That's an bold statement to make. Canada is also experiencing a historic opiod crisis right now, but their life expectancy is dropping no near as fast as US. Something else is going on.
EDIT: I don't think the parent post should be flagged. The opioid crisis is real and has a noticeable effect on life expectancy. It's just not the whole story, that's all.
But is Canada doing better at mitigating the damage from the opioid crisis? For example safe injection sites presumably lower the fatality rate of drug addiction quite significantly.
As a Canadian I can tell you, no. This year British Columbia on average has 5 deaths per day from fentanyl OD, rising from 3/day from just 2 years ago.
The majority of deaths are normal people who used contaminated recreational drugs in their home, as oppose to street junkies that are quickly revived by ambulances.
In an ironic way, yes. People who quietly OD in their house die while junkies are quickly noticed by their street pals and revived (and would often fight the paramedic for breaking their high.)
(Apparently it's now 6 deaths/day, up from 5/day in 2021).
Are you saying that 3 out of 4 people in the US are addicted to one drug or another, or am I misunderstanding.
> there was 70%+ opioid prescription rate
This I can completely believe. I broke a bone, and when the doctor was asking how much pain I was in out of 10. I said 0, when I don't move it. They still prescribed me opioids.
I asked if they expected the pain to increase, and they said they expected it to actually get less painful to move overtime if anything, and if it started hurting to get seen by another doctor. When asked about the painkillers then the answer was "Just in case".
In a discussion of life expectancy, excess carbohydrate consumption in a nation with 75% overweight/obese population seems pretty relevant. Surely, sugar is the single biggest source of excess carbohydrate consumption.
And the way people thirst for their sweet treats and drinks, it certainly looks like addiction. Not that it removes any culpability of other excess carb consumption like alcohol and breads.
To be fair regarding the pain, I was in approximately 0 pain when I first broke my wrist, to the point where I didn't even realize it was broken until I realized that I couldn't move my hand. I definitely got worse over the next 24 hours or so, after they had set it back and sent me home with a soft plaster half-cast thing.
But I definitely didn't need opioid painkillers, acetaminophen did just fine. Same goes for my wisdom teeth.
if you think thats ridiculous I once got a two month script for opiate painkillers after my wisdom teeth were removed. "just in case" was the excuse as well. pretty pathetic when most of the discomfort was easily controlled with half an aspirin and some rest.
When I got my wisdom teeth surgically removed, the pain was quite bad and I was glad to have something stronger than over the counter. My prescription was only for 1 week. When it ran out, I still had some pain not fully controlled by over the counter pain meds.
Well you were pretty lucky then. I've had pain for weeks after a surgical extraction that was hardly touched by 800mg ibuprofen. It depends a lot on how well it heals, IIRC. And other considerations like whether incisions were required.
I think when you need it you need it quickly because if the pain starts to get out of hand the pills will no longer have any effect. Is it so hard to not take them if you don't need them?
I wonder if this has changed since then though. I had surgery on my shoulder a couple of years ago, and had a one week prescription for opioids, then it was as much Tylenol as I could eat but nothing stronger.
That doesn't necessarily mean 81.3 people out of 100 have prescriptions, if people can have more than one prescription per year. I'd assume the affected people probably get something like monthly prescriptions? (not sure if that's how it works)
Giving the prescription rate as a percentage confused me (though it seems commonly done). What's meant is the number of prescriptions per 100 persons, per year. I assume a rate of 70 could mean 70 persons received one prescription each, or one person received 70 prescriptions?
US life expectancy was falling well before COVID in spite of spending much more in PPP terms than any other country in the world on healthcare. The country seems to prefer to be fleeced than to consider other options that might be labeled as socialism.
Everything you just said is true, but it could also be simultaneously true that most of the drop was due to covid. The two are related in fact- structuring your whole health care system to maximize profit no matter what the side effects might be makes it brittle in the face of a pandemic.
Basically I'm saying that my statement, and your statement, are not contradictory but rather two sides of the same coin.
I would imagine it's also 2nd order effects on the health system - delayed diagnosis, treatments, and surgeries. Full ER rooms means stroke patients don't get seen as fast, reluctance to interact with the medical system means treatment isn't sought, and devoting large swaths of hospitals to COVID patients means the "not an issue now but will be in a year" conditions aren't dealt with. I doubt many of these effects were avoidable, but it's still unfortunate.
This is likely related to COVID as well, just indirectly.
- Research has shown that recent COVID-19 infection increases risk of heart attacks, strokes, and a ton of other vascular diseases.
- Overwhelmed hospital systems will have poorer outcomes in emergencies such as sepsis where time-based care is a huge factor. Worldwide sepsis mortality has gone up over the last two years, for example.
You simply can't fix systemic health issues with a pill, shot or a multivitamin. obesity correlates with higher covid mortality and this article mentions quite clearly that alaskan life expectancy decreased despite succesfull vaccinations. Worse yet, obesity seems to be increasing rather than decreasing so whatever any politician, healthcare service or advocacy group has done the past 20 years, the USA is still not closer to a solution to the lowering life expectancy. Covid might be over but there will always be a next crisis.
No. Over 4M people in the US are out of the workforce because of long Covid. The death rate from Covid this year is on pace to be a multiple of average flu deaths.
>You simply can't fix systemic health issues with a pill, shot or a multivitamin.
I feel like this is the biggest impediment to universal healthcare in the usa. When much of the developed world implemented it, around late 1960s. You had fully recovered from debt of WW2, working economies producing lots and the cost of healthcare was low.
It goes without saying as well that most shots, pills, or multivitamins are not covered at all. How about the myriad of problems that simply aren't solveable.
>obesity correlates with higher covid mortality and this article mentions quite clearly that alaskan life expectancy decreased despite succesfull vaccinations.
If you went to a grocery store or restaurant the probability that it's full of sugar/carbs is extremely high. If suddenly tomorrow everyone switches off sugar/carbs, we would have immense food shortages. So we can't really encourage people to switch off carbs.
>Worse yet, obesity seems to be increasing rather than decreasing so whatever any politician, healthcare service or advocacy group has done the past 20 years, the USA is still not closer to a solution to the lowering life expectancy. Covid might be over but there will always be a next crisis.
Newfoundland's very popular liberal government implemented a sugar tax recently.
I think it's a great idea and those who do it first will benefit in the long run. Flipside, I don't think government should be allowed to do anything with food. No restricting, no taxing, your extent is only in the 'everyone agrees with' category. Food inspectors for example? We can all agree that's important.
>I feel like this is the biggest impediment to universal healthcare in the usa, When much of the developed world implemented it. ...and the cost of healthcare was low.
I'm not sure what you mean. systemic health issues, like obesity, wouldn't be better off under universal health care because I would end up paying for the other 40%. Which is entirely ""preventable"" whatever that means in todays society where no one actually prevents it.
as to what you mean when you say "When most of the developed world implemented it" I'm not sure we have the same classification of 'universal health care'
For me, based in the Netherlands, I wouldn't classify our system as universal health care at all. There is a tax for health insurance but it doesn't cover anything that any america, brit or canadian would call universal health care. The government negotiates a minimum package that all insurers need to provide which sets you back 120 euro's a year. for lower income, the government will give a tax break up to 110 euro's a year. Companies are also paying for health care and only whats left after that is paid by the governement. However when you require certain healthcare services, you pay the first 385 euro's out of your own pocket. This is on a yearly basis and is never covered by anyone but yourself. anything above that is fully covered and paid for. though there are lots of exeptions. You wont have to pay consultants, vaccinations and other commons. You'll still get the receipt sent to your adress so there's quite alot of price transparency going around. I remember hospitals billing me for over 4000 euro's of various services and procedures all neatly organised but ofcourse this only set me back 385 euro's. Denmark and other neighbours have similar setups that look like universal health care but are far from it, compared to canada or britain. And I wouldn't change the dutch system ever because Its simply the best functioning healthcare system of the world.
>If suddenly tomorrow everyone switches off sugar/carbs, we would have immense food shortages
If everyone would bike to work tomorrow everyone except the Netherlands would have a bike shortage.
Don't say all/any.
Vice versa
But really, Find me any state which recorded lower obesity than @previous-year
>Newfoundland's very popular liberal government implemented a sugar tax recently.
Its great that you're optimistic about this policy and I'm always quite positive of the future but obesity is one I'm simply not seeing any signs of anything that would have a chance of improving any situation. Coca cola zero sugar is the prime example of the only solution that people would be willing to accept even though their drink still spikes blood sugar and the correct step is to never buy softdrinks again. a sugar tax is only going to weigh more on the impoverished.
Believe it or not, weight loss (nutritionists, prescriptions, etc) isn't covered by health insurance when the patient doesn't have heart disease or diabetes. Insurance companies aren't gonna treat obesity itself as a disease.
I think people need to realize that health insurance has fuck all to do with holistic health care. Nobody is looking out for you most of the time. You need to be on top of your health.
Insurance companies do cover some holistic health care: they cover preventative annuals, bloodworks, et al. The fact of the matter is, obesity isn't considered a healthcare concern to treat on a system manner. It's not like a fat person can discipline themselves out of a fatness they didn't exactly discipline themselves into. Lots of obese people are uneducated and poor who cannot afford the time or energy to cook. Where's the free gym memberships, free nutritionists, government-subsidized HelloFresh or some other healthy meal delivery?
If obesity is the problem on a societal level, we're certainly not treating weight loss like a solution.
Makes sense and is expected based on how things function in America right now.
Opioid prescriptions and abuse
Increased traffic deaths + road rage incidents (https://www.nhtsa.gov/press-releases/early-estimates-first-quarter-2022)
Deaths of despair + suicides (Many sources and discussions about this)
Lack of access to basic health care (lack of access to abortion will contribute here soon)
Obesity and fast food (self-explanatory)
Alcoholism from being bored during the pandemic (https://news.harvard.edu/gazette/story/2022/01/covid-related-drinking-linked-to-rise-in-liver-disease/)
(edit) and of course COVID-19 related deaths and illness
I mean there are just so many factors going against us, and either neglect or disagreement on how to solve these problems. On the left you have people who are suggesting that being obese is ok (it's not, it's a health problem, doesn't mean you need to be ashamed or be insulted though) and on the right, well, that speaks for itself.
Similar to global warming, though, the solutions for these problems are technocratic and unlikely to generate any sort of broad public support or acknowledgement in the sense that people vote for candidates based in something like advocating for decreasing traffic fatalities. So long as partisans continue to bicker and worship ridiculous ideological positions we won't have any pragmatic solutions or attempts to mitigate these problems because the technocrats can't function in an environment where ideological purity and populism are the currency instead of facts and solutions.
None of these will cause a downfall of America or anything, we're just going to be a bit more, eh, chaotic?
The biggest underlying issue is the decline of family units. No one talks about it but it’s true. You can’t function as a society when there is no immediate support system left in the form of family and loved ones. We are inherently a social creature.
Cuba, one of the poorest countries in the western hemisphere has a longer life expectancy than the US because they have universal healthcare. They also have a higher divorce rate than the US.
From Pew Research (2010), the decline in marriage is offset by rise in new families:
The Resilience of Families. The decline of marriage has not knocked family life off its pedestal. Three-quarters of all adults (76%) say their family is the most important element of their life; 75% say they are “very satisfied” with their family life, and more than eight-in-ten say the family they live in now is as close as (45%) or closer than (40%) the family in which they grew up. However, on all of these questions, married adults give more positive responses than do unmarried adults.
The Definition of Family. By emphatic margins, the public does not see marriage as the only path to family formation. Fully 86% say a single parent and child constitute a family; nearly as many (80%) say an unmarried couple living together with a child is a family; and 63% say a gay or lesbian couple raising a child is a family. The presence of children clearly matters in these definitions. If a cohabiting couple has no children, a majority of the public says they are not a family. Marriage matters, too. If a childless couple is married, 88% consider them to be a family.
The Ties that Bind. In response to a question about whom they would assist with money or caregiving in a time of need, Americans express a greater sense of obligation toward relatives—including relatives by way of fractured marriages– than toward best friends. The ranking of relatives aligns in a predictable hierarchy. More survey respondents express an obligation to help out a parent (83% would feel very obligated) or grown child (77%) than say the same about a stepparent (55%) or a step or half sibling (43%). But when asked about one’s best friend, just 39% say they would feel a similar sense of obligation.
I think there's a really good argument to be made that the marriage rate was previously inflated artificially by cultural expectations and gender inequality.
What kind of life could you expect to make for yourself as an unmarried woman when you didn't even have the right to open a bank account on your own?
Family unit decline is a symptom not the underlying cause, it's a small part of the matrix of issues, it's often invoked as a means of blaming something inherently unchangeable, undefinable and unregulateable as a diversion.
And everyone does talk about it, I hear about it 3 times a week and it's because it's a useful distraction and a wedge to force legislation of personal moral choice.
It's like saying all problems individuals are having are caused by the individual. Somehow society, culture, governance and macro economic forces have no effect.
If you think the breakdown of the family unit is the root cause, let me assure you, homeschool familes are facing the same issue in our current environment.
Of course if we want to embrace absurdist reductionism the REAL problem is the dysfunction of churches abandoning their societal role for political power in the 80s, family's DO break down and now we have no "generally apolitical" relational safety net outside of the workplace, so social dysfunction can promulgate with no positive feedback loop of increased social cohesion to stop it. We need religious, areligious and apolitical societies that will facilitate mingling of social classes and are focused on the social good.
I think it's 'an issue' but not the major issue, except where it's 'acute'. A lot of couples are not getting married these days, which is 'something' but not like a disaster but in extremely impoverished/violeng ghetto areas you see well over 50% of kids not having any meaningful relationship with their Fathers. Now that is a 'primary' issue but it's also tied to incarceration, violence etc..
Definitely ultra violence (related to universal gun access), lack of healthcare, excessive inequality in some areas, obesity etc. are big factors.
I'm not sure if the most recent post-COVID data is hugely helpful because America did 'not very well' on that one despite having vaccines available. I mean, that's a whole other level of sad. But give it 3 years to see where the data sits without the 'COVID' blip.
At a glance this reads close to "families with no father figure". You probably didn't mean the likes or to induce knee jerk reactions, but would replace "family unit decline" as being an issue of concern with "there's little to no social/gov provided safety net" for folks who need it.
Family as we know it is a historical oddity. Before the industrial revolution the social networks were much broader and involved whole communities, or much more extended families than what we consider normal now. We can introduce other social groups that help people in need and provide support and are not based primarily on family ties. This is orthogonal to “family units”, which is more of a conservative dog whistle. There are not fewer families now than there used to be, it’s just that a family is not necessarily the stereotypical married heterosexual couple with their 6 children.
Straight people should get their act together. Y’all are so stuck on an image of family that has only existed for two generations at most, and it causes you to be lonely and unable to form relationships of meaningful strength outside that image. I feel sorry for straight people.
I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it.
And overweight patients require more and more expensive treatments over the course of their lives, creating a perverse incentive in a for-profit healthcare system.
>I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it.
Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother.
>creating a perverse incentive in a for-profit healthcare system.
Normally private insurers would dump these kinds of people (perhaps leaving them for some government insurer to deal with if such exists). But in a world where insurers' profit margin is regulated to a fixed percentage of the money that flows through insurers they are valuable people to have around.
> Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother.
Pretty much. But larger thing is that ... doctors are not nutritionists nor lifestyle experts. They do know their own specialization very well, but they are not able to make people loose weight. They do not have evidence based well know strategies of the "we know that this program/advice makes x% of people to make loose weight long term" sort. Usually, what patient gets is general advice of "eating less" followed by some unsustainable diet that is necessary going to fail and just lead to yoyo cycle.
By unsustainable I mean the sort if diet that leads to malnutrition of some sort due to missing stuff your body needs or the one that is too low in calories making the person following it unable to function normally.
Medical staff now get personal satisfaction scores from patients at some hospitals, so now there is also a huge tension about telling patients things they don’t like.
Anecdotally, this was a big reason many of my friends left medicine and nursing.
> the number of Americans with health insurance is at a historic high, Biden bragged about it on Twitter last week
I have "good" insurance through my employer. Over the summer I had appendicitis. The cost of the surgery and hospital stay after insurance would have bankrupted my brother and put any of my cousins in substantive medical debt. It would have been nearly a fifth of my retired mother's net worth.
Having insurance is great because it makes lots of care attainable, but it's a vast overstatement to say that having it gives you access to basic care. A majority of Americans have less than $1000 in savings—that's not even an ambulance ride.
FYI, out of pocket maximum in the US is $8,400 for an individual for a calendar year. If the appendicitis happened Dec 31, and treatment was received across 2 calendar years, then two years worth of oop max would apply, so $16,800.
I used to be me worried until I realized about the out of pocket maximum. But I'm still not sure how it works in practice. Are there ways that hospitals could charge for things that are considered separate from that number, like out of network or not covered things in the insurance plan? There always seem to be extra charges from what the health plans advertise, so I hesitate to trust their out of pocket maximum too.
The big risk used to be getting billed by an out of network provider while you are at an in network facility. Such as getting a surprise bill for $10k from an anesthesiologist that you had no idea was out of network since you thought your hospital was in network and there was no need or ability to check.
But as of Jan 1, 2022 that is no longer a concern:
The other concern was getting out of network care due to an emergency where you cannot choose in network care, but that is also no longer a concern per above link.
I have had two child births in the past 6 years, and both years we hit our family oop max (~$5k), and after that, we did not have to pay a cent. We took the opportunity to get a whole bunch of healthcare like seeing an ENT, dermatologist, vasectomy, physical therapy to recover from childbirth, etc and all were fully paid for.
I always use the insurer’s website to find in network providers, and I can even get a procedure/diagnosis code and get estimated costs before a visit.
Thank you for posting this! I had no idea that surprise out of network billing and surprise emergency billing were no longer allowed.
Among many, many other things, that was one of my biggest gripes with the US healthcare system. Walking down the street you run the risk of bankruptcy from simply existing, if you have to get emergency care while unconscious.
Insurance does not pay for copay/coinsurance amounts between deductible and out of pocket maximum. After out of pocket maximum is when insurance pays all of it.
Surprise balance billing is no more since Jan 1, 2022:
These health insurances you get in the US are horrible because you can easily pay hundreds of dollars if you go to the doctor depending on your plan. There’s a minimum you need to spend from your own pocket before the insurance starts covering you. For this reason many (most?) people who are insured still do not visit their doctor.
I'd say obesity of by far the worst out of those, since its so widespread and covid certainly didn't help there. That Americans are generally way more overweight than say Europeans is something I keep hearing for multiple decades and became a regular meme source, and I keep seeing it regularly.
I saw a lot of attempts for normalization of this in US media, ie Hollywood family/comedy movies painting it as something to be OK with, and not a disease that will slowly but surely ruin your life and kill you prematurely, all completely preventable. I wonder how much better US healthcare would be if obesity wasn't such an epidemic there, the costs for treating all those comorbidities that eventually come is staggering, all long term treatments.
HFCS must have lion share in this, as overall processed cheap junk food. We don't have it all figured out here in Europe, but at least our approach to food, its quality and quantity is way better here.
The average american is just plain unhealthy. Terrible diet, little daily activity. It's in the stats, which people ignore. You just plain see it with your own eyes as well. It's a genuine problem, not a lifestyle choice.
I phrased that wrong. Unhealthy habits are often permissively looked at as just a different lifestyle choice ("hey, I just like my burgers and sodas man!"), rather than really being problematic.
Yeah, but the environment does not exactly makes it easier. More like, it usually makes it harder. The way places are build for example - most people have to use car, the option to go by walk. public transport or by bicycle is not there for most people. There are not even sidewalks in quite many places and if you walk somewhere, you are "odd" (I had cops stop at me just because I was walking somewhere. They thought something is wrong.).
The expectation seems to be that you wont just have physical movement normally as part of your daily life, you have to use car to go to special place (gym, park further away) to do things like exercising, jogging etc. And Americans work a lot too, there stereotype of lazy American, but that lazy American works a lot more hours then people in other parts of the world.
I mean, the amount of physical movement I had definitely changed with how easy and pleasant it was to have some low key movements. And the way America is build, it is fairly often neither. Even the way Americans talk about it - low key going by walk or bicycling or whatever is the first to be sacrificed to minor safety improvement or to general "if you want to do it that much, you can go to bike trail, mountains, etc". That however cuts off everyone except most determined.
I wouldn't claim Americans are lazy, in contrary - you guys work way too much and rest from it too little! But if its about physical movement thats another story for many, as is painfully visible.
I completely agree with your description, when I was in US in sort of work&travel program almost 20 years ago on university, I had such huge problems getting by walking to places in ie Hollywood or Maine (2 different universes btw also in obesity). Had to walk on the main road to cut time to work easily by 30 mins one way. I had (good) people sending me to homeless shelters since I looked so odd just trying to walk to places.
The problem is - even if movement and exercise is super healthy, and the more you do the better you feel about yourself, that's not most of the obesity problem. You would have to run 2-3 marathons every day without exception to burn all the excess junkfood energy many people consume.
You can be very healthy by eating well and not being sporty at all. You can't be healthy long term if you are sporty and eat tons of junk (exception may be folks doing sports on professional levels). You may look OK but ie your arteries, heart etc will tell different story.
This is very true. I track my calorie intake for this reason. There is no possible way for me to exercise enough to burn as many calories as I would like to consume. In addition, it helps me make healthier eating choices especially when "bad" food is so inexpensive and readily available.
> You would have to run 2-3 marathons every day without exception to burn all the excess junkfood energy many people consume.
But that is not how it work at all. First the moderate amount of exercise does more for your health then weight loss itself. If the consideration is health and not just aesthetic, moderate movement matters a lot.
Second, it changes how your body works overall - how much energy you spend on daily activities just by existing. As you get into form, you become more active in general, simply because you feel good. It changes your apetite too.
The mechanical recounting of calories does more harm then good, precisedly because it makes people conclude that exercise such as walking around does not matter- but empirically it does.
> You can be very healthy by eating well and not being sporty at all.
You can be healthy and fat too. And the strategy you describe is how you become thin and physically weak - in the long term that is not healthy. Not when you are at 1000 or less steps per day, effectivelly.
> I saw a lot of attempts for normalization of this in US media, ie Hollywood family/comedy movies painting it as something to be OK with, and not a disease that will slowly but surely ruin your life and kill you prematurely, all completely preventable.
The thing is, looking at OECD ranking I am sitting in country with much lower obesity then USA.
The obesity stigma here is much lower then in USA and was always lower. The stereotype of fat people was that they are friendly and easier to get along with.
I spent a month in Asia, when I was planning the trip I was a little worried about eating out all the time and my health and weight gain. I actually ended up losing weight despite eating every meal in a restaurant.
Everything was so much less sweet, less sugar in everything. Even cookies weren't that sweet
You may have been more active than usual, also? Even just walking to get places each day, instead of spending your entire day sitting at a desk or in a car, makes a huge difference.
>A typical elite cross-country skier will burn about 30 calories a minute during training — by comparison, a 155-pound person on an elliptical machine burns about 11 calories a minute.
I believe the units above are supposed to be kilocalories. For comparison, a single pastry easily has 200+ kilocalories, and 350mL of sugary soda has 150 kilocalories.
>There is almost no amount of physical activity that can offset excess consumption.
Very odd statement to make without quantifying how much "excess" there is in the "excess consumption". If walking a couple extra hours a day on vacation burns (say) 500 calories, that's a pretty large buffer of extra food you can eat - a 20% increase if you're eating 2500 calories per day. But of course a determined glutton can out-eat this.
> "There is almost no amount of physical activity that can offset excess consumption."
This is not consistent with my personal experience. In general I eat what I want, whenever I'm hungry. Sure I try to eat healthy stuff, but sometimes I binge on crap too. I've found that so long as I stay reasonably physically active (nothing crazy, I'd say I average 60 minutes or so of running, cycling, or walking daily), I stay slim. But if I'm not getting that level of exercise for a prolonged period I will start to put on weight.
When I'm on vacation I can easily spend hours walking around a city seeing the sites. I'll often get really tired and hungry by the end of the day - it definitely uses up a lot of energy!
> "For comparison, a single pastry easily has 200+ kilocalories, and 350mL of sugary soda has 150 kilocalories."
But how efficient is your body at actually converting those calories to energy (and subsequently, stored fat)? Surely not anything like 100%! Or to put it another way, there's a lot of calories in your poop ;)
> But how efficient is your body at actually converting those calories to energy (and subsequently, stored fat)? Surely not anything like 100%! Or to put it another way, there's a lot of calories in your poop ;)
Good point! Although, absorption seems pretty high according to this study (75%).
I guess I should revise my statement to say no one can outrun a daily donut/sodas/sugary coffee/bag of chips/cookies/ice cream/beer etc. on a regular basis as a lifestyle, but it could be possible on vacation.
The other saying here is “abs are made in the kitchen”.
How are you defining worst? Genuinely asking, because as far as I know opioid contributes far more to the falling in life expectancy because it kills people from an early age. Even a fat person's body can keep going into their 50s and 60s.
Terrible diets lead to obesity and insulin resistance. Doctors do the blood glucose test and if the patient does not figure out eating and nutrition on their own, the Doctors often write prescription for insulin to supposedly control blood glucose. This has the obvious effect of accelerating insulin resistance, though the blood glucose numbers do look better for a while.
> That Americans are generally way more overweight than say Europeans
Indeed, and this is why it's difficult to discuss universal health care with European friends and coworkers.
It's one thing to subsidize basic humanity, some poor soul who got the wrong DNA sequence shattered at the wrong time by the wrong cosmic ray, or who tripped on a sidewalk and wrecked their pelvis. Absolutely laudable goal.
It's another thing entirely to subsidize the stars of My 600lb Life.
And inbefore the inevitable downvotes for being "heartless", I am a former fatass with an abiding hatred for my former self. Fat people largely bring their health problems on themselves. This is a fact. Source: me.
The graph is quite shocking to me. Looks like the series was coasting around a constant 76.5-ish until 2019, where it completely nosedived twice in a row. Is this due to COVID?
Hard to say. What we know for sure is that it 100% does NOT have ANYTHING to do with the safe and effective vaccines. I can’t believe people would even think that!
I got pericarditis after the booster, it felt like it was going to turn into a heart attack at any moment. I’m fanatical about my health so I could easily imagine others who are less careful getting a heart attack from the vaccine. And due to the anti-vax stigma I’m sure it’s under reported.
Israel isn't the most vaccinated nation on the planet; it was merely the one of the first to have access to vaccine doses. They're basically on par with the United States now:
Just to clarify for other people who were confused, life expectancy increased until 2019 inclusive, then nosedived. So Covid (or higher-order effects of Covid and the response) must be responsible.
I found it especially confusing how certain numbers were presented as the 2019-2021 delta and others the 2020-2021 delta without any way of seeing all the data together. Thanks for linking to the original source as when I looked for it last night I found it difficult to find.
[0] (on Jackson, Mississippi's lack of running water)
> There is no first world and third world anymore.
> There is the ascending world, and then there is the descending world.
> And this is the descending world.
[1]
> A similar phenomenon began right before the fall of the Soviet Union. Life expectancy for men fell from a high of 65 years in 1987 to a low of 57 years in 1994
That's how I interpret his statements, at least. He goes into more detail in his book The Network State, but essentially says America is descending and the future will be the Anarchistic West vs Communist China. He advocates exiting most systems into a "cloud country" which would ultimately manifest in the real world (aggregate online over similar values, purchase physical land, etc)
>That's how I interpret his statements, at least. He goes into more detail in his book The Network State, but essentially says America is descending and the future will be the Anarchistic West vs Communist China. He advocates exiting most systems into a "cloud country" which would ultimately manifest in the real world (aggregate online over similar values, purchase physical land, etc)
I'm curious if he is expecting an anarcho-capitalism type system or he's predicting wildwest/dystopian.
I feel like that's one of the big political divides.
Why is China dominant and being made the boogey man in the USA? They opened free trade zones on their coast. They beat the USA at their own game who contemporarily are increasing taxes.
You have everyone piling into Africa to bring them low tax capitalism especially China. They see their peasant war coming because of the ultra wealthy coast and impoverished west. Africa is about to become the next china with ultra cheap labour. China loses those contracts and must rush to replace them.
For the USA to beat China, anarcho-capitalism is the likely option. That's the #1 scary unspoken thing about Trump. He represents exactly this.
I am intrigued about the cloud country. It almost feels like Estonia might be that place? Or perhaps their attempt?
Anarcho-capitalism? Not to beat a dead horse, but there's no capitalism without a strong central state. The state is not organized in opposition to capitalism; the state is a central component of the capitalist system. It's not a coincidence that the modern state and modern market capitalism appear in the historical record at precisely the same moment.
I think our big problems are mostly due to inadequate control over capitalism due to globalization making it too easy for large companies to avoid oversight and become parasitic and attack their host. The need for short term profit then becomes the only thing that those companies optimize for, leading to a death spiral of short term thinking.
Anarcho-capitalism is certainly not going to help any of that.
This is a really annoying narrative. The Dutch empire "fell" in the 18th century, and they never regained their former glory. Danish glory fell in the 11th century. The Swedish empire fell in 1721. Today those are three of the best places in the world to live.
For context: life expectancy declined for the first time in decades in 2014 (from an all time high of 78.84 years, to 78.69 years), plateaued at 78.54 until 2019 (when it increased to 78.79 years), and then fell off a cliff from 2020 onwards, to 77.28 years.
There's a lot of speculation in this thread, but the article specifically identifies the causes:
> While the pandemic has driven most of the decline in life expectancy, a rise in accidental deaths and drug overdoses also contributed, as did deaths from heart disease, chronic liver disease and cirrhosis, the new report found.
Unless they're referring to a different report than the one they linked to [1], the report did not say this. They did not offer anything in the way of explanations besides hand-waving proposals that, in some cases, were contradicted by their own data.
They proposed the greater loss in minority life expectancy as being driven by "systemic racism as well as inadequacies in the US handling of the pandemic." What that's supposed to mean was never stated. The next sentence reflected upon a higher rate of non-minority deaths the following year which the paper claimed "likely has multiple explanations." None of those possible explanations were offered.
They concluded with offering an estimated life expectancy in America of 76.44 for 2021. The final official numbers from the UN numbers ended up with 77.2.
A pandemic hit and killed millions of people. It had a disproportionately high impact on the elderly, which will have the effect of "chopping the tail" off a Poisson distribution and dragging the mean down as a result.
The past several years of data should almost certainly be considered an outlier that will stand out on a long-term trend now that COVID has vaccines.
This article would have really benefited from an easily-creatsd line chart trending life expectancy over time. It would have given a lot of context to the drop. I was surprised at the oversight by both the NYT journalists and editors.
> Life expectancy for women in the United States dropped about 10 months, from just under 80 years in 2020 to slightly more than 79 in 2021. Life expectancy for men dropped a full year, from about 74 years to 73.
We've known that there's a gap in life expectancy between men and women for awhile now. But the surprising thing is that the gap is increasing; you might expect that life expectancy would drop a certain percentage for all groups, leading to the ones with the highest life expectancy getting the largest drop.
I dont think that is reasonable expectation. Some issues affect men more - covid, substance abuse, suicide and general violence belonging in that category.
That's just restating the issue: you're just saying "premature death affects men more." The question is why. It's not some natural state of affairs but something created by social and political choices.
For COVID, for example, the risk ratio for men compared to women is larger than the risk ratio for e.g. black people compared to white people. But public health authorities in the US prioritized access to vaccines to racial minorities (who indeed had higher age-adjusted mortality rates than white people), while not doing the same for men. This is an ideological choice, driven by the idea that bad things that happen to men aren't worthy of social concern.
More broadly, the gendered death statistics are indicative of systemic inequalities.
You said that "But the surprising thing is that the gap is increasing;" It is not surprising at all, due to excess mortality being in areas that are traditionally more "manly" reasons to die of + covid.
To restate, then: the status quo is that men die earlier than women, because of certain social and perhaps biological factors. On top of that, there are trends that are increasing premature death rates. What's surprising is that those trends affect men more than women.
Wouldn't chromosomal genetic variation have some effect?
Which is why xy/male mammals and zw /female birds have greater tendency toward genetic variety? Probably not a huge effect overall though.
I would think that real world experiments with babies have shown that babies dressed as baby boys get far less social interaction from strangers which negatively effects early vocabulary and verbal/social engagement/experience/training.
Which is tragic, under socialing boys and then mocking them for lack of social skills when they get older.
It might explain the base life expectancy gap (though see [0]; monks and nuns have a much smaller life expectancy gap, which suggests that social effects are dominating). But that wouldn't explain the trendline of an increasing life expectancy gap.
When exposed to mutagens like radiation do women fair better then men? If our DNA environment is getting more hostile would same/same chromosomes be more resilient? Would it make any / a measurable difference?
This surprised me, because I'd have guessed women would fair better, for reasons similar to you. Though I mostly see population-wide studies and not anything that looks at genetic/chromosomal damage.
> But public health authorities in the US prioritized access to vaccines to racial minorities (who indeed had higher age-adjusted mortality rates than white people), while not doing the same for men. This is an ideological choice, driven by the idea that bad things that happen to men aren't worthy of social concern.
This would only be true if cities were largely sex-segregated, making it as easy both to target or ignore a particular sex as it is to target or ignore black people. Your ideology accusation is unnecessary, as there is a material difference between the specific situations of black people and males. In fact targeting aid towards black people consequently targeted aid toward black males (a subset of black people.)
And with that targeting, black people are still less likely to be vaccinated than white people, so black people clearly weren't targeted enough. Although it was nice to see white people having to come in from the suburbs for the first time in years to get a vaccination. It was like what black people in the city have to do to get to their "neighborhood" public school. It was sad that they set up networks to disproportionately take up early slots, though.
Take the likelihood of being vaccinated between black people and all males, against the disproportionate effects of covid on males vs women, the cost of specifically targeting men (by giving men a special app or something, or by prioritizing men over women?) vs the cost of specifically targeting black people (put the vaccination centers in or near black neighborhoods if possible.) Control for everything else. I'd bet if you calculated it out, you've saved a lot more person-years per dollar doing the plan they went with instead of your plan.
That's not even considering the fact that black people start in a median more precarious position than most other groups (other than maybe Native Americans and undocumented migrants), so between a black and non-black person, the median black person will have their mortality damaged more at the same severity of illness.
> In fact targeting aid towards black people consequently targeted aid toward black males (a subset of black people.)
And decreased aid targeted toward white males (a subset of males.)
> black people are still less likely to be vaccinated than white people, so black people clearly weren't targeted enough
The same is true of men vs women, so men clearly weren't targeted enough either.
Moreover, this entire comment thread is driven by the fact that men died a whole lot more than women due to COVID. That's ipso facto evidence that men were undertargeted.
> the cost of specifically targeting black people (put the vaccination centers in or near black neighborhoods if possible.)
Prioritizing who has access to a vaccine is cheaper than opening new vaccination centers in underprivileged areas (which fwiw I support). And it went further than this: in most localities, white men were explicitly deprioritized, having to wait a month or more longer to get access to the vaccine compared to e.g. black women, who were at lower risk.
Also, by choosing not to apply a gender lens, public health authorities overinvested in black women and underinvested in black men. It's likely that if mens' higher vulnerability to COVID was allowed to be brought into consideration, fewer black people (and fewer people overall) would have died.
Wiki posted the 2022 report on life expectancy from the UN [1]. US life expectancy has now fallen to 70th in the world. The countries ahead of us now are including places such as impoverished micronations. Any explanation for this drop, needs to be able to explain not only the deaths but why the extreme relative impact.
COVID alone could account for that. Differences in rankings from that article's 2019 UN and 2021 UN are almost entirely correlated with COVID death rates per 100k[0] (death rates in parens):
The US is a large country with a very high variance of outcomes. It effectively "contains" impoverished micronations, which are mentioned in the article, such as Native Americans.
The death of Gorbachev has reminded me that one effect of the end of the USSR was a catastrophic drop in the life expectancy of Russian men, by something like 20 years. It's quite a good "marker" for decline.
> "Although the U.S. health care system is among the best in the world, Americans suffer from what experts have called “the U.S. health disadvantage,” an amalgam of influences that erode well-being, Dr. Woolf said."
That's an impressive piece of equivocation. So good that it has a special disadvantage?
The point being made, I think, is that it isn't the health care system at fault in these disadvantages, but rather some external factors. Obesity, for example, is particularly high in the US, and leads to reduce lifespan.
We're fatter than our peers [0], we drive more (and therefore crash more often) [1], we're more violent [2], and we abuse drugs at much higher rates [3]. Those are our "special disadvantages."
I wonder how much further decline is already baked in. People actually dying is a lagging indicator. It’ll be interesting to see the predicted life expectancy for 40 years.
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[ 2.2 ms ] story [ 217 ms ] threadThat's an bold statement to make. Canada is also experiencing a historic opiod crisis right now, but their life expectancy is dropping no near as fast as US. Something else is going on.
EDIT: I don't think the parent post should be flagged. The opioid crisis is real and has a noticeable effect on life expectancy. It's just not the whole story, that's all.
The majority of deaths are normal people who used contaminated recreational drugs in their home, as oppose to street junkies that are quickly revived by ambulances.
(Apparently it's now 6 deaths/day, up from 5/day in 2021).
Are you saying that 3 out of 4 people in the US are addicted to one drug or another, or am I misunderstanding.
> there was 70%+ opioid prescription rate
This I can completely believe. I broke a bone, and when the doctor was asking how much pain I was in out of 10. I said 0, when I don't move it. They still prescribed me opioids. I asked if they expected the pain to increase, and they said they expected it to actually get less painful to move overtime if anything, and if it started hurting to get seen by another doctor. When asked about the painkillers then the answer was "Just in case".
And the way people thirst for their sweet treats and drinks, it certainly looks like addiction. Not that it removes any culpability of other excess carb consumption like alcohol and breads.
But I definitely didn't need opioid painkillers, acetaminophen did just fine. Same goes for my wisdom teeth.
This would indicate that after a peak in 2012 of 81.3 prescriptions for every 100 people, it has decreased to 43.3 in 2020.
This number doesn't pass the sniff test unless you're including caffeine dependency.
In 2015 NIH reported 10% had ever had a substance abuse problem:
https://www.nih.gov/news-events/news-releases/10-percent-us-...
https://www.cdc.gov/drugoverdose/rxrate-maps/index.html
Basically I'm saying that my statement, and your statement, are not contradictory but rather two sides of the same coin.
- Research has shown that recent COVID-19 infection increases risk of heart attacks, strokes, and a ton of other vascular diseases.
- Overwhelmed hospital systems will have poorer outcomes in emergencies such as sepsis where time-based care is a huge factor. Worldwide sepsis mortality has gone up over the last two years, for example.
https://www.cdc.gov/obesity/data/adult.html
How is it over?
I feel like this is the biggest impediment to universal healthcare in the usa. When much of the developed world implemented it, around late 1960s. You had fully recovered from debt of WW2, working economies producing lots and the cost of healthcare was low.
Today in universal healthcare systems you are seeing much if not all of them reducing. For example, https://ca.news.yahoo.com/5-changes-to-ohip-now-in-effect-20...
It goes without saying as well that most shots, pills, or multivitamins are not covered at all. How about the myriad of problems that simply aren't solveable.
>obesity correlates with higher covid mortality and this article mentions quite clearly that alaskan life expectancy decreased despite succesfull vaccinations.
With obesity comes diabetes and uncurable disease. The medicine for which is not covered in most countries and not to mention has gotten very expensive. https://www.canada.ca/en/public-health/services/reports-publ...
https://www.diabetes.co.uk/diet-for-type2-diabetes.html
If you went to a grocery store or restaurant the probability that it's full of sugar/carbs is extremely high. If suddenly tomorrow everyone switches off sugar/carbs, we would have immense food shortages. So we can't really encourage people to switch off carbs.
>Worse yet, obesity seems to be increasing rather than decreasing so whatever any politician, healthcare service or advocacy group has done the past 20 years, the USA is still not closer to a solution to the lowering life expectancy. Covid might be over but there will always be a next crisis.
Don't say all/any.
https://globalfoodresearchprogram.org/wp-content/uploads/202...
Newfoundland's very popular liberal government implemented a sugar tax recently.
I think it's a great idea and those who do it first will benefit in the long run. Flipside, I don't think government should be allowed to do anything with food. No restricting, no taxing, your extent is only in the 'everyone agrees with' category. Food inspectors for example? We can all agree that's important.
as to what you mean when you say "When most of the developed world implemented it" I'm not sure we have the same classification of 'universal health care'
For me, based in the Netherlands, I wouldn't classify our system as universal health care at all. There is a tax for health insurance but it doesn't cover anything that any america, brit or canadian would call universal health care. The government negotiates a minimum package that all insurers need to provide which sets you back 120 euro's a year. for lower income, the government will give a tax break up to 110 euro's a year. Companies are also paying for health care and only whats left after that is paid by the governement. However when you require certain healthcare services, you pay the first 385 euro's out of your own pocket. This is on a yearly basis and is never covered by anyone but yourself. anything above that is fully covered and paid for. though there are lots of exeptions. You wont have to pay consultants, vaccinations and other commons. You'll still get the receipt sent to your adress so there's quite alot of price transparency going around. I remember hospitals billing me for over 4000 euro's of various services and procedures all neatly organised but ofcourse this only set me back 385 euro's. Denmark and other neighbours have similar setups that look like universal health care but are far from it, compared to canada or britain. And I wouldn't change the dutch system ever because Its simply the best functioning healthcare system of the world.
>If suddenly tomorrow everyone switches off sugar/carbs, we would have immense food shortages If everyone would bike to work tomorrow everyone except the Netherlands would have a bike shortage.
Don't say all/any. Vice versa But really, Find me any state which recorded lower obesity than @previous-year
>Newfoundland's very popular liberal government implemented a sugar tax recently. Its great that you're optimistic about this policy and I'm always quite positive of the future but obesity is one I'm simply not seeing any signs of anything that would have a chance of improving any situation. Coca cola zero sugar is the prime example of the only solution that people would be willing to accept even though their drink still spikes blood sugar and the correct step is to never buy softdrinks again. a sugar tax is only going to weigh more on the impoverished.
If obesity is the problem on a societal level, we're certainly not treating weight loss like a solution.
Similar to global warming, though, the solutions for these problems are technocratic and unlikely to generate any sort of broad public support or acknowledgement in the sense that people vote for candidates based in something like advocating for decreasing traffic fatalities. So long as partisans continue to bicker and worship ridiculous ideological positions we won't have any pragmatic solutions or attempts to mitigate these problems because the technocrats can't function in an environment where ideological purity and populism are the currency instead of facts and solutions.
None of these will cause a downfall of America or anything, we're just going to be a bit more, eh, chaotic?
And it's just that, a meme, not a reality.
https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ...
https://statisticalatlas.com/United-States/Household-Types
The Resilience of Families. The decline of marriage has not knocked family life off its pedestal. Three-quarters of all adults (76%) say their family is the most important element of their life; 75% say they are “very satisfied” with their family life, and more than eight-in-ten say the family they live in now is as close as (45%) or closer than (40%) the family in which they grew up. However, on all of these questions, married adults give more positive responses than do unmarried adults.
The Definition of Family. By emphatic margins, the public does not see marriage as the only path to family formation. Fully 86% say a single parent and child constitute a family; nearly as many (80%) say an unmarried couple living together with a child is a family; and 63% say a gay or lesbian couple raising a child is a family. The presence of children clearly matters in these definitions. If a cohabiting couple has no children, a majority of the public says they are not a family. Marriage matters, too. If a childless couple is married, 88% consider them to be a family.
The Ties that Bind. In response to a question about whom they would assist with money or caregiving in a time of need, Americans express a greater sense of obligation toward relatives—including relatives by way of fractured marriages– than toward best friends. The ranking of relatives aligns in a predictable hierarchy. More survey respondents express an obligation to help out a parent (83% would feel very obligated) or grown child (77%) than say the same about a stepparent (55%) or a step or half sibling (43%). But when asked about one’s best friend, just 39% say they would feel a similar sense of obligation.
https://www.pewresearch.org/social-trends/2010/11/18/the-dec...
What kind of life could you expect to make for yourself as an unmarried woman when you didn't even have the right to open a bank account on your own?
https://www.flagshipbanks.com/blog/the-history-of-women-and-...
And everyone does talk about it, I hear about it 3 times a week and it's because it's a useful distraction and a wedge to force legislation of personal moral choice.
It's like saying all problems individuals are having are caused by the individual. Somehow society, culture, governance and macro economic forces have no effect.
If you think the breakdown of the family unit is the root cause, let me assure you, homeschool familes are facing the same issue in our current environment.
Of course if we want to embrace absurdist reductionism the REAL problem is the dysfunction of churches abandoning their societal role for political power in the 80s, family's DO break down and now we have no "generally apolitical" relational safety net outside of the workplace, so social dysfunction can promulgate with no positive feedback loop of increased social cohesion to stop it. We need religious, areligious and apolitical societies that will facilitate mingling of social classes and are focused on the social good.
Definitely ultra violence (related to universal gun access), lack of healthcare, excessive inequality in some areas, obesity etc. are big factors.
I'm not sure if the most recent post-COVID data is hugely helpful because America did 'not very well' on that one despite having vaccines available. I mean, that's a whole other level of sad. But give it 3 years to see where the data sits without the 'COVID' blip.
[1] https://www.census.gov/newsroom/press-releases/2021/families...
No government can replace the support system a family can provide.
the number of Americans with health insurance is at a historic high, Biden bragged about it on Twitter last week
it doesn't matter if you go to the doctor...if you don't take the doctor's advice and eat better + exercise...
I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it.
And overweight patients require more and more expensive treatments over the course of their lives, creating a perverse incentive in a for-profit healthcare system.
Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother.
>creating a perverse incentive in a for-profit healthcare system.
Normally private insurers would dump these kinds of people (perhaps leaving them for some government insurer to deal with if such exists). But in a world where insurers' profit margin is regulated to a fixed percentage of the money that flows through insurers they are valuable people to have around.
Pretty much. But larger thing is that ... doctors are not nutritionists nor lifestyle experts. They do know their own specialization very well, but they are not able to make people loose weight. They do not have evidence based well know strategies of the "we know that this program/advice makes x% of people to make loose weight long term" sort. Usually, what patient gets is general advice of "eating less" followed by some unsustainable diet that is necessary going to fail and just lead to yoyo cycle.
By unsustainable I mean the sort if diet that leads to malnutrition of some sort due to missing stuff your body needs or the one that is too low in calories making the person following it unable to function normally.
Anecdotally, this was a big reason many of my friends left medicine and nursing.
I have "good" insurance through my employer. Over the summer I had appendicitis. The cost of the surgery and hospital stay after insurance would have bankrupted my brother and put any of my cousins in substantive medical debt. It would have been nearly a fifth of my retired mother's net worth.
Having insurance is great because it makes lots of care attainable, but it's a vast overstatement to say that having it gives you access to basic care. A majority of Americans have less than $1000 in savings—that's not even an ambulance ride.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...
But as of Jan 1, 2022 that is no longer a concern:
https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bill...
The other concern was getting out of network care due to an emergency where you cannot choose in network care, but that is also no longer a concern per above link.
I have had two child births in the past 6 years, and both years we hit our family oop max (~$5k), and after that, we did not have to pay a cent. We took the opportunity to get a whole bunch of healthcare like seeing an ENT, dermatologist, vasectomy, physical therapy to recover from childbirth, etc and all were fully paid for.
I always use the insurer’s website to find in network providers, and I can even get a procedure/diagnosis code and get estimated costs before a visit.
Among many, many other things, that was one of my biggest gripes with the US healthcare system. Walking down the street you run the risk of bankruptcy from simply existing, if you have to get emergency care while unconscious.
And do you know why insurance didn't cover all but the deductible? Was it the crappy balance billing that's so common now?
Surprise balance billing is no more since Jan 1, 2022:
https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bill...
I saw a lot of attempts for normalization of this in US media, ie Hollywood family/comedy movies painting it as something to be OK with, and not a disease that will slowly but surely ruin your life and kill you prematurely, all completely preventable. I wonder how much better US healthcare would be if obesity wasn't such an epidemic there, the costs for treating all those comorbidities that eventually come is staggering, all long term treatments.
HFCS must have lion share in this, as overall processed cheap junk food. We don't have it all figured out here in Europe, but at least our approach to food, its quality and quantity is way better here.
The expectation seems to be that you wont just have physical movement normally as part of your daily life, you have to use car to go to special place (gym, park further away) to do things like exercising, jogging etc. And Americans work a lot too, there stereotype of lazy American, but that lazy American works a lot more hours then people in other parts of the world.
I mean, the amount of physical movement I had definitely changed with how easy and pleasant it was to have some low key movements. And the way America is build, it is fairly often neither. Even the way Americans talk about it - low key going by walk or bicycling or whatever is the first to be sacrificed to minor safety improvement or to general "if you want to do it that much, you can go to bike trail, mountains, etc". That however cuts off everyone except most determined.
I completely agree with your description, when I was in US in sort of work&travel program almost 20 years ago on university, I had such huge problems getting by walking to places in ie Hollywood or Maine (2 different universes btw also in obesity). Had to walk on the main road to cut time to work easily by 30 mins one way. I had (good) people sending me to homeless shelters since I looked so odd just trying to walk to places.
The problem is - even if movement and exercise is super healthy, and the more you do the better you feel about yourself, that's not most of the obesity problem. You would have to run 2-3 marathons every day without exception to burn all the excess junkfood energy many people consume.
You can be very healthy by eating well and not being sporty at all. You can't be healthy long term if you are sporty and eat tons of junk (exception may be folks doing sports on professional levels). You may look OK but ie your arteries, heart etc will tell different story.
But that is not how it work at all. First the moderate amount of exercise does more for your health then weight loss itself. If the consideration is health and not just aesthetic, moderate movement matters a lot.
Second, it changes how your body works overall - how much energy you spend on daily activities just by existing. As you get into form, you become more active in general, simply because you feel good. It changes your apetite too.
The mechanical recounting of calories does more harm then good, precisedly because it makes people conclude that exercise such as walking around does not matter- but empirically it does.
> You can be very healthy by eating well and not being sporty at all.
You can be healthy and fat too. And the strategy you describe is how you become thin and physically weak - in the long term that is not healthy. Not when you are at 1000 or less steps per day, effectivelly.
The thing is, looking at OECD ranking I am sitting in country with much lower obesity then USA.
The obesity stigma here is much lower then in USA and was always lower. The stereotype of fat people was that they are friendly and easier to get along with.
Everything was so much less sweet, less sugar in everything. Even cookies weren't that sweet
https://www.nytimes.com/2018/02/23/sports/olympics/cross-cou...
>A typical elite cross-country skier will burn about 30 calories a minute during training — by comparison, a 155-pound person on an elliptical machine burns about 11 calories a minute.
I believe the units above are supposed to be kilocalories. For comparison, a single pastry easily has 200+ kilocalories, and 350mL of sugary soda has 150 kilocalories.
Very odd statement to make without quantifying how much "excess" there is in the "excess consumption". If walking a couple extra hours a day on vacation burns (say) 500 calories, that's a pretty large buffer of extra food you can eat - a 20% increase if you're eating 2500 calories per day. But of course a determined glutton can out-eat this.
This is not consistent with my personal experience. In general I eat what I want, whenever I'm hungry. Sure I try to eat healthy stuff, but sometimes I binge on crap too. I've found that so long as I stay reasonably physically active (nothing crazy, I'd say I average 60 minutes or so of running, cycling, or walking daily), I stay slim. But if I'm not getting that level of exercise for a prolonged period I will start to put on weight.
When I'm on vacation I can easily spend hours walking around a city seeing the sites. I'll often get really tired and hungry by the end of the day - it definitely uses up a lot of energy!
> "For comparison, a single pastry easily has 200+ kilocalories, and 350mL of sugary soda has 150 kilocalories."
But how efficient is your body at actually converting those calories to energy (and subsequently, stored fat)? Surely not anything like 100%! Or to put it another way, there's a lot of calories in your poop ;)
Good point! Although, absorption seems pretty high according to this study (75%).
https://pubmed.ncbi.nlm.nih.gov/1091963/
I guess I should revise my statement to say no one can outrun a daily donut/sodas/sugary coffee/bag of chips/cookies/ice cream/beer etc. on a regular basis as a lifestyle, but it could be possible on vacation.
The other saying here is “abs are made in the kitchen”.
Indeed, and this is why it's difficult to discuss universal health care with European friends and coworkers.
It's one thing to subsidize basic humanity, some poor soul who got the wrong DNA sequence shattered at the wrong time by the wrong cosmic ray, or who tripped on a sidewalk and wrecked their pelvis. Absolutely laudable goal.
It's another thing entirely to subsidize the stars of My 600lb Life.
And inbefore the inevitable downvotes for being "heartless", I am a former fatass with an abiding hatred for my former self. Fat people largely bring their health problems on themselves. This is a fact. Source: me.
https://www.axios.com/2022/08/31/covid-us-life-expectancy
Idk why they decided to write out every single number when a chart or graph would have been easier to read.
But I’m assuming covid dominates the deaths.
https://ourworldindata.org/explorers/coronavirus-data-explor...
[0] (on Jackson, Mississippi's lack of running water)
> There is no first world and third world anymore.
> There is the ascending world, and then there is the descending world.
> And this is the descending world.
[1]
> A similar phenomenon began right before the fall of the Soviet Union. Life expectancy for men fell from a high of 65 years in 1987 to a low of 57 years in 1994
[0](https://twitter.com/balajis/status/1564853661351628802)
[1](https://twitter.com/balajis/status/1564859125829230592?t=fYc...)
I'm curious if he is expecting an anarcho-capitalism type system or he's predicting wildwest/dystopian.
I feel like that's one of the big political divides.
Why is China dominant and being made the boogey man in the USA? They opened free trade zones on their coast. They beat the USA at their own game who contemporarily are increasing taxes.
You have everyone piling into Africa to bring them low tax capitalism especially China. They see their peasant war coming because of the ultra wealthy coast and impoverished west. Africa is about to become the next china with ultra cheap labour. China loses those contracts and must rush to replace them.
For the USA to beat China, anarcho-capitalism is the likely option. That's the #1 scary unspoken thing about Trump. He represents exactly this.
I am intrigued about the cloud country. It almost feels like Estonia might be that place? Or perhaps their attempt?
I believe he likens it to BLM Riots:Jan 6 every day, type of dystopia.
> I am intrigued about the cloud country. It almost feels like Estonia might be that place? Or perhaps their attempt?
He is super bullish on Estonia, IIRC.
The Network State is free as a PDF or to read online if you're interested: https://thenetworkstate.com/
I think our big problems are mostly due to inadequate control over capitalism due to globalization making it too easy for large companies to avoid oversight and become parasitic and attack their host. The need for short term profit then becomes the only thing that those companies optimize for, leading to a death spiral of short term thinking.
Anarcho-capitalism is certainly not going to help any of that.
https://www.prb.org/resources/high-death-rate-among-russian-... `
[0]: https://en.wikipedia.org/wiki/Correlation_does_not_imply_cau...
https://ourworldindata.org/grapher/life-expectancy-at-birth-...
> While the pandemic has driven most of the decline in life expectancy, a rise in accidental deaths and drug overdoses also contributed, as did deaths from heart disease, chronic liver disease and cirrhosis, the new report found.
They proposed the greater loss in minority life expectancy as being driven by "systemic racism as well as inadequacies in the US handling of the pandemic." What that's supposed to mean was never stated. The next sentence reflected upon a higher rate of non-minority deaths the following year which the paper claimed "likely has multiple explanations." None of those possible explanations were offered.
They concluded with offering an estimated life expectancy in America of 76.44 for 2021. The final official numbers from the UN numbers ended up with 77.2.
[1] - https://www.medrxiv.org/content/10.1101/2022.04.05.22273393v...
https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf
The paragraph I quoted is drawing from the chart on page 5.
A pandemic hit and killed millions of people. It had a disproportionately high impact on the elderly, which will have the effect of "chopping the tail" off a Poisson distribution and dragging the mean down as a result.
The past several years of data should almost certainly be considered an outlier that will stand out on a long-term trend now that COVID has vaccines.
Seems about right.
We've known that there's a gap in life expectancy between men and women for awhile now. But the surprising thing is that the gap is increasing; you might expect that life expectancy would drop a certain percentage for all groups, leading to the ones with the highest life expectancy getting the largest drop.
Perhaps an equity lens is merited here.
For COVID, for example, the risk ratio for men compared to women is larger than the risk ratio for e.g. black people compared to white people. But public health authorities in the US prioritized access to vaccines to racial minorities (who indeed had higher age-adjusted mortality rates than white people), while not doing the same for men. This is an ideological choice, driven by the idea that bad things that happen to men aren't worthy of social concern.
More broadly, the gendered death statistics are indicative of systemic inequalities.
Which is why xy/male mammals and zw /female birds have greater tendency toward genetic variety? Probably not a huge effect overall though.
I would think that real world experiments with babies have shown that babies dressed as baby boys get far less social interaction from strangers which negatively effects early vocabulary and verbal/social engagement/experience/training.
Which is tragic, under socialing boys and then mocking them for lack of social skills when they get older.
[0] https://paa2012.princeton.edu/papers/122836
This surprised me, because I'd have guessed women would fair better, for reasons similar to you. Though I mostly see population-wide studies and not anything that looks at genetic/chromosomal damage.
This would only be true if cities were largely sex-segregated, making it as easy both to target or ignore a particular sex as it is to target or ignore black people. Your ideology accusation is unnecessary, as there is a material difference between the specific situations of black people and males. In fact targeting aid towards black people consequently targeted aid toward black males (a subset of black people.)
And with that targeting, black people are still less likely to be vaccinated than white people, so black people clearly weren't targeted enough. Although it was nice to see white people having to come in from the suburbs for the first time in years to get a vaccination. It was like what black people in the city have to do to get to their "neighborhood" public school. It was sad that they set up networks to disproportionately take up early slots, though.
Take the likelihood of being vaccinated between black people and all males, against the disproportionate effects of covid on males vs women, the cost of specifically targeting men (by giving men a special app or something, or by prioritizing men over women?) vs the cost of specifically targeting black people (put the vaccination centers in or near black neighborhoods if possible.) Control for everything else. I'd bet if you calculated it out, you've saved a lot more person-years per dollar doing the plan they went with instead of your plan.
That's not even considering the fact that black people start in a median more precarious position than most other groups (other than maybe Native Americans and undocumented migrants), so between a black and non-black person, the median black person will have their mortality damaged more at the same severity of illness.
And decreased aid targeted toward white males (a subset of males.)
> black people are still less likely to be vaccinated than white people, so black people clearly weren't targeted enough
The same is true of men vs women, so men clearly weren't targeted enough either.
Moreover, this entire comment thread is driven by the fact that men died a whole lot more than women due to COVID. That's ipso facto evidence that men were undertargeted.
> the cost of specifically targeting black people (put the vaccination centers in or near black neighborhoods if possible.)
Prioritizing who has access to a vaccine is cheaper than opening new vaccination centers in underprivileged areas (which fwiw I support). And it went further than this: in most localities, white men were explicitly deprioritized, having to wait a month or more longer to get access to the vaccine compared to e.g. black women, who were at lower risk.
Also, by choosing not to apply a gender lens, public health authorities overinvested in black women and underinvested in black men. It's likely that if mens' higher vulnerability to COVID was allowed to be brought into consideration, fewer black people (and fewer people overall) would have died.
Most (all?) proposed explanations fail to do so.
[1] - https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...
Peru (654) -- #66 -> #138
Bulgaria (541) -- #81 -> #144
Bosnia (489) -- #52 -> #90
... Skipping a few for brevity
Brazil (321) -- #55 -> #127
USA (317) -- #44 -> #70
Chile (316) -- #33 -> #55
Greece (312) -- #20 -> #46
Italy (290) -- #3 -> #13
Russia (257) -- #103 -> #176
Mexico (257) -- #85 -> #169
Spain (240) -- #6 -> #11
France (237) -- #12 -> #18
[0] https://coronavirus.jhu.edu/data/mortality
> "Although the U.S. health care system is among the best in the world, Americans suffer from what experts have called “the U.S. health disadvantage,” an amalgam of influences that erode well-being, Dr. Woolf said."
That's an impressive piece of equivocation. So good that it has a special disadvantage?
[0] https://pbs.twimg.com/media/DpNdUMeXUAAEHA4.jpg:large
[1] https://streets.mn/wp-content/uploads/2015/11/annual-VMT-dri...
[2] https://i.insider.com/55831cda69bedde87600549e?width=700&for...
[3] https://www.issup.net/knowledge-share/publications/2016-09/u...