What happened to US life expectancy?
theincidentaleconomist.com
theincidentaleconomist.com
Answer: Americans engage in more risky behavior than other OECD members (driving, we also drive worse than some OECD members, etc):
http://www.forbes.com/sites/theapothecary/2011/11/23/the-myt...
http://b-i.forbesimg.com/theapothecary/files/2013/11/Nationa...
Car exhaust is also a big deal. Air pollution kills.
Instead of talking about the very concretely understood dangers of car culture, people want to spout total nonsense about sugar or freak out about a little second hand smoke.
All that driving also puts the average American at huge risk for dying young in a car crash.
http://www.kidsandcars.org/back-overs.html#Studies
One of my more memorable events back when I lived in a suburban cul-de-sac as a teenager was walking home from school and finding a neighbor's 4-year-old stumbling into the street, blind with tears. Her mom hadn't noticed that she wasn't in the car when she drove out.
[1] http://www.theguardian.com/world/shortcuts/2013/oct/11/brita...
[1] http://www.washingtonpost.com/blogs/she-the-people/post/morm...
The mormon lifestyle is: no drinking, everything is based around family/community, and travel the world to convert others. Plus, something about a musical.
Fun fact: A few tech companies refuse to recruit at BYU because mormons can't work all weekend.
CORRECTION: It's actually one day a month.
In other words, all of the fun, yummy, or convenient, but terrible for you things that tend to be in our lives, they're not allowed to do.
* Absolutely no work on Sundays (not even checking work email)
* A strong social safety net. Mormons are expected to tithe (pay 10% of their income to the church), and this is used in part to provide for members in need. Extensive volunteering is also expected, and used for some of the same purposes (e.g. caring for elderly or disabled).
I can't speak for Mormonism, but this was the most informative summary I've seen on the subject:
http://www.dummies.com/how-to/content/whats-not-on-the-mormo...
I'd say it boils down to how often you drink, serving size, and how much sugar.
OK. But that doesn't tell me much. :)
I brought this up because it has been conventional wisdom up until recently that you'd do better health-wise without coffee, while recently the topic has seemed to become more nuanced. Wikipedia lists both health risks and health benefits. It's not clear, to me, that it is straightforward to balance all the purported benefits and downsides and land on one or another conclusion.
As for tea, I have never seen that that is something that is unhealthy (assuming no extra ingredients like sugar). Conventional wisdom says that green tea is in fact very healthy. I haven't read much about the effects of black tea.
Personally I drink both coffee and tea without adding anything to them.
http://en.wikipedia.org/wiki/Health_effects_of_coffee#Health...
And unique features of Mormon practice presumably aren't involved, since the study found the same improvement for members of other religions with the same identified "optimum" features.
Source: I am a mormon.
The study [1] did not find that Mormon men have a 10 year advantage of other American men, it found that the "optimum" subgroup of white Mormon men ("optimum" defined as never smoked, married, 12+ years education, and at least weekly church attendance) had a 9.8 year life expectancy advantage over white males in general in the US -- and that similar figures were seen for the same "optimum" characteristics among all religions.
[1] Original source: http://www.belnapfamily.org/brentjbelnap/institute/Preventiv...
http://b-i.forbesimg.com/theapothecary/files/2013/11/CONCORD...
Further, remove fatal injuries from life expectancy data and U.S. is #1 in life expectancy. Source:
http://b-i.forbesimg.com/theapothecary/files/2013/11/Nationa...
This methodology is questionable, to say the least, and can potentially produce perverse results, and to my knowledge, they have not shown their working to show that they have not fallen into the many many pitfalls this method can generate.
Further Ohsfeldt and Schneider has never been formally published or peer reviewed.
The graphs in the article showslife expectancy at birth, which is a number dominated by infant mortality rate. For life expectancy at age 65, the US is slightly above the OECD average. Comparable to Germany or Norway. See Page 19 of this PDF: http://www.oecd-ilibrary.org/docserver/download/8109111ec004....
The other OECD countries started pulling away on infant mortality starting in the 1970's: http://www.conferenceboard.ca/Files/hcp/health/health2012_in....
http://www.newsweek.com/us-leads-industrialized-world-premat...
This is unlikely to affect the stats. Giving poor people access to health care does not improve physical health in any measurable way. It does make them feel better, however.
Increased access to prenatal care has a very clear correlation with reducing early births (and that Oregon study focused narrowly on improvements in blood pressure, cholesterol or glycated hemoglobin. Reducing infant mortality isn't in there.).
Edit: Also, how much impact do you think earlier diabetes intervention will have in a 2 year period? I can at least conceive of earlier intervention having some impact after 5 or 10 years.
Of the various public health concerns, infant mortality is one of those that are most directly addressable with medical care directed at the poor. Improved access to health services won't get a poor person to change his diet, but can be very effective in catching potential complications from pregnancy, treating infections in neonates, etc.
Also, the study you linked-to doesn't support the claim you're making ("Giving poor people access to health care does not improve physical health in any measurable way."). The study looked at just three physical health outcomes, after two years: blood pressure, cholesterol, and glycated hemoglobin (a measure related to blood sugar level control). These are lifestyle-related measures unlikely to be affected in merely two years.
Moreover, the study is inappropriately designed to test the conclusion you assert. First, it is based on giving a random sampling of people access to Medicaid ("In 2008, the state of Oregon drew names by lottery for its Medicaid program for low-income, uninsured adults."). But to address lifestyle diseases, you need to build a culture of intervention over a long period of time. You can't do this in just a few years targeting a few members of the community. Second, the study doesn't measure the impact of "access to health care" but rather access to Medicaid. The non-control group still received healthcare services, they just did so through the emergency room and by doctors' visits that went unpaid ("Medicaid decreased the probability of having an unpaid medical bill sent to a collection agency by 25 percent.").
[1] http://www.washingtonpost.com/business/economy/economic-ineq...
This is because people can't read more than one thing, it's not a conspiracy on the part of the government.
Messages from the US government are correct, Americans in general consume too much fatty foods. That people can't look at what they're eating, see it contains 900% of their daily sugar intake and instead stop thinking at that bright 'LOW FAT' sticker on the front is not the governments fault.
And god damn, grains are a portion of the diet, they're not pushing a high grain diet. The food pyramid is 'all things in moderation' in an infographic form.
And grains aren't going to kill you.
What are you basing this on? I've seen no controlled studies supporting the idea that saturated fats are harmful.
Anecdotally, I switched to a diet high in saturated fats and without grains or sugars, and my cholesterol numbers went from good to absolutely optimal, with high HDL and very low triglycerides. Friends on the same diet report similar results.
"For specific fatty acids the following is proposed: saturated fatty acid (SFA) and trans fatty acid intake should be as low as possible"
"There is a positive, dose-dependent relationship between the intake of a mixture of saturated fatty acids and blood low density lipoprotein (LDL) cholesterol concentrations, when compared to carbohydrates. There is also evidence from dietary intervention studies that decreasing the intakes of products rich in saturated fatty acids by replacement with products rich in n-6 polyunsaturated fatty acids (without changing total fat intake) decreased the number of cardiovascular events. As the relationship between saturated fatty acids intake and the increase in LDL cholesterol concentrations is continuous, no threshold of saturated fatty acids intake can be defined below which there is no adverse effect. Thus, also no Tolerable Upper Intake Level can be set."
Also, feel free to peruse the many references given here: http://en.wikipedia.org/wiki/Saturated_fat#Cardiovascular_di...
No, no study concludes they need to be cut out (they don't), but to say there are no studies suggesting there are higher risks with higher fat intakes is not correct.
And just for your high fat diet and everything is cool:
Hooper, 2001 "There is a small but potentially important reduction in cardiovascular risk with reduction or modification of dietary fat intake, seen particularly in trials of longer duration."
"Serenity now, insanity later."
http://www.scientificamerican.com/article.cfm?id=carbs-again...
One of the studies they reference: "In March the American Journal of Clinical Nutrition published a meta-analysis—which combines data from several studies—that compared the reported daily food intake of nearly 350,000 people against their risk of developing cardiovascular disease over a period of five to 23 years. The analysis, overseen by Ronald M. Krauss, director of atherosclerosis research at the Children’s Hospital Oakland Research Institute, found no association between the amount of saturated fat consumed and the risk of heart disease."
I doubt grains are that big a deal for most people.
Unsaturated fats are the only thing in the diet that is clearly bad and people still eat loads.
C.f. http://www.scientificamerican.com/article.cfm?id=carbs-again... "In March the American Journal of Clinical Nutrition published a meta-analysis—which combines data from several studies—that compared the reported daily food intake of nearly 350,000 people against their risk of developing cardiovascular disease over a period of five to 23 years. The analysis, overseen by Ronald M. Krauss, director of atherosclerosis research at the Children’s Hospital Oakland Research Institute, found no association between the amount of saturated fat consumed and the risk of heart disease."
Coconut oil and dairy fat are safe. Other fats should really be minimized. To the extent that any fatty acids are "essential" you'll easily get them incidentally from foods. All vegetable oils are bad for you and fish oils are bad for you.
That being said, from what I can tell, unsaturated fats are a far cry from your claim of "clearly bad", and even farther from "the only thing in a diet that's clearly bad". From a quick Google search, it appears that there's preliminary evidence that high amounts of PUFAs increase the rate of metastasis in rats with cancer, and preliminary evidence that high amounts of PUFAs decreases the "all-cause mortality" rate and rate of cancer events in humans with cancer. With such a low bar for "clearly bad", one could dig up a thousand and one studies about refined carbs (let alone sugar) that make it infinitely more "clearly bad".
*I mean that in the sense of reading up on things from reliable sources (studies etc), not that I'm a researcher
"[T]he Amish have had a 72-year life expectancy not only for the past few decades, as have most Americans, but for the last 300 years—since they settled in the United States in the 1700s, when most people living in America were dying in their 40s."
http://gerontology.umaryland.edu/documents/Advances_in_Aging...
Low incidence of alcohol use, strong communities with a tradition of midwifery, narrow genetic pool (which would tend to exaggerate any gene pool effects) are all things that could contribute to lower rates of infant mortality.
Life expectancy from birth weights times of poor medicine and prenatal care towards the low end of the life expectancy scale because of much higher infant mortality rates, whereas in modern times life expectancy from birth would be weighted the opposite.
So basically, if you filter out infant mortality and other "first years of life" deaths, you get a more accurate picture of how long someone could actually expect to live if they make it past the initial thresholds to human existence.
At least that's what I've grasped thus far.
I'm still trying to figure out how to say this. I'm wondering if the "natural" life expectancy in the U.S. has always trailed the "natural" life expectancy of the rest of the OECD (judged collectively, anyway) but because of some systemic effects in Europe this natural disparity was offset for some decades. The effect might have been something that gradually faded, exposing the natural life expectancy differential.
I don't want to overstate things here -- there are some clear candidates for things that might have gone wrong with health in the United States in the last couple of decades that we want to look at. But I suspect this is not the only thing we're seeing in this data.
And stats like these here suggest that Western European states that presumably changed less after the wall came down drifted away from the US, too: http://www.indexmundi.com/g/g.aspx?v=30&c=fr&c=gm&c=uk&c=us&...
Couldn't find graph-able stats that'd go back to the 90s or are totaled by Eastern Europe, sadly, but poking around here suggests that several Eastern European states experienced a significant increase in life expectancy between 1990 and 2000, three years for e.g. Slovakia.
The median age in the U.S. is close enough to 40, so every year, murder impacts life expectancy by something like (8/100000) * 40.
(The error from assuming the highest murder rate should pretty much swamp any other inaccuracy in there)
You can actually do better in that regard in a German-style nationalized healthcare system than an American-style quasi-national corruptocracy.
But there is only one way to guarantee it completely and in principle: separation of state and medicine, just as we have separate of state and church and should have separation of state and economics.
That's a nice series of words that doesn't really have coherent meaning: "politics" and "economics" are different names for essentially the same thing, the manner in which a society distributes power. You can't separate them -- state action is inherently economic.
The only thing that state action inherently is, is coercive. (Though I'm not advocating anarchy; coersion can be moral.)
Some have also suggested that unfavorable US
performance is explained by higher risk of iatrogenic
disease, drug toxicity, hospital-acquired infection,
and a cultural preference to “do more,” with a bias
toward new technology, for which risks are understated
and benefits are unknown.
The US and Canada are not the same country, but they're similar in a lot of ways. If Canada's graph shows the same drop, it'd be an indication that maybe the problem isn't with the US healthcare system, maybe it's something about culture/diet/environment/etc.
At worst in my childhood were maybe a McDonalds and a Dairy Queen. No cable TV and few other cultural influences.
Now we're fat, WalMart shopping, gun toting, rap music/urban culture, even dialects are more US sounding.
http://www.imdb.com/title/tt0086373/
I figured all Canadians were hosers who scarfed donuts and drank beer.
Then I watched Kids In the Hall and I figured they were mostly funny gay fellows.
Then I watched South Park . . .
It seems more systemic to me. I go to my supermarket and decide to eschew snacks like candy or potato chips for dried fruit or the like. But even the dried fruit has extra sugar added to it. I look at the vitamins and such on some yogurts and there is very little healthy about them. Normal dinner type foods are loaded with sodium, cholesterol, saturated fat etc. Even when one wants to be eat healthy, it can be a trial, because so much food is loaded with junk, even "healthy" type foods.
if you walk into a any grocery store, there's fresh/unprocessed meat, poultry, eggs, fish, vegetables, fruit everywhere. you don't need to buy anything that comes in a box or wrapped in plastic or has added sugar or salt or anything.
you don't need to eat anything beyond that selection to be healthy. whether or not you want to go through the trouble of preparing it is another matter.
Combine that with misleading labels and massive advertising budgets of ready meals and it's easy to understand how people fall into the trap.
I grew up in poor Appalachia. Every single person I knew, understood perfectly well how to use a shopping list, and how to cook. I simply can't imagine who these people are that don't know such things, given my comparison group is in theory low on the education chart.
I just assumed everyone knew how to cook at least basic things because that was how I was raised. He was raised with his mom doing everything for him, so after graduating (meal plans in college meant no need to cook), he literally could barely make toast. For the first 6 months after living together, his dinner usually came from Burger King.
Now I find that people my age (late 40's) and older are often the same way. Somehow they've managed to spend their entire lives eating takeout or microwaved meals.
In my single days, I managed to impress any number of women simply because I made them home-cooked meals. Insane, but true.
It wasn't so long ago that the second one went in (and that was at least partly to capture foot traffic from the high school).
http://www.youtube.com/playlist?list=PL4sylQahxyepBiKD1V7VPk...
But is life expectancy the end all and be all. At age 98 my aunt, who was of sound mind and body, was informed she'd probably live to be a 100. Her response? "Oh, God, I hope not." She lived to 102, aware and cognizant to the end.
The USA has a lower than average life expectancy at age 65, and the life expectancy has also grown less than average for that group, according to the OECD[1]
EDIT: >But is life expectancy the end all and be all I agree there. The same document includes a "healthy life years at age 65" (only for European countries though), but it is arguably a much less objective measurement and hence less useful.
[1] http://www.oecd-ilibrary.org/docserver/download/8111101ec066...
"The life of a single person is worth more than all the money of the richest man on earth." - Che Guevara
Yes, war for examples, sounds logical, but how many Americans have died in wars in the past 30 years? 10,000? Does that really move the needle?
This link is (on table 2) the PPP adjusted incomes for each decile of the OECD countries: http://www.oecd.org/site/piaac/Additional%20tables.xlsx
The US median 1st decile hourly earnings are $7.40. Austria, the Czech Republic, Estonia, Germany, Italy, Japan, Korea, the Netherlands, Poland, the Slovak republic, and Spain are all below there.
Australia, Canada, Denmark, Finland, France, Ireland, Norway, Sweden, and the UK are above there.
So I don't think that poverty is causing the US to underperform compared to the OECD mean or median.
If one does that I bet that first decile American scores way lower on the number of hours he can afford to spend in a hospital per year, or on the number of days he has to work for a visit to the dentist.
On the other hand, I think he will be able to buy more over the counter medicines.
I assumed that when dewiz listed "poverty" in a group of confounding variables like "war" or "pollution" (which, by the way, is another thing that the US is probably not particularly bad about) in explaining lower life expectancies, he wasn't trying to use "poverty" as a proxy for "low access to healthcare," so much as something that independently worsens healthcare outcomes even controlling for healthcare access.
(And, by the way, while I don't think that it explains the difference in life expectancies raised by the parent article, I do agree with dewiz that poverty almost certainly has a negative effect on healthcare outcomes, even if you perfectly control for access to healthcare.)
There's a difference between "low earnings" and "poverty", the two are only equivalent in a system with no public support.
What you are looking for is a distribution of life expectancies per country.
[1] http://www.ipsnews.net/2013/03/spain-leads-the-eu-in-gm-crop...