Natural Causes Summary

Should we spend our lives fretting over health concerns and battling aging, or should we embrace the natural course of life and focus on living meaningfully?

1. The health-care industry profits from unnecessary screenings.

Many routine health screenings, especially for elderly patients, may not be as beneficial as advertised. Barbara Ehrenreich argues that these procedures are often unnecessary for older adults, such as people in their seventies or beyond, yet continue primarily because they generate profit for the health-care industry.

Technological advancements like high-resolution CT scans allow doctors to detect even the slightest abnormalities. This often leads to a cascade of follow-up tests, treatments, and interventions, all of which come at a financial cost to the patient and generate income for the medical industry. For the elderly, the author posits that such measures can sometimes do more harm than good, unnecessarily complicating their final years instead of allowing them to enjoy a peaceful life.

For example, Ehrenreich shares her decision to stop mammogram screenings after experiencing the anxiety of a false-positive result. Her focus shifted toward enjoying her remaining years instead of enduring distress caused by unnecessary health interventions. Likewise, she mentions cases of senior citizens well into their late nineties or even hundreds still being screened, raising questions about the purpose and effectiveness of such procedures.

Examples

• Older patients undergoing regular cancer tests that show minimal health outcomes.
• High rates of follow-up treatments stemming from suspected, yet non-threatening, abnormalities.
• Ehrenreich’s personal account of stress and fear from an inaccurate test result.

2. Childbirth in Western medicine has humiliating aspects.

Modern childbirth often involves a series of medical rituals that may not always benefit the mother or childbirth process. Ehrenreich highlights how these practices can degrade a woman's dignity and autonomy during one of the most vulnerable times in her life.

For decades, women were subjected to procedures like pubic hair shaving, enemas, or being put in specific birthing positions under anesthesia. These steps, far from empowering women, often caused unnecessary discomfort and harm. Instead of helping, practices like forceps delivery or laying women on their backs led to complications during and after childbirth.

Ehrenreich suggests that these rituals seem designed not for medical benefits but rather for reinforcing control over women. For example, labeling women "dirty" and shaving them only exacerbates their vulnerability. Rather than fostering respect and care, these outdated procedures perpetuate a sense of subjugation.

Examples

• The widespread practice of forceps use in the mid-20th century, sometimes harming infants.
• Unnecessary shaving and enemas promoted under false hygiene narratives.
• Mandating laborers to lie on their backs, ignoring safer, natural birthing positions.

3. Cancer screening: A help or a hindrance?

Billions are spent annually on cancer screenings, yet their life-saving effectiveness is questionable. Ehrenreich critiques the emphasis placed on routine exams like mammograms and prostate screenings, arguing they may not significantly impact mortality rates.

Studies show that annual mammograms don’t necessarily reduce breast cancer-related deaths. Similarly, prostate cancer screenings for older men often identify slow-growing cancers that may never turn life-threatening. In cases like these, treatments expose patients to unnecessary physical and emotional strain. Ehrenreich also points to the trauma some women experience in gynecological contexts, particularly during invasive exams.

By questioning whether these tests offer real benefits, she underscores the personal and financial cost of prioritizing screenings over other aspects of life.

Examples

• A 2014 UCLA study showing that prostate treatment in elderly men often targets insignificant cancers.
• Women experiencing anxiety or trauma from intimate or uncomfortable gynecological exams.
• $10 billion spent in 2015 on physical exams in the U.S. without clear mortality improvements.

4. Fitness obsession stems from societal competition.

Western culture’s fixation on exercise emerged from societal pressures to compete and succeed. Ehrenreich argues that fitness trends, from gym memberships to expensive supplements, are intertwined with a desire for social prestige and a competitive edge.

The modern fitness craze took off in the 1980s when job security dwindled, and competition for economic survival intensified. Being fit became linked to ideas of personal discipline and middle-class identity. Employers took notice, too, as physical appearance increasingly signaled professional competence, adding yet more pressure.

This focus on fitness, Ehrenreich suggests, often has little to do with health and more to do with social standing. Organic and "clean eating" trends, for example, are accessible primarily to wealthier classes, reinforcing societal inequities.

Examples

• $26 billion annual spending by Americans on gym memberships.
• 1980s economic shifts leading to greater middle-class competition and individualism.
• Health-focused behaviors coded as "classy," while sedentary lifestyles are stigmatized.

5. Technology shortens attention spans.

Advancements in technology have had unexpected effects on our cognitive abilities. Ehrenreich explores how constant use of devices like smartphones and tablets affects our brains, leading to shrinking attention spans.

A Microsoft-sponsored study in 2015 revealed that adults' average attention spans fell from 12 seconds (in 2003) to 8 seconds. With distractions like notifications, social media, and instant messaging, it’s harder than ever to focus on deep, meaningful tasks. This has led to a rise in diagnoses like ADD or ADHD, often paired with medications targeting concentration.

As technology rewires our brains for fast-paced, fragmented information, it also impacts our well-being. Poor sleep quality and mental fatigue are just two outcomes of technology's relentless grip.

Examples

• A 4-second drop in adult attention spans over 12 years.
• Rise in Adderall prescriptions for diagnosed attention deficit conditions.
• Task-switching behavior reducing our ability to process complex ideas.

6. Aging is needlessly stigmatized.

Modern society often portrays aging as something to be fought against rather than embraced. Ehrenreich examines how this societal fear drives obsessive fitness routines and lifestyle sacrifices, robbing older adults of joy and authenticity.

People over 50 are often told to undergo intense exercise regimens and strict diets to "age successfully." Ehrenreich challenges these messages, arguing that such approaches miss the perks of growing older. Wisdom, authenticity, and creativity often bloom in later years, providing unique opportunities to live meaningfully without the relentless pursuit of youth.

Instead of dreading aging, Ehrenreich encourages readers to welcome this life stage as a time of reflection, enjoyment, and freedom from societal constraints.

Examples

• Betty Friedan’s observation that older adults become more genuine and self-assured.
• Lynne Segal’s note that artists often produce their richest work in old age.
• The societal push for rigorous diet and gym routines as a path to "success."

Takeaways

1. Evaluate the necessity of regular health screenings, especially in later life, focusing on quality of life rather than fear of illness.
2. Embrace aging as a natural, fulfilling process—prioritize experiences and relationships over cultural pressures like fitness.
3. Limit distractions from technology to preserve mental focus and cognitive abilities. Practice deep work over multitasking.