in the Chicago Tribune.

Others say a candidate’s health habits offer important clues.

“It’s not a matter of what illnesses you bring but what’s your endurance going to be like, and how do you prepare your body to endure a lot of stress,” said Dr. James Dewar, Vice Chairman of family medicine at the University of Pittsburgh Medical Center. He assessed the candidates’ health letters and saw no red flags but wished Trump’s contained more information.

Dewar dismissed the letter’s contention that Trump would “be the healthiest individual ever elected to the presidency,” noting it ignores lean, active President Barack Obama.

The campaign offers a preview, as the travel, junk food, crowds and questions make for “an incredible cardiovascular stress test,” said Dr. Michael Roizen, Chairman of the Cleveland Clinic’s wellness institute.

But over potentially eight years in the White House, “you want them to have mental functioning that is both quick and intact,” Roizen added.

With life expectancy at a record high and a generation of more active seniors, older presidential candidates are no surprise. But older age also raises concern about the risk of developing Alzheimer’s disease. Reagan, who turned 70 shortly after his first inauguration, was diagnosed with Alzheimer’s several years after leaving office.

There’s little way to predict whose brain might falter over time, Dewar said. The best defense: “Regular exercise, adequate sleep and diet are things that we associate with keeping our body and our brain healthy.”

Possibly the factor most promising for longevity: Both candidates’ parents lived into their 80s and 90s, Olshansky noted.

Presidents do tend to accumulate gray hair and wrinkles, but Olshansky’s previous research found many outlived the life expectancy of their time, likely thanks to wealth and access to top medical care that Clinton and Trump also have.

Altogether, “we have sufficient information to believe the two of them are both likely to be healthy long enough to survive eight years in office,” Olshansky said.

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