U.S. life expectancy will soon be on par with Mexico’s and Croatia’s
washingtonpost.com
washingtonpost.com
- In the US, a baby is more like to get intensive medical care if it's born with a condition vs. other countries where they are often labelled as "stillborn"
- The US has a higher than expected premature birth rate. These babies are more like to die, so that pulls down the average life expectancy.
For example, in the United States, arrivals of all living infants are counted as births, but a few European countries (the Czech Republic, France, Ireland, the Netherlands, Norway and Poland) have more restrictive definitions. For example, France and the Netherlands report live births only if the infant weighs at least 500 grams — a little more than a pound — or were born at 22 weeks’ gestation or later.
In December, the U.S. government reported that life expectancy had declined in 2015 for the first time since 1993 as death rates for eight of the 10 leading causes of death, including heart disease, rose.
points to there being a real problem, not just a problem with how the number is calculated.
"But these reporting differences cannot account for the full extent of the gap between countries, says Paul Wise, MD, a pediatrician at Packard Children’s and a health policy analyst at Stanford. “The reporting differences are a minor part of the story but not an excuse for why the U.S has such a high mortality rate.”
Because even when researchers look only at births that meet the criteria for all European countries — 500-gram babies born at 22 weeks and later — the United States doesn’t fare any better. In 2009, Marian MacDorman, PhD, a statistician at the Centers for Disease Control and Prevention’s National Center for Health Statistics drew up a new ranking list, comparing the United States with 20 European countries and excluding the deaths of all babies born before 22 weeks’ gestation. The United States still ranked below most European countries."
http://sm.stanford.edu/archive/stanmed/2013fall/article2.htm...
Also, whether or not you count a pre-mature birth as a "life" is only one of several differences in how counting is done.
I guess my take is that some of the difference is due to counting and some is due to differences in healthcare.
> If you have good insurance and you live on the East Coast and the West Coast,
> you probably get the best health care in the world...
> In many parts of the country, top health care simply isn't available.
https://github.com/axibase/atsd-use-cases/blob/master/USMort...
The lead chart shows the U.S. ranked 32nd of 35 nations, for both women and men. (My quick count might be off by a little.)
In addition, this sounds bad to me:
[The U.S.] has the highest infant and maternal mortality rates of any of the countries in the study, and the highest obesity rate. It is the only one without universal health insurance coverage and has the “largest share of unmet health-care needs due to financial costs,” the researchers wrote.
Tellingly, the United States was the first high-income country to see a halt to the pattern of increasing height in adulthood, a reliable indicator of improving public health, according to Majid Ezzati, a professor of public health at Imperial College London, who led the research team.
Some Americans get a “bad start to life in nutrition and education” and suffer “high rates of homicide,” Ezzati said. “And then lack of universal insurance. Some people probably get diagnosed too little and too late.
Taken as a whole, the US is low on the list. Taken by state, it really depends on where you live.
edit: Reading farther down breaks things out by race, which suggests that it is only partially responsible. White life expectancy in those southeastern states is quite a bit worse.
* Astronomically high rates of obesity, diabetes, etc. across all genders, races and incomes.
* Poor diet. The food is delicious, but bad for you. In many places it is very difficult to find healthy food and when you do it tends to be limited in selection and expensive.
* Lack of physical activity. Everything is car oriented, no or very little public transit. Nothing is walkable, and you really don't want to when it's 100 degrees outside in the summer.
The thing that always surprises me is how our bad habits cut across all other demographic lines. I know just as many unhealthy rich people as poor people. Any way you slice it, the unhealthy lifestyle here is a problem.
(FWIW, I'm overweight but working like hell to get down since my doctor warned me that I was pre-diabetic. 50 pounds down, 40 to go!)
Source: disappointed myself not once but twice before I figured it out.
Thanks for the story and I know little about Alabama personally, but I'd be very surprised if the data said that health and healthy habits are not dependent on wealth.
YMMV, but I and many others who water fasted (nothing but water) 3-20 days report finding those temperatures far more tolerable, comfortable even. Many people find losing weight easier on periodic water fasts (once a month, for example) than counting calories, so this might aid your weight loss quest (congratulations on your exceptional personal and disciplined accomplishment).
After a certain point during a water fast, your body undergoes physiological changes drawing blood closer to the core, and your extremities feel cold as a result. Further beyond that point (seems to depend upon how keto-adapted you are before you start the fast), if you have fat reserves, the body adapts to burning fat, and the cold sensitivity becomes a little bit better. Personally, I found I really enjoy blistering hot and even humid+hot weather while fasting. High 30-low 40 C, 100+ degree F hot is a pleasant fireplace-like warmth while fasting as long as I'm moving; if I stay still without sunscreen then I can start to feel uncomfortable from the burning sensation on my skin, but my body still is happy with the outside temperature.
If this effect applies broadly across the population, then encouraging people in hot and humid climates to adopt walk-able urban layouts even during the height of summer heat waves might involve encouraging some form of caloric restriction. If you want to experiment with this effect, try doing short-duration fasts by skipping an odd meal here and there now, and by this summer, and you could be walking in the AL sun for an hour or so each day to help hit your end of the summer goal weight.
The blacks is a head scratcher. You would expect Baltimore or Chicago to crush DC thanks to their famous gang violence but maybe those states don't provide statistics.
D.C. has a high violent crime rate, but Republican politicians recently don't trumpet it to attack the local government and the party behind it the way they do Baltimore or, particularly, Chicago's, perhaps because while D.C. has an elected (and Democrat-dominated) city government that is allowed some latitude, it's government is Constitutionally a Congressional power, and Congress regularly exercises that power to prescribe local policy or veto local government acts, so they'd end up pointing the finger at their own failures if they were to blame government in D.C.
Back in high school, her friend had received a scholarship to visit DC. Being young and from Cambodia, she and her friend at the time had a rosy impression of the US from movies and other media. The assumption must have been that DC, being the capital, would epitomize the glamorous, American-dream image that is exported globally. Apparently on the first night there though, the friend decided to go out exploring the city but very quickly ended up in a dodgy area. Already a little perplexed by the surroundings and some strangely-behaving characters that were wandering around, the friend heard a commotion from above and looked up to see four guys sitting in a tree, yelling and smoking crack / meth (or maybe weed, but I'm guessing not). After returning from the trip, the friend faced some incredulous reactions in response to this story from their other classmates, but now that they're older and more aware of reality in the US, it's probably not so unbelievable.
Is that acceptable? Other wealthy nations are improving much more rapidly. Certainly the U.S. could be doing better. It's immoral, a tragedy, and an embarrassment.
From the article;
The reasons for the United States' lag are well known. It has the highest infant and maternal mortality rates of any of the countries in the study, and the highest obesity rate. It is the only one without universal health insurance coverage and has the “largest share of unmet health-care needs due to financial costs,” the researchers wrote.
Tellingly, the United States was the first high-income country to see a halt to the pattern of increasing height in adulthood, a reliable indicator of improving public health, according to Majid Ezzati, a professor of public health at Imperial College London, who led the research team.
Some Americans get a “bad start to life in nutrition and education” and suffer “high rates of homicide,” Ezzati said. “And then lack of universal insurance. Some people probably get diagnosed too little and too late.
> At some point this trend, paticularly the opiods, has to start shortening average lifespans.
I don't know what effects drugs, including opiods, have on lifespan. Certainly, taking the right prescription drugs extends lifespan in many cases. But even the wrong one might affect quality of life more than lifespan.
[1] https://krugman.blogs.nytimes.com/2015/11/04/heartland-of-da...
There are several public universities in the US that would however be comparable to ETH: UC Berkeley, UCLA, UVA, UNC, etc. ETH still isn't on the level of even a Berkeley when it comes to science or technology output.
Does anyone know of studies showing life expectancy at the coasts or by state instead of country aggregate?
- http://kff.org/other/state-indicator/life-expectancy/?active...
- https://en.m.wikipedia.org/wiki/List_of_U.S._states_by_life_...
TLDR; Coasts being always superior isn't really an accurate depiction. Hawaii (1), CA and Connecticut (tie for 3 and 4) definitely are coastal, but also rich. Minnesota (2) is definitely a surprise for me. NC, SC, and Georgia aren't rank that high and FL is marginally higher.
A lot of states with the highest life expectancy are among the least obese states. That means there is something about the lifestyle there that promotes better health.
Maybe you wouldn't control for them; for example, some of those variables may be consequences of being Democratic areas. I'd guess higher education is, as the GOP often wants to cut funding for it.
That's not what the parent comment is doing, unfortunately. It's sad that yet another HN discussion is derailed.
Croatia is also an emerging first world nation (though coming via the second world rather than the third as Mexico is) closely related to nations like Italy and Hungary with admirable levels of health and education. It has the support of the EU and all the experience in developing quality social services that implies.
Croatia and Mexico are good countries to share company with in the longevity statistics.
Of course people will try to scare you by implying those are backward countries. It's like when people compare your education statistics to Finland (#1 in elementary education) and Hungary (home of John von Neumann, known as the smartest man of the atomic and computer ages by the great minds that founded both sciences, and the Polgar sisters). Just because you aren't familiar with a nation doesn't mean it isn't great in some way.
And the thing that makes the system one of the best in the world is that it provides care at prices that middle class people can afford and where those prices are public quickly and easily to everyone. And it does so with a relatively small cost compared to GDP.
Compare that to the expense of Canada's system or the insanity of the USA system.
If the same issue were to come up here in the US, I would have 2 options:
1 - with current ACA insurance - pay $200 + 50% of cost = $700
2 - with no insurance - about $1200 out of pocket
Which option do you think I (and most other people) would prefer?
You are joking right? Have you ever set foot in an IMSS Hospital? Describing it as a third world health care service is being generous.
Source: I'm Mexican.
Yes. And I've experienced the USA health care system also.
Health care that doesn't require waiting in a dingy room and health care that is effective at treating nearly every condition that modern science can treat well is not the same thing. IMSS will cure you or keep you from getting worse or dying at the same level of effectiveness as the USA's system at 1/30th the cost and you probably can get it for free.
I pay for private care because it's nicer and I don't like waiting, but that private care is very, very affordable also compared to the USA or Canada.
I won't say Mexican health care is perfect, but it is good and it is accessible.
Describing it as a third world health care service is being generous.
I've seen third world health care when I was in Guatemala. It's not just a matter of slow and dingy but of frauds, total lack of available services, dangerously unsterile practices, public ignorance of safe public health practices in both medicine and food handling, and a whole panoply of faults and dangers. And Guatemala is above the world's average income and about average in education/literacy levels. Mexico is not a third world country just because public services aren't as nice as we'd like.
> Any statistic that accurately measures health-care systems across nations must satisfy three criteria. First, the statistic must assume actual interaction with the health care system. Second, it must measure a phenomenon that the health care system can actually affect. Finally, the statistic must be collected consistently across nations.
Says who? The authors use these benchmarks to determine if life expectancy and infant mortality are valid units of measurement. Their actual claim, implicitly, is that life expectancy is unrelated or unaffected by quality of the health care system. And the infant mortality's numbers are biased against the US (here their argument is better but why would the UN knowingly include such biases?). The argument they present is weak...to put it charitably.
Not once did they ask the question "why are health outcomes so stratified by income and wealth in the U.S.?", because their ideology is that that is acceptable.
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It's right there in bold: "Most obese adults are not low income (below 130% of the poverty level)."
But maybe food stamps aren't allocated the way i think they are.
I mean, soda might be a weird thing for you, but it's clearly something that's a standard part of the American diet. It's a 100 billion dollar industry. I don't really understand how removing soda for poor people would have a substantial impact on obesity.
[1] https://www.nytimes.com/2017/01/13/well/eat/food-stamp-snap-...
edit
"removing soda for poor people" isn't really even the case. it's just not allowing food stamps to pay for soda. I think, effectively, people will just use cash for that, and not change their habits. So $5 less for gas, or rent, or whatever they might actually use the cash for.
Also, sugar is a standard part of the American diet. But Americans are obese. Here is at least one expert who thinks sugar is the problem: https://www.ucsf.edu/news/2009/06/8187/obesity-and-metabolic...
I'd sort of think, that you, as an economist would go for more of a national tax on soda. Basic basic macro, subsidize what you want, and tax what you don't. You seem to not want soda and also want to punish food stamp users. A tax like that would be regressive, and seem to support your (as i understand them) twin goals.
Instead, you're advocating piling on regulation, making both government and commerce more difficult. I kind of think you're just trolling me, but i'm still willing to give the benefit of the doubt.
What exactly is the link between getting food stamps and being obese, and how dose resolving that alleged connection solve obesity in the united states?
edit
I see, after a careful reading, you're not asserting it would solve obesity. You're asserting that soda, if not subsidized would be consumed less, thus improving the situation.
I think you're underestimating people's willingness to use food stamps for other things and cash for soda. I think you're not really evaluating soda vs sugar and are sort of arbitrarily picking that one thing.
I think the costs of the regulations you're proposing would overshadow any effect on the 5% of 5% who's behavior actually changes.
But, ok, now i see, you're not trolling. You're moving the goalposts from soda to sugar - but ok, you're not crazy.
FWIW, I'm pushing 50 and besides the occasional party, I've never had soda in the house from birth to present, and I probably only treat myself to a soda a 1-2 times a month.
It's worse than that, because SNAP isn't intended to, and generally doesn't, provide 100% of your food budget. So removing unwanted things from the list of what you can buy with it is completely ineffective because yesterday people were buying soda with SNAP and meats with cash and tomorrow they just buy soda with cash and meats with SNAP.
This is one of the reasons why replacing things like SNAP with a UBI gives an efficiency gain. Because of that substitution effect, the entire bureaucracy dedicated to making sure people buy "the right things" with SNAP doesn't actually restrict what people buy and is a pure dead-weight economic loss.
Compare education subsidies, which actually do restrict what people buy, and are therefore worse than a UBI because they do this: http://slatestarcodex.com/2015/06/06/against-tulip-subsidies...
And if you actually want people to drink less soda, stop subsidizing the production of corn syrup.
Eliminate all sugar subsidies would have better health outcomes. Big Sugar is a real lobbying force to reckon with in US politics. Considering how damaging sugar is to the US healthcare system's overall affordability that all US citizens pay for, I'm not opposed to an instantaneous elimination of the subsidies, and let the chips of the attendant unemployment associated with Big Sugar fall where they may. Those subsidies come with a horrendous long tail of consequences.
Life expectancy is dropping in the US? Shocking. Do tell.