The decline in U.S. life expectancy is unlike anything seen in a century (2018)

America: the Farewall Tour - https://www.worldcat.org/title/america-the-farewell-tour/ocl...

DECLINE of EMPIRES: The Signs of Decay - https://youtu.be/Q2CCs-x9q9U

Today, in Paradise, the power was out for most of the day... like Mogadishu or Baghdad. America, like a slowly-boiled frog, has become a third-world country:

- no universal healthcare

- grotesque inequality: lower average pay, unlivable wages, more billionaires, millions of homeless.

- wealth transfer from the poor to the rich through tariffs, fines, fees and other taxes

- crumbling infrastructure - tens of thousands of structurally-deficient bridges and crossings

- apathetic, uncaring police letting crime go unpunished and misery flourish

Americans don't know how bad they have it... it's great for the very rich, but it's horrible for most people including the aspirational rich who will never be so and yet vote/work against their own interests and be cowardly traitors against We The People.

I read the charts a little differently - overall tobacco product usage has gone down quite significantly, with cigarettes and cigars driving the majority of that. I think it's a safe assumption to make that at least some of that drop is due to the switch to e-cigarettes like Juul. Obviously "how much" of that drop is due to the increase in e-cigarettes vs. the natural decline of smoking is in question, but I would not draw a conclusion that e-cigarettes are hurting children.

https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...

Life expectancy is computed by counting deaths per cohort and year. That is, the statisticians will count the number of people your age who die in your location this year, and the number of people one year older, etc. At the end of the year, they do the totals and compute that, say, 0.1% of people your age died at your location, and 0.1% of people one year older, etc.

Then they compute your life expectancy by multiplying those chances together.

People moving shouldn't affect that significantly, because this computation doesn't use the past at all. All the data comes from one year.

The big assumption there is that your chance of dying in ten years is assumed to be the same as people ten years older than you dying this year. The small assumption is that the population is assumed to be stable and countable within the present year (I suppose it's possible to work around that with more sophisticated statistics, though).

Insurance companies only profit from prevention when they can prevent something they'd been paid to insure against beforehand. They may be forced to employ prevention to offer competitive insurance deals, but that makes them interested only in individual prevention for their customers. From a revenue perspective they depend on the prevalence of sickness.

I'm not saying that everybody in an insurance outfit has their priorities consciously aligned like that. But we shouldn't expect advice from an insurance to be good for our health. Sometimes they might prefer if we die fast. Or stay in therapy and opt for the extra-care package.

Additionally, suggesting solutions that don't have any revenue attached to them is doubleplusungood for the HN denizens for whom the only yardstick of progress is Tres Commas Tequila.

Yep. You can see this in my state (Texas) simply by driving from a metroplex a couple of hours out into the country. Obesity visibly skyrockets.

Part of it is cultural, but part of it is economic. Healthy food is simply more expensive, especially if you want it to taste good.

People eat too much low value food. Some of that is due to poverty, but when over half the population is overweight, it isn't just an issue of lack of good food.

It's bad choices. Largely brought on by bad government advice and incentives.

Edit:

Expanding a bit, I recently talked with a couple friends from college. One had lost 100lbs and another had lost quite a bit of weight. The main change they made was to cut out soft drinks. One of them said, "Why didn't anyone tell me that's a bad idea?"

Worded another way, I've heard it explained before that we tell people "eat more of this". People take that to mean "Eat what you already eat, plus these things, and you will be healthy."

What it actually means is "Don't eat this garbage that is making you sick." But it's never worded that way. Add to that the fact that all government nutrition advice is basically just pandering to the highest bidder with little regard for what actually makes for a healthy diet, and it's no wonder people have so many problems.

You can construct an incredibly healthy diet on just 2$ - 4$ per day or less: rolled oats (70c/lb or less) -> can be used to make oat milk, oat meal, baked goods, etc and it lowers your LDL with tons of health benefits.

Other things all can be found for less than 1$/lb => bananas, apples, onions, beans, rice (38c/lb or less at costco!!), bell peppers, grapes (sometimes), potatoes, lentils, etc. Oatmeal and Beans are a superfood, greatly undervalued in our society. The key is to shop in the bulk section of the store.

All these things and more are at least 10 times less costly than mcDonalds, we just need to get the word out. Once there's consumer demand for these things we can start alleviating the food dessert areas in the US.

I think it's actually the fact that the war on opioids has translated into a war on prescription pain drugs, in general.

So, when you're a chronic pain sufferer and have gone without and you get ahold of something - anything - to remediate the pain, you're far more likely to take a little extra just to get the pain to STFU for a while so you can do things like sleep through the night for the first time in seemingly forever.

I've heard tales of American veterans (through the VA) being referred to things like yoga to manage their chronic pain, when it's entirely due to neurological damage and things like yoga will do fuck-all to help with that.

Is it any wonder then that people might be more liable to OD when they obtain something to try to manage the pain that otherwise never ceases?

I'd say it is a fundamental issue in American society (the war on opioids translating into no pain management medications whatsoever) with callous indifference - rather than anything else.

I think there's a narrative that is the opioid crisis is driven by addiction, when it seems to be, and has historically has been, inefficient drug pricing.

The dirty little secret that no one talks about: Many of the Miracles of Modern Medicine that save lives don't restore you to full functioning. It's often a miserable existence with no hope of really getting your life back.

And it's not a small number. Up to 20% of people identify as handicapped while another 40% of the population has a milder degree of impairment and actively eschews the stigmatizing label of handicapped.

As far as I can tell, income inequality mainly stems from inequality of opportunity. I think a country is as free as its ability to give all its citizens the same opportunities.

Agree. But I'd like to add:

- MLK was assassinated when he shift from civil rights to addressing poverty and income inequality.

- Bobby Kennedy was also making noise about the issue.

- Currently, the mainstream media narrative is a relentless Red v Blue. There is no narrative for Haves v Have-nots.

The System does work; quite well actually. And those who it works well for are not going to give up those benefits without a fight. But The People are too busy chasing symptoms and fighting each other. Change anytime soon feels unlikely.

The term arose out of the cold war, meaning countries that weren't aligned with either the United States (first world) or the USSR (second world). That can't be what you mean.

Later, it started to mean countries with poorly developed economies. That isn't the case, even if lots of our infrastructure is well used (really, if you have lots of infrastructure, you want at least some of it to be near the end of the useful life...).

I suppose a recent definition looks at places with stark disparities in wealth/income. The US has that, but low income people here are doing quite well compared to most of those places, with lots of support coming from the government. We are wealthy enough to do much more, but things like Medicaid are not worthless.

There isn't any evidence for that root cause though. If someone has a comfortable, secure life with food and shelter they aren't going to be unhappy no matter how much someone else has.

Fixing "income inequality" completely misses the actual root cause. I don't know what the root cause is, but I have lived next to some people who were substantially wealthier than I was and I didn't feel anything negative. Some inequality is healthy and nobody knows how much is ideal.

It sounds like a nice-to-have-thing but how on earth does that actually follow? The US spends enormous sums on education, the 2nd most of any country on earth (behind Norway) and ~33% more than OECD average. How can you be sure the problem is that we are investing too little?

Investment hardly seems like the issue, ROI seems a lot more pertinent. For infrastructure, even heavily unionized countries can build public works projects like subways at far less cost than the USA.

So its hard to buy that we invest too little per se. We get very little for our investments, whatever they are, which makes people in-my-opinion rightly cautious about investing more until some honest root cause analysis of the poor ROI is performed and openly acknowledged.

While his policies and voting record may tell a different story, that comment left a lasting impression on a lot of people. I have yet to see him speak directly to poor white people as Yang did, and I suspect he (Bernie) is afraid of alienating his younger, left-learning base. To see who I mean, check out those replies to Yang's tweet.

[0] https://www.politico.com/story/2016/03/bernie-sanders-povert...

Edit - Obesity does contribute to liver deaths, so it's there.

Most Americans don't view economic and social issues through the lens of race war, however. Certainly, non-white Americans, who have also been affected by globalism, automation, unemployment and the collapse of traditionally stable industries like mining and manufacturing, would not be amenable to viewing themselves as either a symptom of, or merely collateral damage in, the narrative of the decline of white people.

Bernie, Warren, Harris, etc. speak directly to issues which disproportionally affect other groups (police violence against blacks, immigration policy that mainly affects Hispanics, etc.), but never this one. It gives an impression of unequal treatment, and leaves some feeling unnoticed and ignored. This creates opportunity for the first politician to say, "I see you, I see your suffering, and I will not ignore you."

And there are probably other confounding factors; eg, it may be much more difficult for a homeless individual to exist in a rural town than a city - the stats would show that as more homeless in the city, even though the ambient conditions are better. So sure the stats say that there is more poverty in the cities - but that might just be signalling that poverty is much more painful in rural areas. This means that people could be saying things that are technically wrong (hence the myth) but are very accurate to the lived experiences and pressures on someone in a rural area.

"We focus on non‐Hispanic whites because their mortality trends were particularly adverse in the last decade and differ from those of non‐Hispanic Blacks and Hispanics.

In contrast to non‐Hispanic whites, mortality has continued to decline among Hispanics and non‐Hispanic Blacks, although death rates remain substantially higher for Blacks than for whites (Harper, MacLehose, and Kaufman 2014; Murphy et al. 2017; Stein et al. 2017). The underlying mechanisms driving mortality trends for non‐Hispanic whites are fundamentally different from those driving trends for other racial/ethnic groups, as suggested by James and Cossman (2017)."

[0] https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12249

Can you clarify what you mean by that?

If countries are having difficulty replacing it is there really a meaningful distinction? Even Europe doesn't have as much atheism or deaths of despair as the US.

Likewise, the drop in fertility rate has been steeper in the US. Rates dropped from almost 4 in 1960 to 1.8 today. Sweden dropped from about 2.5 to 1.85.