How Americans Die

In some cases, the findings in the text don't seem to be reflected in the graphs.

Incidentally, there is also some evidence of Alzheimer's disease being linked to risk factors typically associated with type 2 diabetes. [1]

[0] http://en.wikipedia.org/wiki/Diseases_of_affluence

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/

(Less significant here means a ten year swing in life expectancy. Exercise, not smoking, calorie restriction - these are things that can make 5-10 year expected differences. Everything else is pretty marginal if you exclude the obvious exogenous line items like risk of accident. But an improving implementation of SENS provides indefinite extension of healthy life out to the expected limits due to accident rates, which is somewhere in the 1000-5000 year range for present data).

The mainstream medical research community is largely focused on patching late stage manifestations of aging. Most work and funding goes towards either manipulating proximate causes rather than root causes, or trying to find ways to alter the operation of metabolism to make the disease process less terrible - but again without addressing causes. Until such time as the research community is overtaken by the "address root causes" disruption currently taking place, of which SENS is an exemplar, but by no means the only movement, then progress towards extended life and defeat of age-related disease will continue to be painfully expensive, slow, and marginal.

The trends in life extension achieved through medicine to date are all largely incidental, unintentional. Where aging itself as a collection of processes [1] has been slowed it wasn't because that was the deliberate intent. Again, because until very recently no-one has been trying to address aging itself rather than focusing on the nature of its outcomes. It is the same difference as that between working to reverse or prevent rust in metal structures versus working on repairing structural failures that occur due to that rust.

[0]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC423155/

[1]: http://sens.org/research/introduction-to-sens-research

I.e., the graph in slide #10 says:

Cancer in 1990 killed 40422, but in 2010, 50962.

Heart disease in 1990 killed 36545, but in 2010, 45783.

That seems like cancer and heart disease have become worse, not less deadly over the years. That slide is baffling unless you realize that the population must have increased significantly between 1990 and 2010.

On eating healthily, it is sad that over a century after we started nutrition research, we are still so clueless. There is actually a lot of good information out there, but what conclusions to draw are hard to determine. This is for a variety of reasons: government policy interference, nutritional "belief" fiefdoms, a lot of very bad research, media preferring a sensational story, and certain interests with a strong incentive to confuse the matter. It takes effort, but a person can come up with a scientifically supported diet (in fact, more than one).

The place where we are still in the dark ages is the impact our gut biome plays. As the recent article about African hunter-gatherers show, we are completely clueless about what constitutes a good gut biome. Instead, I feel like much of our knowledge is of the analogous form, "smoking one pack a day is more healthy than smoking two packs, so smoking one pack is the healthy choice" (this analogy holds for many aspects of nutritional health, for example, sugar). We don't have access to a truly healthy gut biome, so our baseline comes from the "least unhealthy" group.

That's not necessarily true. Various methods of suicide are subject to substitution effects. As shown by several recent studies in Australia, a decline in the share of suicides by firearm results in a consummate rise in suicides by hanging.

   The category ‘‘drug-induced causes’’
   includes not only deaths from dependent and nondependent use of
   drugs (legal and illegal use), but also poisoning from medically
   prescribed and other drugs. It excludes accidents, homicides, and
   other causes indirectly related to drug use. Also excluded are
   newborn deaths due to mother’s drug use. (For drug-induced causes,
   see Technical notes.) Between 1997 and 1998 the age-adjusted death
   rate for drug-induced causes increased 5 percent from 5.6 deaths per
   100,000 U.S. standard population to 5.9, the highest it has been since
   at least 1979.

    In 2010, there were 38,329 drug overdose deaths in the United States; 
    most (22 134; 57.7%) involved pharmaceuticals; 9429 (24.6%) involved 
    only unspecified drugs. Of the pharmaceutical-related overdose deaths, 16,451 
    (74.3%) were unintentional, 3780 (17.1%) were suicides, and 1868 (8.4%) 
    were of undetermined intent. Opioids (16,651; 75.2%), benzodiazepines (6497; 29.4%), 
    antidepressants (3889; 17.6%), and antiepileptic and antiparkinsonism drugs 
    (1717; 7.8%) were the pharmaceuticals (alone or in combination with 
    other drugs) most commonly involved in pharmaceutical overdose deaths. 
    Among overdose deaths involving opioid analgesics, the pharmaceuticals 
    most often also involved in these deaths were benzodiazepines (5017; 30.1%), 
    antidepressants (2239; 13.4%), antiepileptic and antiparkinsonism drugs (1125; 
    6.8%), and antipsychotics and neuroleptics (783; 4.7%)." - 
    See more at: http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.gaJ8WlzN.dpuf

"Well, there was that group of American doctors," she answered. "They came to Shivapuram last year, while I was working at the Central Hospital." "What were they doing here?" "They wanted to find out why we have such a low rate of neurosis and cardiovascular trouble. Those doctors!" She shook her head. "I tell you, Mr. Farnaby, they really made my hair stand on end—made everybody's hair stand on end in the whole hospital." "So you think our medicine's pretty primitive?" "That's the wrong word. It isn't primitive. It's fifty percent terrific and fifty percent nonexistent. Marvelous antibiotics—but absolutely no methods for increasing resistance, so that antibiotics won't be necessary. Fantastic operations—but when it comes to teaching people the way of going through life without having to be chopped up, absolutely nothing. And it's the same all along the line. Alpha Plus for patching you up when you've started to fall apart; but Delta Minus for keeping you healthy. Apart from sewerage systems and synthetic vitamins, you don't seem to do anything at all about prevention. And yet you've got a proverb: prevention is better than cure." "But cure," said Will, "is so much more dramatic than prevention. And for the doctors it's also a lot more profitable."

"About the way they treat people with neurotic symptoms. We just couldn't believe our ears. They never attack on all the fronts; they only attack on about half of one front. So far as they're concerned, the physical fronts don't exist. Except for a mouth and an anus, their patient doesn't have a body. He isn't an organism, he wasn't born with a constitution or a temperament. All he has is the two ends of a digestive tube, a family and a psyche. But what sort of psyche? Obviously not the whole mind, not the mind as it really is. How could it be that when they take no account of a person's anatomy, or biochemistry or physiology? Mind abstracted from body—that's the only front they attack on. And not even on the whole of that front. The man with the cigar kept talking about the unconscious. But the only unconscious they ever pay attention to is the negative unconscious, the garbage that people have tried to get rid of by burying it in the basement. Not a single word about the positive unconscious. No attempt to help the patient to open himself up to the life force or the Buddha Nature. And no attempt even to teach him to be a little more conscious in his everyday life. You know: 'Here and now, boys.' 'Attention.' " She gave an imitation of the mynah birds. "These people just leave the unfortunate neurotic to wallow in his old bad habits of never being all there in present time. The whole thing is just pure idiocy!"

Out of context it reads a bit funny, but the whole book is compelling. Everything Huxley and Watts took from eastern philosophy is interesting.

Full book here: http://www.huxley.net/island/aldoushuxley-island.html

This presentation is style over substance.

Remaining life expectancy in old age is growing by about 1 year per decade.

An interesting, albeit a little too populist take on the options for the future of medicine and longevity:

http://inthetank.newamerica.net/blog/2013/09/drooling-your-s...

As I mentioned elsewhere, the current trends are all due to entirely incidental effects on the processes underlying aging. We should expect to see a great discontinuous leap upwards in life expectancy in the next few decades if the present disruption in the field of aging research takes hold and wins control of the mainstream, such that there is a sea change in the community to focus on actually treating aging itself rather than focusing on patching over its late-stage consequences. This hasn't been done yet to any meaningful degree, and so we should expect interesting results once it is a going concern.

1. AIDS was a really important retrograde factor in this general story, and developing the commitment to research and deploy strategies for dealing with it was a major victory.

2. Alzheimers and similar illnesses are a huge factor in terms of healthcare for the elderly. A similar success there would yield tremendous results.

Here, I claim "broad-based" depends heavily how you choose your cohorts. For example, the life span of the least educated whites in the US has shrunk (which might be relate to the increase in drug deaths mentioned by the article).

http://www.nytimes.com/2012/09/21/us/life-expectancy-for-les...

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http://www.nytimes.com/2013/05/03/health/suicide-rate-rises-...

* The US economy, at least for part of the populace, is pretty crappy; working three jobs, money worries, the financial crisis, it all adds up. * The internet; more (negative) news from all over the world, telling people how terrible it all is. At the same time, "Facebook Envy", people getting told how bad their life is in comparison to their facebook friends (which is skewed because a lot of people only put the good stuff on there). * People are dicks.

There is some research about "happyness" that started around 1970, two difference scientists asked more or less similar question since then: what you did in your day, and how happy you felt.

In 1970 women used to claim to be happier than men, there was a very large gap there.

Currently the gap is smaller, but reversed (men are happier instead), also both men and women are unhappier than in 1970s.

Regarding workload, women are working now (summing home chores and outside work) much more than 1970, men are also working more, but one thing that the researcher was noted, is that the time specifically dusting the house decreased a lot, since there is no major invention in that field since 1970s, he had the conclusion that maybe the source of unhappyness is that people don't have time even to keep their home clean, and are living in homes that are dirtier than they were in 1970.

Now I need to figure where was those articles (there are two of them with published data), I frankly don't remember :( (I stumbled on them on a night of random reading on internet)

There’s all kinds of reasons for that, many of which are related to lifestyle. Payment is an issue, but there are programs in the US available for the those that have no other option to afford treatment thanks to the Ryan White CARE Act. But even if the medicine is paid for, unfortunately in this cohort we see a lot of additional issues prevalent such as: drug use, homelessness, mental instability - all leading to patients not staying on their drug cocktail regimen.

Homophobia has AIDS and AIDS-related mortality as comorbidities. There exist fewer support structures for gay black men than exist for gay white men, which e.g. reduces knowledge transfer, makes it less of a cultural norm to stay on your drug regimen, provides fewer role models for how to live as an HIV-positive man.

It's also important to note another factor: our disproportionately black prison population and our epidemic of prison rape. Anal rape by multiple men, many of them with one or more other STDs, is an ideal way for an HIV infection to be transferred. HIV also gets transferred in prison through consensual sex: most prisons don't offer free condoms to inmates. The net result is the rate of contracting HIV is 10 to 100 times higher within prison than outside it.

1) HIV is more easily transmitted man-to-man or woman-to-man than it is man-to-woman or woman-to-woman. Thus, all else being equal, men are more likely than women to get HIV, and therefore AIDS.

2) For various historical and political reasons, race and class are closely correlated in the US. Black men are more likely to be poor than white men.

3) Poor people are much less likely to have access to condoms and be educated about safe sex, and are more likely to use street drugs and share needles. They're also less likely to have good access to health care, meaning than HIV won't be treated properly and is more likely to progress to AIDS and, eventually, death.

Put those three factors together, and you end up with black men having a much higher incidence of AIDS than other groups.

Is immortality the presumed goal?

On the other hand, guns are used in about 2/3rd of suicides.