Looking back at my own youth, I certainly don't ever recall thinking, "Of course I can do this stupid thing! That won't kill me!" But I also don't recall ever thinking much about death or life-long injuries or anything like that. Any of those behaviors that might be considered reckless rarely got more thought than, "That looks cool!" (I seem to recall in particular a number of "stunts" on bicycles as we attempted to emulate Evel Knievel.)
Of course, as you age, you start seeing more friends and relatives die. The finality of life starts to sink in, and you begin to understand what consequences can really mean. But, interestingly, what caught my attention was less the consequences of big actions that lead to immediately dramatic results (e.g. drunk driving leading to car crashes) and more the consequences of a number of little actions that lead to extended, deteriorative results. That is, you're less likely to get killed in a fiery plane crash than you are to slowly grow old, start having lung problems from smoking, go through years of painful chemotherapy for cancer treatments, start having to lug around an oxygen tank, which gets more and more difficult to do as arthritis sets in, before you eventually find yourself bed-ridden as your brain atrophies with little to engage your mind.
In my lifetime, I've been to one closed casket funeral because the person's body was too mangled to display. By contrast, I've been to dozens of open casket funerals where I could look down on the withered and weathered faces of people who I knew hadn't even remotely enjoyed the last years of their lives. Strokes leaving them unable to speak, hearing loss preventing them from holding a conversation, broken hips making them wheelchair bound, dementia keeping them from even recognizing the reality around them... Seeing those people go from being bright, vibrant, engaged friends and family members to barely even shells of a human has had an impact on me.
Of course, some of the problems people encounter as they age are genetic in nature, and all you can do is hope you didn't get that bit of DNA from your folks. But many of those same problems are amplified by how you live your life. Maybe liver cancer does indeed run in your family, but if you throw a lot of hard drinking on top of that, you're going to radically increase your odds of getting it yourself. By contrast, if arthritis runs in your family, you can slow its onset by working to keep your joints limber through stretching and exercise. It's that last piece that I think is worth expanding on, throughout your entire life.
I think about it in kind of Sisyphean terms. You eat healthy and you work out to push things up the hill. At some point, though, you'll experience a set-back. Whether it's age-related or genetics or maybe you do indeed just randomly get hit by a bus. That's the equivalent of falling back down the hill. BUT, the higher up the hill you are in the first place, the set-backs won't push as far back down. Say something happens that impacts your ability to lift and you lose half your stength. If you were bench-pressing 100 pounds, that means you can now only lift 50. But if you were bench-pressing 200 pounds, you're now lifting 100. There's a greater numeric difference in the losses of the latter case, but you're still able to lift 100 pounds... which is still twice as much as in the first case!
For those who don't know, I was in an accident a couple years ago where I was struck by a reckless driver. I broke and dislocated my shoulder, and my left leg was pretty well shattered. I spent three weeks in the hospital and another year and a half doing physical therapy. It took me nearly three months before I could even attempt to walk. But virtually every doctor, nurse, and therapist I saw during that time said that I would have been phenomenally worse off if I hadn't been running marathons prior to the incident. I was in good physical shape, and I was used to the mental rigor of working long hours through a lot of sweat and pain to achieve a goal. Had I been more of a couch potato, I might still be able to walk, but there's a fair chance I would've needed a cane and I wouldn't be able to run at all! (I'm not back to doing marathons, but I am able to run several times a week. And even if it is noticeably slower than before, that I'm able to run at all is amazing!)
The same holds true for mental capacity. The more you're able to stay mentally active -- not just doing the daily crossword or whatever, but continuing to engage with life by remaining curious and trying to learn new things -- the less of an impact cognitive declines will have. One reason why people often have serious declines after the loss of their sight or hearing as the grow older is that they're no longer able to engage in ways they used to. They can't see to read and they lose the stimulous of addressing and analyzing the news from reading the paper, or they can't hear and lose the stimulous of engaging with other people. Those parts of the brain that process those inputs gets turned off and they often can't find substitutes.
Our bodies, like everything else, will break down over time. We can't stop from aging and we're not immortal. But by continuing to push ourselves both mentally and physically over our entire lives, we can keep from growing old. When aging does start to catch up with us, the higher up that hill we are to begin with, the longer it's going to take to slide all the way down to the bottom.
So I try to push myself every day. To learn something new. To get my body to run farther or do more push-ups or whatever. I'm not always successful (man, this year has been difficult to even just maintain, much less pushing forward!) and there are occasionally major set-backs (like the aforementioned accident). But rejecting complanency, refusing to stop pushing myself, that's what's going to set me up for a better life.
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