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Comment by ludston | Hacker News Reader

Congratulations to China and the Chinese people who have managed to measurably improve their livelihoods over the last few decades.

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As a developing nation, China should indeed be experiencing an increased lifespan. But under normal circumstances, China's life expectancy increases should be getting closer and close to the curve of developed nations without actually touching - because all countries should be making progress.

So the obvious story here is the actual decrease in US life expectancy, a situation broadly reflecting declining living conditions in the US.

With respect to living conditions, it appears the "everything is gettng better," and "everything is getting worse," ideas are among the most succeptible to groupthink, and to cognitive dissonance.

I also see this at reddit. Depending on the topic, and how it is framed, it seems everyone is either in agreement that life getting better, or that it is getting worse.

For a counter example to your comment, most at this popylar HN thread(1) were in agreement that life is getting much better.

I could be wrong, this has just been my observation.

1- https://news.ycombinator.com/item?id=16258434

Not in dispute - the question wasn't whether life in the U.S. was getting better but whether it was getting shorter.

Ok, but just personally I would say life expectancy / healthcare access are primary measures of 'is life getting better or worse' for people.

It depends on whether the factors leading to shorter life are deliberate (or just willful) or accidental.

It's hard to flesh out self determination from ennvironmental factors. Not to sound overwhelmingly 'r/iam14andthisisdeep, but consider: 1) Nomadic hunter gatherers who have shortened their lifespans due to their lifestyle choices, or lack of choice/information in determining their lifestyle; and 2) App developers who may also have shortened their lifespan due to lifestyle choices, or even also lack of choice/information (ie sedentary lifestyle to afford rent/food/taxes/legal aid, sugar consumption due to inaccurate information from leading scientists regarding health risks).

I just think we can't really know which one we'd prefer had we not experienced both.

Nomadic hunters had quite long lifespans; agriculture introduced shorter lifespans and difficult lifestyles.

We agree on point two though: Laws allowing no overtime for developers have allowed long work hours that we now know are very harmful.

> We agree on point two though: Laws allowing no overtime for developers have allowed long work hours that we now know are very harmful.

Excuse me? Keep your grubby hands off my time. I alone should decide if, when, and how I sell my mortality for cold hard cash. Whether or not you think it's bad for me is of absolutely no importance to my right to do it.

And what if both of those are caused by self-indulgence? Ballooning waistlines reducing lifespans while concomitantly causing healthcare shortages (because of high demand due to obesity-related chronic conditions) is definitely "getting worse" but it's an odd and self-inflicted sort of worse.

It's a fact, not a question, that US life expectancies have declined. The way the decline has happened, suicide and drug overdoses compensating for medical advances that normally provide a slow, steady increase in life expectancy in most countries, give a strong indication that life in the US has also gotten worse for a significant fraction of the population.

The story looks like a credible source of facts, but any takeaway is a minefield of ways to be wrong. I assume life expectancy is vulnerable to Simpson's paradox and that the we really need detailed analysis to determine why the aggregate difference exists.

Without that the differences in the article are not large enough to really draw anything out of except vague feelings of national pride.

Life expectancy is also a dangerous QoL metric in itself because it is so influenced by so many things (particularly infant mortality) that although longer is generally better it doesn't paint a very detailed picture. In an extreme case; I know that a pretty reasonable percentage of very elderly people would argue that a prolonged life leads to lower quality. "Healthy life expectancy" might be a much better indicator, but that looks like a technical term and I don't see a definition for it.

I'm surprised there's no measure for life expectancy, given you made it to age 20.

There is!

https://en.wikipedia.org/wiki/Survival_function

I understand this is what actuaries spend their days tabulating. (I am an engineer not an actuary but in the past I been involved in efforts to apply the same maths to asset aging. However your mileage varies massively with the quality of your data).

>So the obvious story here is the actual decrease in US life expectancy, a situation broadly reflecting declining living conditions in the US.

True, however complicated by the obesity pandemic. Some informed estimates posit that by 2030 the majority of Americans will not be merely overweight but outright obese. [0] That alone is surely sufficient to retard and revert the US life expectancy.

[0] https://www.ncbi.nlm.nih.gov/pubmed/22608371

Complicated, how? Obesity forming <whatever mechanism> is part of declining living conditions.

Obesity is a sign of improved living conditions that is also a sign of declining living conditions. The former conditions are largely out of the individual's control while the latter conditions are largely in his control. That is, being able to be obese is dictated by the economic vitality of one's country whereas being obese is dictated by one's actions.

Absolutely, but also the lobbying and campaigns vilifying fats, the lack of a competent authority explaining the benefits of sweeteners instead of sugars etc.

On a macro level, I don't buy it. If the economic reality is that you live in a food desert and you are bombarded by sugar propaganda every living day of your life ... sure, there is some kind of selection process of the most fit for that environment going on. Not sure it's a good outcome though, the optimal strategy seems to be get as many kids as you can before dying of obesity in your forties.

But one's actions are also largely dictated by societal living conditions. Many people are extremely time-constrained due to working + commuting + child caring hours. Finding time to exercise or to prepare healthy food is a challenge. Add to this that healthy food is often less easily available and more expensive than unhealthy choices. There is a degree of individual control, but it is society that controls what is easy or hard for the individual to choose.

> Add to this that healthy food is often less easily available and more expensive than unhealthy choices.

It's worth pointing out this isn't true everywhere. In America, cheap fast food is generally unhealthy, yes. As an extreme counter example, a bowl of pho in Vietnam is cheap by local wage standards, has very little grease, and can be ready within 2 minutes of you ordering.

I call bullshit on this. "Busy" people always seems to have plenty of time to watch TV, be on Facebook/Twitter and/or play video games.

There are a lot of roadblocks put in the way to controlling your weight. In the US that on the intake, junk food is readily available while healthy food is a luxury. Conversely, the US working environment suffers from increasingly medieval labor laws[+], limiting one's ability to exercise or live a well balanced lifestyle.

I wouldn't be so eager to say "being obese is dictated by one's actions". It's an equal mix of self-control and an unhealthy environment.

[+]: "Independent contractors", arbitration, union stigma/busting

I dispute that avoiding obesity requires either exercise or high-quality nutrition. It is simply a matter of maintaining a caloric balance at a healthy weight. This can be effectively controlled entirely on the intake side. (See the nutritionist who lost weight and improved his bloodwork on a gas station junk food diet. [0]) Other countries with varied labor and economic conditions (presumably among them are some you would not label medieval) are experiencing the same obesity pandemic. There is nothing unique about the US in this regard other than it has been leading the trend.

[0]: http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/

Recent declines are largely attributable to opioids.

After that, suicides and alcohol are major contributors.

https://www.vox.com/science-and-health/2017/9/20/16338996/dr...

But yeah, the opioid epidemic is so large it's noticeably shifting overall mortality stats.

Obesity related mortality actually improved from 2000 to 2015, though possibly as a result of better interventions, I'm not sure.

I sort of feel like the contributors are a cluster of symptomatic problems all rooted in inequality, from lack of universal healthcare, to more people in prison than any nation (where prisoners then get substandard health care), to underfunding of wages to an increasing underclass. It seems we have this storm of rising problems in the US.

Shouldn't there still be diminshing returns to some extent in that model? Say for instance improving drinking water quality. Compared to dysentery tainted water a chlorination system would yield dramatic improvement. Then more sediment filterung, robust filtering to remove metal and plastic pollution, etc. But once you reach the point of "sterile mineral water quality from every tap" you will have been beyond measurable lifespan improvement even factoring in lifestyle changes resulting from high quality abundant water. Granted a country has /many/ areas to work on for public health but it may eventually hold no lifespan difference just from sheer saturation of benefits obtained through lifetimes of work.

And there is a shameful backslide in the US for life expectancy for various reasons.

There are diminishing returns for cleaner water past some point, as you say. Cheap and unhealthy foods is a well known major reason, but there are other major factors too.

American cities place low priority on walkability: it's usually cheaper for the real estate industry to build out rather than build up. Regardless of if that's intentional urban planning or not, it reduces the minimum amount of exercise people get.

Another major reason is infrastructure maintenance. I'll bet the recent leaded water issues in many cities made a non trivial dent in America's longevity stats.

Finally, my personal take is that this may be a side effect of some elements of American society. Maybe it's a combination of it being such a large and diverse country. I grew up in America, but I've been living in smaller, more homogenous Asian societies the last few years. Homogenous demographics have their problems, but it seems like they're generally less willing to screw over their fellow country people for a quick buck. (China is worse than America in this regard, so I added a large population to my hypothesis.)

They deserve every bit of praise considering the fact that China was known as the 'land of famine' for majority of its history [0] -- having suffered their last major famine in the 1960s [1], that's just 60 years ago -- a blink of an eye in the grand scheme of things. The turnaround is truly impressive for a country the size of China. Makes one wonder about the power of free markets in lifting huge segments of the population from immense poverty.

[0] https://en.wikipedia.org/wiki/List_of_famines_in_China [1] http://www.sacu.org/greatleapfamine.html

If you look at that list, you could also argue the free market caused the death of around a hundred million people.

> Makes one wonder about the power of free markets in lifting huge segments of the population from immense poverty.

One would argue that it was a market economy with heavy state interventions. I'm not sure I'd call that a "free market".

But then again, I think a "free market" is a purely theoretical concept that only serves as a rough outline in real life, it has no practical application.

I think that was the point. It has absolutely not been a free market (compared-ish to the US economy) and overall it's worked wonders at the macro level, whether you're looking at QoL, infrastructure, business conditions, education, or most other measures I can think of besides privacy and human rights.

没有共产党就没有新中国

Or maybe it wouldn't have taken so long. ;p

If you consider 50 years to go from having <10% literacy to >99%, while also stabilizing an entire nation's food supply, and becoming an economic super power on par with EU/US then I hate to see what you consider fast.

Oh we should also talk about their entire coastal region we’re devistaed by land war and Japanese occupation.

I don't have a source for this, but my understanding is that much of the improvement in China's literacy rate came from the government's redefining of "literate" down to about a 1st or 2nd grade school level.

Still, I can't help but be happy at how so many people's lives have improved so greatly in such a short time.

Simplified Chinese made a huge difference. It's one of the few undeniably good things to come from the CCP, although adopting a phonetic alphabet might have been even better.

There were horrible problems that derailed progress, it's pointless to deny them. On the other hand, some of the suffering came externally, like sanctions and embargoes designed to make life miserable and induce the country to fail/the regime to collapse. Also military threats that depleted meager resources and made normal investment impossible.

What can be said is that, given this set of very difficult challenges, whether self-induced or not, the outcome, such as it is, is a commendable one.

Japan was devistates by WW2 also, but they bounced back quickly. China being one of the most powerful (and richest) countries in the world is actually not that unusual considering world history.

google translate converts this to:

Without the Communist Party, There Would Be No New China

But considering the party that the communists replaced were the Nationalists... who are in control of Taiwan.. which is even richer per capita than China (31k/person)... that seems unlikely.

Can you explain more why the Nationalists were successful in Taiwan, but you believe they wouldn't have been in China?

Edit: this is not to say that I believe the Nationalists would have been more successful than the Communists in China.. China is certainly a far larger task, both in building out a larger country and pulling more poeple out of poverty. So this is a sincere question about your opinion on the nationalists.

I don’t believe they’d be successful in China because they weren’t historically.

Also we can compare how a nationalist, democratic, and capitalist country of similar size, population, colonial explotation, and natural resource wealth would fair in India. Which again makes the PRC come out rosey.

Ignoring whether I would choose 'Capitalist' as the first word to describe India's economy, India is still a bad comparison. The only reason it's even democratic is because it inherited British institutions. Taiwan built its democratic institutions from the ground up itself, after and during decades of military dictatorship, it's a completely different situation.

I say this as somebody who has had multiple-hour long debates with people on whether China would have been better off under the Nationalists. Despite ambivalence toward the Nationalists mixed with loathing for Chiang Kai Shek, I've always passionately advocated that China would be better off if the Nationalists had triumphed.

With that said, I can think of two (good) reasons people might think that China's current rise could not have happened under the Nationalists.

1. The Nationalists were extremely poor at stamping out corruption and warlordism. China appears to have been too large a region for them to competently exercise control. Their success in Taiwan therefore may be partly attributable to a smaller landmass over which they were more capable of exercising competent hegemony.

2. Taiwan's success is partly a result of their gradual liberalisation. It's hard to say whether this same liberalisation could have taken place on the mainland.

That said, like I mentioned, I think it's hard to argue that China wouldn't have been better off. Certainly in the short term. Without the Communists taking power you avoid every atrocity under Mao. That alone is hard to offset with any later (pseudo-)unity and progress.

US military and economic support for the ROC may have been a much smaller priority too if the mainland hadn't "gone red". But then again if the ROC had won the mainland, they probably wouldn't have poured resources into the Korean War.

And so on... it's a fascinating sequence of hypotheticals.

Yeah definitely. Although I've argued the US would probably have poured funds in as a buffer against Russia. Especially given the relationship between USSR and Guomintang was not 100% unambiguously hostile, so the US would want to make sure they weren't tempted to flip by USSR assistance.

I think that the role US money played in Taiwan's success is vastly overplayed anyway. The US basically abandoned them to their fate until the Korean war kicked off.

It's always a fascinating set of hypotheticals like you said.

And given the terrible air, water and soil pollution they suffer from, this means the rest must be really, really top notch. Or that we don't have all the metrics.

Also obesity is bad for you.

Or just assume China will fix its air in 10 years while Americans (and Chinese) keep getting fatter? Lotta ways you can work these numbers!

I don’t know. They said it would be fixed in 2015 back in 2010. The fix is always 5 years away given whatever the current 5 year plan is.

Also, China has a ridiculously high smoking rate, with no end in sight for it really. On the other hand, smoking rates in the USA have fallen quite a bit in my lifetime.

So is obesity really that much worse compared to smoking and apocalyptic air pollution? An interesting question to ponder.

Then you should really think if your impression of the apocalyptic situation is actual thing or just propaganda. Smoking though is a probability thing just as the obesity is.

I lived in Beijing for 10 years (until 2016). Even the most committed wumao wouldn’t it’s pretty bad. Western media (if you mean by propaganda) if anything makes the problem sound not as bad as it really is, but how could any westerner even begin to comprehend an AQI reading over 300 let alone 500 or 1000. Actually, the only people who say the air isn’t bad are the ones who have never been before.

The air quality in China is objectively terrible, but I do think that the government are serious about fixing it. China is now the biggest market for electric vehicles and photovoltaic panels by a considerable margin. The issue is being talked about quite openly on Chinese social media, which suggests that the Party have a great deal of confidence.

While I’ll admit the current thrust is promising, a lot of it is extremely fragile. The electric vehicle push is completely incentive drive of course; e.g. why Beijing has so many Tesla’s these days despite the 2X markup has to do with the separate EV allocation in its plate lottery. Is that economically sustainable? Who knows. Solar is even more precarious as the country still lacks to the grid to move it from West to East where it is needed. LanZhou has cleaned up nicely, but it isn’t helping anything in Hebei much.

The current push to cleanup air pollution has hit some walls in being too harsh. China lacks rule of law at the local level, factory owners commonly skirt regulations, so what does happen is very heavy handed (close all factories that do X vs. just the ones that are out of compliance). They actually had to let up on the campaign after CNY this year because too much production was taken offline.

So bad you left in 2016, I'm in Beijing since 2012 and I can tell 2017 has been the year of change for air pollution. I really expect the next months/years to improve as well because the AQI still occasionally reach 300-350 and it's already far too high.

I guess we will have to wait another 5-7 years to reach US and Europe current air quality though.

I know it’s gotten better this year but keep in mind they were promising this for a long time, it wasn’t there first try at the problem. Regardless, I don’t want my kid getting asthma, so we really had no choice but to leave, even given the current improvement it would have still been a problem. The air might be clean for the next generation or the one after that, but it’s not going to be for us.

I’m tired of reading headlines like “Beijing to have clean air by 2015” wait no “2020” ok maybe “2025.” Glad that they’ve made progress but the government has lost all credebility otherwise.

True, but remember that 4,000 people died in four days in London during the "pea souper" of 1952, when visibility was about a metre or less:

https://www.bbc.co.uk/news/av/stories-42357608/death-by-smog...

https://www.pinterest.co.uk/grahamsrealm/great-smog-of-1952/...

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