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Comment by legitster | Hacker News Reader

> For an explanation, a look at America’s geography is revealing [...] the national trend of stagnant life expectancy reveals huge regional variation (see map). In a place like Hazard, in eastern Kentucky, life expectancy is lower now than it was in 1980. In a place like Manhattan, or some wealthier counties of Colorado, it has increased by not much less than anywhere in Europe.

If you actually look at the map, it's pretty clear that geography is the biggest factor. The rural lifestyle is killing people - poverty, the amount of time spent in a car, the boredom.

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Is poverty, the amount of time spent in a car, or boredom anything new since 1980? If anything we (they) are less bored, constantly stimulated.

Since there has been a large increase in deaths of despair specifically, I'm inclined to blame the spike in accessibility of addictions. In 1980 you could maybe become an alcoholic or addicted to cigarettes, or gambling if you went out of your way. Now you have alcohol, 1000 forms of nicotine, gambling at your fingertips, social media, porn, fentanyl, meth, ...

Some of these addictions, like fentanyl, will kill you directly. The others just make you check out from life, and eventually, living.

Or, people are in more despair in these areas because they have been dying since the 90s. I escaped a rural town for exactly that reason. If I didn't have a way out, and had to "live a life" in that town for 60 years, I'd probably have ended up offing myself.

It used to be you could get a random job and live an average life which could give you time to develop hobbies and have friends and do enjoyable things, as well as just be less stressed, but now rural areas are half welfare and half people working themselves to death for the most basic life imaginable to americans.

Night in the Woods explores the ennui of a dying small factory town. D: That opened my eyes to it since I have zero real life experience.

I think the difference is what's considered "average". I'm pretty sure the average rural life has always been somewhat unexciting and hard, and that hasn't changed. Now you can compare your life to the urban/modern folks more easily due to social media and other wonders of the modern age. The definition of "average" has shifted to include things that are out of your reach.

But if you're right and it's all about the availability of jobs, then the rise of remote work should soon revive these rural areas.

People in cities have access to the same forms of addiction, so it can't be accessibility as the reason.

Poor people in cities are in the same situation.* The geographical distinction is I think a red herring that goes away when you control for wealth. The article mentions wealthy people in Colorado, which is mostly not very urban.

*Even rich people have the same problems, but probably better resources for mental healthcare

The meth and opioid crisis hit rural regions much more significantly than urban areas.

It's also interesting that they point out 1980 vs 2023. Pre-Globalization, those rural areas used to have factories that by the 90s began leaving for Canada+Mexico and by the 2000s for China.

Vast swathes of America's rural hinterland effectively deindustrialized, leaving rural residents economically disenfranchised

Same with mines, which is what the Hazard, Kentucky economy was built around.

This is not just an economic crisis but also a crisis of meaning. The mines and factories provided stable, decently paying jobs. People could feel they had a place in the world and see a future for their children. Now what?

I fear that the college-graduate white-collar work that has provided meaning, stability, and economic sustenance for most of us on this site is headed for a similar pass with AI.

> This is not just an economic crisis but also a crisis of meaning. The mines and factories provided stable, decently paying jobs. People could feel they had a place in the world and see a future for their children. Now what?

Exactly! When people don't see a future they either despair (ie. Hit the bottle or meth) or rage (ie. Political polarization and extremism).

> I fear that the college-graduate white-collar work that has provided meaning, stability, and economic sustenance for most of us on this site is headed for a similar pass with AI

Already started happening in certain segments of tech. If you work in Cybersecurity, Infrastructure, or Cloud the talent base across the board doesn't exist in the US anymore - it's mostly in Israel and India now.

Similar shifts are going to happen over the next few years now that

1. Plenty of US trained and educated H1Bs are forced to return to India and China

2. Remote work is normalized

3. Colleges don't teach much aside from leetcode and some fullstack development now.

Accounting, back office, marketing, communications, and administrative roles have already been outsourced or automated

You bring up an interesting argument: is it healthier to live Urbanely vs Rurally? I see many advantages & disadvantages for both.

Having grown up in a city, and tried both, I plan to live somewhere in the middle:

On the outskirts of a small city (For me, about 30000-80,000 seems to be the sweet spot, preferably with a university, and with large enough parks for a 2 hour hike, and/or a river) while also being within 45 minutes from a large city.

I work remotely, and I am interested in living closer to nature and keeping a few livestock.

At a 45 minute distance, a 2-day-hybrid work week wouldn't be too bad, especially since that city offers things I can't get in my town (specialty groceries and IT meetup events).

Based on this article it seems like Urbanely is healthier in basically every way.

For me, the article only shows 1 data visualization which is expressly about the Rural vs. Urban divide. I don't think the article did the topic much justice. I wish it had more data analysis, rather than how it quotes specific numbers, in several cases, without really using them to relate to the thesis of the article.

For example:

"In 2021, according to the cdc, 107,000 people died of drug overdoses, the vast majority linked to heroin or fentanyl. No other rich country comes close to this rate of drug deaths (though Scotland is not that far off). And in 2021 around 43,000 Americans died in car crashes, which was the highest figure since 2005 (the number fell a bit last year); in Germany the rate was a quarter of America’s. Around 26,000 were murdered, against just 300 in Italy."

This is very very general information. Yet the thesis (I think?) suggests that health outcomes are different based on Urban vs Rural living. Why not relate not general opiate consumption data, but rather compare urban & rural opiate consumption, and relate to to another correlating factor such as education or economy. The article does to a degree, but I feel like it's lacking in analysis.

I doubt it's the places themselves — rather, the selection effect on who stays and who goes.

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