> On the other side of the globe? I guess that wouldn't cross my mind.
Everything is interconnected. If your country is the only one on the planet that is doing well, it will not be long until resentments start brewing. If inequality stretches too far, eventually it results in instability. You can see this now with the amount of people immigrating to richer countries, both legally and illegally, and the resulting instability it causes, both in the countries that people immigrate to and those that they have left. Taken to the extreme, it eventually leads to wars between countries over resources. The United States might have the biggest military in the world, but it can't win a war against the rest of the world combined.
This is why Joe Biden came out and said that it wasn't the United States economy that worried him, but the economical weakness in the rest of the world. If people think that the United States prints money only to look after the interests of the United States, it will lose its status as the reserve currency of the world. This is already starting to happen, with China making strong inroads in Africa and Latin America with disgruntled countries that have been left behind. If America loses influence in these countries, it's power diminishes and it will only be a matter of time until it is your doctors who are being paid less than convenience store managers in foreign countries. You might not be alive to see it, but your grandchildren might be. It was only 90 years ago that it was the UK and not the United States that was the dominant world power.
> I do like the idea that there are well paid jobs that don't require many years of schooling. Seems good for social mobility.
Only if those jobs require a similar amount of years of experience to attain. Otherwise people stop pursuing the jobs that require many years of education in favour of earning more money in those that don't and your systems start to collapse as everyone chases the easy money.[1] As Dalio explains in the video above, it is investment in education which is the first step for those countries that begin to ascend and grow.
So the UK was a dominant power 90 years ago and now it's a minor player, meanwhile the US is dominating... but yeah, it's the US that's got capitalism wrong. Okay.
Perhaps it's your socialized medicine that is causing doctors to be commoditized and undervalued.
How did the UK lose its status as dominant power? By being involved in two costly wars within the space of 30 years that, even though it won, left it essentially bankrupt. The US has already been involved in Afghanistan and Iraq, it has an incredible amount of debt, it has domestic problems and it’s now spending an increasingly large sum of money on the Ukraine Russia war. If China decides to kick off in Taiwan and the US gets involved in that one too then, even if the US ended up winning, it could very well be in so much debt that, like the UK, it is superseded by an emerging power. In this scenario, China would be depleted from the loss and it would likely be India that took the mantle as the emergent superpower.
We know the healthcare system in Britain has been suffering from neglect for some time and AFAIK doctors often either work for the NHS or are independently contracted by them. Also, while Buc-ees technically a convenience store, it also a gas station (they held the record as the world largest with 120 gas pumps)with a large deli, tons of groceries, and the cleanest bathrooms you will ever find off the highway. They do a lot of business and have a large team of of very busy workers. Their income is well earned. That said, healthcare workers are very underpaid in Britain and have been for some time, but it's not fair to compare the incomes while trying to diminutize Buc-ees by simply labelling it as "convenience store".
Why would anyone do such a stressful job for that money? Especially now that education is so costly. I made more than that as an electronics engineer, and later as a software developer, and I was able to go home every single day of my career knowing for certain that nothing I did or didn't do had killed anyone.
Just for a little more context on why this is, Buc-ee’s is a gigantic operation. They're major truck stops with super-massive gas stations, tons of parking, and very large stores with a wide variety of stock including a lot of food. At any given point during the day they could easily have a hundred customers on premises gassing up or at a store. Managing that operation is not like managing a typical roadside gas station/store.
I think the social ramifications of car dependence are overlooked. US loves its freedom but in many ways cars make people much less free by taking away their free time, money, social interaction, physical activity, etc. It's incredible how expensive car infrastructure is, which increases taxes to an often unsustainable level (and poorer people not living in the sprawl of single family homes end up subsidizing). Paving everything looks disgusting and is bad for the environment and economy. Not to mention minimum parking laws' contribution to the housing crisis, or the trauma caused by ~40,000 deaths per year due to cars (not to mention all the other injuries). It's not hard to see why this sort of lifestyle could damage your health.
I hope we can get more deep dives on this topic as you mentioned because there are millions of people that would use viable alternatives. These would carry over to QOL improvements for everyone else too.
As the resident HN conservative, I wish the GOP would embrace bikes as a symbol of freedom. Cars are NOT tools of freedom - you are at the whim of gigacorporations and authoritarian governments like Iran.
With a bike, you move through the world, on extremely low cost infrastructure, while becoming a Fit Western Man and through Self Reliance. You don't need subsidies, you just need a bit of Strength and Forethought and all those other conservative goals.
> I wish the GOP would embrace bikes as a symbol of freedom. Cars are NOT tools of freedom - you are at the whim of gigacorporations and authoritarian governments
What you have in the US isn't too far, two parties for the illusion of democracy and a butt load of lobbyists and oligarchs in the back making sure the money printing press keeps on printing for the right people. Conservatism isn't about conserving values or the environment, it's about conserving status and money
We are relearning a lesson from 100 years ago which is that the act of putting your name on a product enters you into a social contract where adulterated products lead to an unprofitable loss of status. It’s a form of mutually assured destruction.
If we finished decriminalizing the “alcohol tier” drugs and allowed for national brands, instead of a mosaic of companies who cannot legally transport product across state lines, then we would have a real alternative for people who think their highest priority is to check out of life for a while. For the people who want to check out as long as possible/forever, they already need loads of therapy. And legalizing or criminalizing activities they like to repeat doesn’t change that.
You take your average severely depressed person, who may describe themselves as too much of a coward to end it all. Now threaten them with ruining the rest of their life? I have news for you, most of them already believe their life is ruined. Putting yourself in harm’s way to feel something is a terrible existence, and I think the people who describe it as slow suicide are not wrong. I also worry sometimes about adrenaline junkies.
You can’t outlaw self destruction. What threat can you possibly make that will have any import?
> For an explanation, a look at America’s geography is revealing [...] the national trend of stagnant life expectancy reveals huge regional variation (see map). In a place like Hazard, in eastern Kentucky, life expectancy is lower now than it was in 1980. In a place like Manhattan, or some wealthier counties of Colorado, it has increased by not much less than anywhere in Europe.
If you actually look at the map, it's pretty clear that geography is the biggest factor. The rural lifestyle is killing people - poverty, the amount of time spent in a car, the boredom.
The meth and opioid crisis hit rural regions much more significantly than urban areas.
It's also interesting that they point out 1980 vs 2023. Pre-Globalization, those rural areas used to have factories that by the 90s began leaving for Canada+Mexico and by the 2000s for China.
Same with mines, which is what the Hazard, Kentucky economy was built around.
This is not just an economic crisis but also a crisis of meaning. The mines and factories provided stable, decently paying jobs. People could feel they had a place in the world and see a future for their children. Now what?
I fear that the college-graduate white-collar work that has provided meaning, stability, and economic sustenance for most of us on this site is headed for a similar pass with AI.
> This is not just an economic crisis but also a crisis of meaning. The mines and factories provided stable, decently paying jobs. People could feel they had a place in the world and see a future for their children. Now what?
Exactly! When people don't see a future they either despair (ie. Hit the bottle or meth) or rage (ie. Political polarization and extremism).
> I fear that the college-graduate white-collar work that has provided meaning, stability, and economic sustenance for most of us on this site is headed for a similar pass with AI
Already started happening in certain segments of tech. If you work in Cybersecurity, Infrastructure, or Cloud the talent base across the board doesn't exist in the US anymore - it's mostly in Israel and India now.
Similar shifts are going to happen over the next few years now that
1. Plenty of US trained and educated H1Bs are forced to return to India and China
2. Remote work is normalized
3. Colleges don't teach much aside from leetcode and some fullstack development now.
Accounting, back office, marketing, communications, and administrative roles have already been outsourced or automated
Is poverty, the amount of time spent in a car, or boredom anything new since 1980? If anything we (they) are less bored, constantly stimulated.
Since there has been a large increase in deaths of despair specifically, I'm inclined to blame the spike in accessibility of addictions. In 1980 you could maybe become an alcoholic or addicted to cigarettes, or gambling if you went out of your way. Now you have alcohol, 1000 forms of nicotine, gambling at your fingertips, social media, porn, fentanyl, meth, ...
Some of these addictions, like fentanyl, will kill you directly. The others just make you check out from life, and eventually, living.
Or, people are in more despair in these areas because they have been dying since the 90s. I escaped a rural town for exactly that reason. If I didn't have a way out, and had to "live a life" in that town for 60 years, I'd probably have ended up offing myself.
It used to be you could get a random job and live an average life which could give you time to develop hobbies and have friends and do enjoyable things, as well as just be less stressed, but now rural areas are half welfare and half people working themselves to death for the most basic life imaginable to americans.
I think the difference is what's considered "average". I'm pretty sure the average rural life has always been somewhat unexciting and hard, and that hasn't changed. Now you can compare your life to the urban/modern folks more easily due to social media and other wonders of the modern age. The definition of "average" has shifted to include things that are out of your reach.
But if you're right and it's all about the availability of jobs, then the rise of remote work should soon revive these rural areas.
Poor people in cities are in the same situation.* The geographical distinction is I think a red herring that goes away when you control for wealth. The article mentions wealthy people in Colorado, which is mostly not very urban.
*Even rich people have the same problems, but probably better resources for mental healthcare
You bring up an interesting argument: is it healthier to live Urbanely vs Rurally? I see many advantages & disadvantages for both.
Having grown up in a city, and tried both, I plan to live somewhere in the middle:
On the outskirts of a small city (For me, about 30000-80,000 seems to be the sweet spot, preferably with a university, and with large enough parks for a 2 hour hike, and/or a river) while also being within 45 minutes from a large city.
I work remotely, and I am interested in living closer to nature and keeping a few livestock.
At a 45 minute distance, a 2-day-hybrid work week wouldn't be too bad, especially since that city offers things I can't get in my town (specialty groceries and IT meetup events).
For me, the article only shows 1 data visualization which is expressly about the Rural vs. Urban divide. I don't think the article did the topic much justice. I wish it had more data analysis, rather than how it quotes specific numbers, in several cases, without really using them to relate to the thesis of the article.
For example:
"In 2021, according to the cdc, 107,000 people died of drug overdoses, the vast majority linked to heroin or fentanyl. No other rich country comes close to this rate of drug deaths (though Scotland is not that far off). And in 2021 around 43,000 Americans died in car crashes, which was the highest figure since 2005 (the number fell a bit last year); in Germany the rate was a quarter of America’s. Around 26,000 were murdered, against just 300 in Italy."
This is very very general information. Yet the thesis (I think?) suggests that health outcomes are different based on Urban vs Rural living. Why not relate not general opiate consumption data, but rather compare urban & rural opiate consumption, and relate to to another correlating factor such as education or economy. The article does to a degree, but I feel like it's lacking in analysis.
> Nearly 4,000 people died in fires, the highest number in close to 20 years, making for a death rate of nearly twice that of western Europe.
This seems particularly damning considering that in the name of fire safety, the USA (and Canada) goes to the effort to build two stairways in apartment buildings, which makes them harder to build, and compromises the design in making them subjectively worse to live in.
Europe does not do this extra safety step, which benefits their housing, and yet they have fewer fire deaths.
There's a difference though. Old homes in the USA are often made from timber and don't have fire retardants like insulation, drywall (instead they have plaster and lath which is more flammable than drywall), etc. Plus the wood is very old (but very high quality!) which means it's very dry which means it goes up quickly. And with no insulation it spreads really quickly.
Plus a lot of older homes haven't been brought up to date with new hardwired fire alarms, modern electric, etc.
Another quirk of American home building history is "balloon framing" that used long, continuous studs for the exterior walls that could rapidly channel fires between walls. The modern method is called "stick framing" where floors are essentially stacked up which creates fire breaks. So not all wood construction methods are equal where fire safety is concerned. Modern homes will certainly burn, but you should have a reasonable amount of time to escape at least.
> the USA (and Canada) goes to the effort to build two stairways in apartment buildings, which makes them harder to build, and compromises the design in making them subjectively worse to live in.
Did a developer tell you that? Adding multiple stairways in a building is not difficult unless we are talking some sort of converted slum building.
I might be wrong but in most of Europe timber is basically unused as a building material (except for UK). And it seems to be used extensively in the US.
Concrete and bricks don't burn anywhere near as much as wood.
Scandinavia uses timber frequently. People use what they have and a lot of Europe doesn't have ample timber supplies. North America does so it's used and it's a fine material with a lot of upsides. Modern timber framed homes are quite fire safe and have a few ways to slow the spread of fire down so it doesn't rage. But old ones are generally not for a variety of reasons.
While you see some very old timber buildings in the UK from the 1500s and 1600s, we mostly switched to brick centuries ago since we’d cut down most of our trees.
Lots of new timber buildings in the Nordics as they have plenty of trees.
But I believe most of the new housing developments are mostly wood. Brick is external only and possibly not even structural, the heavy lifting is all timber.
It might be too much of an extrapolation but theres quite an odd cultural phenomenon around death in north america. It almost feels as though people think you deserve to die if you’re poor, get sick, dont currently have benefits, etc. There’s a massive for profit institution obsessed with extracting maximim value from you before you die. If you do, it was your responsibility anyway.
We dont really care about people living, or their quality of life. We care about the metrics sureounding those things, and gaming them to the maximum extent permitted by law.
I would just like to clarify - Canada is in North America and it is nothing like you describe above. Actually it's quite the opposite, our healthcare means we're literally all-in to help each other.
You're talking about the United States, not "North America"
I've been living here 15 years, and my partner works in healthcare. I've never once heard of suicide being "promoted".
If you mean that assisted suicide is legal in Canada under very strict circumstances for terminally ill people, then yes, that is correct.
It's legal in multiple developed countries around the world.
Personally, after watching my Mum be eaten alive by Cancer that spread from her lungs to her bones to all her organs, I think it's merciful and much needed.
> Disability experts say the story is not unique in Canada, which arguably has the world’s most permissive euthanasia rules — allowing people with serious disabilities to choose to be killed in the absence of any other medical issue
> You think it's disgusting and barbaric to allow people to make their own decisions about their own life?
No, I think it’s awful that the state will kill people that are not terminally ill. These aren’t the “strict circumstances” you justified this with initially. Now it’s a “personal freedom” thing? And the state should assist in this? Killing someone’s who is sad isn’t a mercy killing like your mother had. It’s active promotion of suicide.
I've noticed this too - it's horrifying. Just the complete ambivalence to death. From covid to gun deaths, traffic accidents + pedestrians being killed by cars to overdoses and suicides. Not to mention all the preventable deaths from lack of access to medical care. If the solution involves "the state", we'd rather just not bother and fighting "government overreach" at the cost of mass death is a completely common position. No license plate cameras, no gun registries, no mental health institution funding, no universal health care. People are starting to overturn vaccines rules about preventing childhood diseases. Rather than acknowledge the utility of some of these interventions and work around any potential downside, just rule out any coordinated action and hope for the best.
Those numerous and recent examples you listed show us that many people would actually rather die and/or contribute to others dying than be told what to do. Rugged Individualism has become elevated to near pseudo-religion, that people are swearing their lives to.
This whole thread really just makes me realize how severe our filter bubbles, echo chambers and distrust of "the other side" has become.
Nobody wants poor people to die and nobody has a religious adherence to "rugged individualism". If you go actually talk to people who disagree with you, instead of reading ridiculous descriptions of their motivations from people inside your bubble who hate them, you might gain an appreciation of their concerns.
I'm amazed at how 4 years of the Trump administration didn't result in Liberals becoming much more open-minded to Libertarian concerns about concentrated power in the federal government. How did we come through that experience without more people saying "OK, I get it now, maybe I don't want so much power and control over my life held by the white house".
100% correct. You hit the nail right on the head. People are dehumanizing other groups by refusing to actually speak with them. This makes it easier for them to discriminate against such groups. The end game of the dehumanizing process is not good if you follow history at all.
People in general are much more reasonable in person than the internet would lead you to believe.
It's not that people are ambivalent to death. It's that a certain amount of death is going to happen. You can't legislate it away. Some of us think we've reached the point of diminishing returns on many topics and don't think giving up liberties will do much good.
No I don't want cameras. No I don't want backdoor encryption. No I don't want gun registries. No I don't want the Fed's to have more money or power.
They are not looking out for our best interests most of the time.
Hackernews never fails to deliver. The comments here are perfectly indicative.
Pretending that implementing a sane healthcare system like Germany or Switzerland is "giving up liberty" relies on the assumption that the tens of millions of Americans without healthcare somehow have more "freedom" than they otherwise would if they could get regular checkups or receive health care that doesn't bankrupt them. Or that there's somehow "freedom" in being tied to a job you don't like solely because of the health insurance coverage. We already more pay per capita for government-run healthcare than e.g. Canada does, except it only covers our poorest and oldest citizens. Just a silly selfish view of 'freedom'.
This is pretty much a Social Darwinist PoV. Blaming systemic issues on individuals supports toxic systems. Sure, people can make better choices, but the choices they're offered don't appear in a vacuum.
I'd expect the outcomes in hospitals to be about the same. It's just that Americans avoid those for obvious reasons.
I highly recommend that you or your partner give birth surrounded by professionals, as well as getting check-ups done before - even if those professionals are expensive.
There's lies, damned lies, and statistics. You need to interpret these stats.
America is a very broad place with a lot of different types of people. We have millions of people that refuse to accept medicine due to religious reasons. Similar to beliefs around birthing children. There are more weirdo's here than anywhere else. This works in America's favor in many ways but is negative in many ways too.
If you're a normal person you don't have to worry. Subtract the weirdo's from the datasets and outcomes are fantastic. The same thing with all these other health and life expectancy numbers. If you're normal, avoid obesity, don't smoke or do drugs and avoid a variety of high risk behaviors, and visit your doctor then you're likely to live a long life.
I'm not sure if it occurs to you, but exactly the same statement applies to every country on earth.
"If you ignore the really bad cases, the average is fine".
Australia accepts more immigrants per capita than any other country on earth - so it's extremely diverse, and remote. Why are the health outcomes in Australia AT LEAST 10x better than the US?
Nah you’re blinded by the stats again. Americans are wildly different than everywhere else and far more diverse. Americans distrust of and hostility towards authority is unparalleled.
The number of kids with no vaccines has quadrupled since 2000 in America and millions of people, either through religion or otherwise refuse medical services. This is completely unlike other western countries. Australia’s diversity is nothing like America and nowhere like the scale. I’ve spent considerable time in both countries and Australia is nothing like America and it’s basically a mono-culture.
On top of that Americans have a lot of other issues like higher rates of obesity and drug use. It’s cultural here and it’s a lot of people. Way more by percentage than other western countries.
An Australian living like an Australian will generally have better health outcomes in America than back home.
This not only includes childbirth, but also up to 42 days after childbirth. This site below goes into the breakdown and the leading causes of death surrounding prenatal, birth, and postpartum deaths in the US. Obesity and heart disease rears its ugly head again sadly along with access to healthcare.
No offense to anyone who is all "yay, life!" but as people learn more, as the blinders fall off, as we are encouraged to question tradition and establishment, what we see at the end of the line doesn't look great. Miserable health if you make it to retirement, disposable marriages, your social institutions crumble. Forget the church and the Elks lodge, we can't even keep bowling leagues and book clubs together. Life starts seeming absurd and has for a long time. Think of that bit in Con Air, where the too-aware serial killer says ""What if I told you insane was working fifty hours a week in some office for fifty years, at the end of which they tell you to piss off? Ending up in some retirement village, hoping to die before suffering the indignity of trying to make it to the toilet on time."
Everything has been first chisled, then jackhammered, and finally bulldozed away. No rocks to fall on us and hide us from the grim end of Terror Management Theory, no sense in planting a tree which we might never sit in the shade of if it will be scorched to a stick in some kind of global warming furnace. We ought not to be surprised, then, if so many elect to reach for non-thought, for entertainment and distraction, because staring into the abyss can get old. We used to have protections, elaborate and impermeable to questioning, which protected us from seeing how unappealing the inevitable decline and end can really be.
Not exactly. It was proposed that we assign meaning. It is not there to be found. Unless you are a virtuoso of self-deception, you will be aware that you have arbitrarily assigned meaning. It is no less hollow than an atheist with a communion wafer. That is the crux of my point: all of the constructs we had, including whimsy and distraction, become reduced to so much translucent -- at best -- mist once we're aware.
Not sure we read the same book then. Because I was commenting on the idea that “life is inherently meaningless and absurd, yet we can find purpose and significance by embracing and confronting this absurdity.”
Protections? In like the Great Depression, for example? Or just in a thin strata of 20 years from the '50s to the '70s thanks to the spoils of WW2 + pre-computerization?
And now we have no child labor, no draft (or even civil service to get people out and mingling with a diverse range of their fellow citizens for the good of the country), the weekend thanks to unions, civil rights, entertainment and knowledge at our fingertips... it's horrible. Why plant the tree, especially if I don't get to enjoy its shade? :c I'm picking up my toys and going home!
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[ 3.0 ms ] story [ 198 ms ] threadManagers at Buc-ee’s, a Texas-based chain of stores, can make more than experienced doctors earn in Britain.
I do like the idea that there are well paid jobs that don't require many years of schooling. Seems good for social mobility.
Everything is interconnected. If your country is the only one on the planet that is doing well, it will not be long until resentments start brewing. If inequality stretches too far, eventually it results in instability. You can see this now with the amount of people immigrating to richer countries, both legally and illegally, and the resulting instability it causes, both in the countries that people immigrate to and those that they have left. Taken to the extreme, it eventually leads to wars between countries over resources. The United States might have the biggest military in the world, but it can't win a war against the rest of the world combined.
This is why Joe Biden came out and said that it wasn't the United States economy that worried him, but the economical weakness in the rest of the world. If people think that the United States prints money only to look after the interests of the United States, it will lose its status as the reserve currency of the world. This is already starting to happen, with China making strong inroads in Africa and Latin America with disgruntled countries that have been left behind. If America loses influence in these countries, it's power diminishes and it will only be a matter of time until it is your doctors who are being paid less than convenience store managers in foreign countries. You might not be alive to see it, but your grandchildren might be. It was only 90 years ago that it was the UK and not the United States that was the dominant world power.
Ray Dalio is quite insightful on this:
https://www.youtube.com/watch?v=xguam0TKMw8
> I do like the idea that there are well paid jobs that don't require many years of schooling. Seems good for social mobility.
Only if those jobs require a similar amount of years of experience to attain. Otherwise people stop pursuing the jobs that require many years of education in favour of earning more money in those that don't and your systems start to collapse as everyone chases the easy money.[1] As Dalio explains in the video above, it is investment in education which is the first step for those countries that begin to ascend and grow.
[1] https://www.theguardian.com/society/2017/may/08/nhs-staff-qu...
Perhaps it's your socialized medicine that is causing doctors to be commoditized and undervalued.
We know the healthcare system in Britain has been suffering from neglect for some time and AFAIK doctors often either work for the NHS or are independently contracted by them. Also, while Buc-ees technically a convenience store, it also a gas station (they held the record as the world largest with 120 gas pumps)with a large deli, tons of groceries, and the cleanest bathrooms you will ever find off the highway. They do a lot of business and have a large team of of very busy workers. Their income is well earned. That said, healthcare workers are very underpaid in Britain and have been for some time, but it's not fair to compare the incomes while trying to diminutize Buc-ees by simply labelling it as "convenience store".
I'd be surprised if a single Buc-ees location had 100 employees, let alone 400.
As other countries (ie. france cited in the article) move further away from car dependency they are accordingly seeing improvements.
I hope we can get more deep dives on this topic as you mentioned because there are millions of people that would use viable alternatives. These would carry over to QOL improvements for everyone else too.
With a bike, you move through the world, on extremely low cost infrastructure, while becoming a Fit Western Man and through Self Reliance. You don't need subsidies, you just need a bit of Strength and Forethought and all those other conservative goals.
What you have in the US isn't too far, two parties for the illusion of democracy and a butt load of lobbyists and oligarchs in the back making sure the money printing press keeps on printing for the right people. Conservatism isn't about conserving values or the environment, it's about conserving status and money
If we finished decriminalizing the “alcohol tier” drugs and allowed for national brands, instead of a mosaic of companies who cannot legally transport product across state lines, then we would have a real alternative for people who think their highest priority is to check out of life for a while. For the people who want to check out as long as possible/forever, they already need loads of therapy. And legalizing or criminalizing activities they like to repeat doesn’t change that.
You take your average severely depressed person, who may describe themselves as too much of a coward to end it all. Now threaten them with ruining the rest of their life? I have news for you, most of them already believe their life is ruined. Putting yourself in harm’s way to feel something is a terrible existence, and I think the people who describe it as slow suicide are not wrong. I also worry sometimes about adrenaline junkies.
You can’t outlaw self destruction. What threat can you possibly make that will have any import?
You can outlaw reckless endangerment.
If you actually look at the map, it's pretty clear that geography is the biggest factor. The rural lifestyle is killing people - poverty, the amount of time spent in a car, the boredom.
It's also interesting that they point out 1980 vs 2023. Pre-Globalization, those rural areas used to have factories that by the 90s began leaving for Canada+Mexico and by the 2000s for China.
Vast swathes of America's rural hinterland effectively deindustrialized, leaving rural residents economically disenfranchised
This is not just an economic crisis but also a crisis of meaning. The mines and factories provided stable, decently paying jobs. People could feel they had a place in the world and see a future for their children. Now what?
I fear that the college-graduate white-collar work that has provided meaning, stability, and economic sustenance for most of us on this site is headed for a similar pass with AI.
Exactly! When people don't see a future they either despair (ie. Hit the bottle or meth) or rage (ie. Political polarization and extremism).
> I fear that the college-graduate white-collar work that has provided meaning, stability, and economic sustenance for most of us on this site is headed for a similar pass with AI
Already started happening in certain segments of tech. If you work in Cybersecurity, Infrastructure, or Cloud the talent base across the board doesn't exist in the US anymore - it's mostly in Israel and India now.
Similar shifts are going to happen over the next few years now that
1. Plenty of US trained and educated H1Bs are forced to return to India and China
2. Remote work is normalized
3. Colleges don't teach much aside from leetcode and some fullstack development now.
Accounting, back office, marketing, communications, and administrative roles have already been outsourced or automated
Since there has been a large increase in deaths of despair specifically, I'm inclined to blame the spike in accessibility of addictions. In 1980 you could maybe become an alcoholic or addicted to cigarettes, or gambling if you went out of your way. Now you have alcohol, 1000 forms of nicotine, gambling at your fingertips, social media, porn, fentanyl, meth, ...
Some of these addictions, like fentanyl, will kill you directly. The others just make you check out from life, and eventually, living.
It used to be you could get a random job and live an average life which could give you time to develop hobbies and have friends and do enjoyable things, as well as just be less stressed, but now rural areas are half welfare and half people working themselves to death for the most basic life imaginable to americans.
But if you're right and it's all about the availability of jobs, then the rise of remote work should soon revive these rural areas.
*Even rich people have the same problems, but probably better resources for mental healthcare
Having grown up in a city, and tried both, I plan to live somewhere in the middle:
On the outskirts of a small city (For me, about 30000-80,000 seems to be the sweet spot, preferably with a university, and with large enough parks for a 2 hour hike, and/or a river) while also being within 45 minutes from a large city.
I work remotely, and I am interested in living closer to nature and keeping a few livestock.
At a 45 minute distance, a 2-day-hybrid work week wouldn't be too bad, especially since that city offers things I can't get in my town (specialty groceries and IT meetup events).
For example:
"In 2021, according to the cdc, 107,000 people died of drug overdoses, the vast majority linked to heroin or fentanyl. No other rich country comes close to this rate of drug deaths (though Scotland is not that far off). And in 2021 around 43,000 Americans died in car crashes, which was the highest figure since 2005 (the number fell a bit last year); in Germany the rate was a quarter of America’s. Around 26,000 were murdered, against just 300 in Italy."
This is very very general information. Yet the thesis (I think?) suggests that health outcomes are different based on Urban vs Rural living. Why not relate not general opiate consumption data, but rather compare urban & rural opiate consumption, and relate to to another correlating factor such as education or economy. The article does to a degree, but I feel like it's lacking in analysis.
This seems particularly damning considering that in the name of fire safety, the USA (and Canada) goes to the effort to build two stairways in apartment buildings, which makes them harder to build, and compromises the design in making them subjectively worse to live in.
Europe does not do this extra safety step, which benefits their housing, and yet they have fewer fire deaths.
Plus a lot of older homes haven't been brought up to date with new hardwired fire alarms, modern electric, etc.
Did a developer tell you that? Adding multiple stairways in a building is not difficult unless we are talking some sort of converted slum building.
I'm sure it's not technically terribly difficult to add a staircase, but it's added time and expense and restricts architects in what they can do.
https://slate.com/business/2021/12/staircases-floor-plan-twi...
Concrete and bricks don't burn anywhere near as much as wood.
Lots of new timber buildings in the Nordics as they have plenty of trees.
But I believe most of the new housing developments are mostly wood. Brick is external only and possibly not even structural, the heavy lifting is all timber.
But I certainly no expert so could be wrong.
> In Scotland timber frame homes already account for around 75% of all new housing, compared to 23% in England.
https://www.pbctoday.co.uk/news/mmc-news/timber-frame-homes-...
Certainly the vast majority of newer homes I saw in England had brick / breeze block los bearing walls.
We dont really care about people living, or their quality of life. We care about the metrics sureounding those things, and gaming them to the maximum extent permitted by law.
I would just like to clarify - Canada is in North America and it is nothing like you describe above. Actually it's quite the opposite, our healthcare means we're literally all-in to help each other.
You're talking about the United States, not "North America"
If you mean that assisted suicide is legal in Canada under very strict circumstances for terminally ill people, then yes, that is correct.
It's legal in multiple developed countries around the world.
Personally, after watching my Mum be eaten alive by Cancer that spread from her lungs to her bones to all her organs, I think it's merciful and much needed.
https://apnews.com/article/covid-science-health-toronto-7c63...
> Disability experts say the story is not unique in Canada, which arguably has the world’s most permissive euthanasia rules — allowing people with serious disabilities to choose to be killed in the absence of any other medical issue
Absolutely disgusting and barbaric.
You think it's disgusting and barbaric to allow people to make their own decisions about their own life?
I, ah, disagree with you. I personally think people should be allowed to choose what they do with their own life. Personal Freedom and all that.
No, I think it’s awful that the state will kill people that are not terminally ill. These aren’t the “strict circumstances” you justified this with initially. Now it’s a “personal freedom” thing? And the state should assist in this? Killing someone’s who is sad isn’t a mercy killing like your mother had. It’s active promotion of suicide.
Ridiculous. And still disgusting and barbaric.
Give it a rest, the state is a not "killing" anyone.
"The State" allows people to choose to end their own life if they want to.
This sounds like someone who has never had significant interactions with the Canadian healthcare system...
Many shoulder shrugs, year long waitlists, misdiagnoses, not respecting DNRs, etc
Nobody wants poor people to die and nobody has a religious adherence to "rugged individualism". If you go actually talk to people who disagree with you, instead of reading ridiculous descriptions of their motivations from people inside your bubble who hate them, you might gain an appreciation of their concerns.
I'm amazed at how 4 years of the Trump administration didn't result in Liberals becoming much more open-minded to Libertarian concerns about concentrated power in the federal government. How did we come through that experience without more people saying "OK, I get it now, maybe I don't want so much power and control over my life held by the white house".
People in general are much more reasonable in person than the internet would lead you to believe.
No I don't want cameras. No I don't want backdoor encryption. No I don't want gun registries. No I don't want the Fed's to have more money or power.
They are not looking out for our best interests most of the time.
Pretending that implementing a sane healthcare system like Germany or Switzerland is "giving up liberty" relies on the assumption that the tens of millions of Americans without healthcare somehow have more "freedom" than they otherwise would if they could get regular checkups or receive health care that doesn't bankrupt them. Or that there's somehow "freedom" in being tied to a job you don't like solely because of the health insurance coverage. We already more pay per capita for government-run healthcare than e.g. Canada does, except it only covers our poorest and oldest citizens. Just a silly selfish view of 'freedom'.
Every time I read articles like these, taking about obesity death rates and such, I think: so? We overconsume. There are limits.
Mothers-to-be in the US are much more likely to die in childbirth than in any other developed country. [1]
When it comes to healthcare outcomes, the US is comparable to Latvia and Chile, not developed nations.
[1] https://www.statista.com/statistics/1240400/maternal-mortali...
I highly recommend that you or your partner give birth surrounded by professionals, as well as getting check-ups done before - even if those professionals are expensive.
It's a societal issue more than a healthcare issue.
America is a very broad place with a lot of different types of people. We have millions of people that refuse to accept medicine due to religious reasons. Similar to beliefs around birthing children. There are more weirdo's here than anywhere else. This works in America's favor in many ways but is negative in many ways too.
If you're a normal person you don't have to worry. Subtract the weirdo's from the datasets and outcomes are fantastic. The same thing with all these other health and life expectancy numbers. If you're normal, avoid obesity, don't smoke or do drugs and avoid a variety of high risk behaviors, and visit your doctor then you're likely to live a long life.
"If you ignore the really bad cases, the average is fine".
Australia accepts more immigrants per capita than any other country on earth - so it's extremely diverse, and remote. Why are the health outcomes in Australia AT LEAST 10x better than the US?
The number of kids with no vaccines has quadrupled since 2000 in America and millions of people, either through religion or otherwise refuse medical services. This is completely unlike other western countries. Australia’s diversity is nothing like America and nowhere like the scale. I’ve spent considerable time in both countries and Australia is nothing like America and it’s basically a mono-culture.
On top of that Americans have a lot of other issues like higher rates of obesity and drug use. It’s cultural here and it’s a lot of people. Way more by percentage than other western countries.
An Australian living like an Australian will generally have better health outcomes in America than back home.
https://www.commonwealthfund.org/publications/issue-brief-re...
Then there is some work regarding opioid use and death through pregnancy and postpartum periods that account more quite a bit as well sadly. https://healthcare.utah.edu/press-releases/2019/05/opioids-l...
Everything has been first chisled, then jackhammered, and finally bulldozed away. No rocks to fall on us and hide us from the grim end of Terror Management Theory, no sense in planting a tree which we might never sit in the shade of if it will be scorched to a stick in some kind of global warming furnace. We ought not to be surprised, then, if so many elect to reach for non-thought, for entertainment and distraction, because staring into the abyss can get old. We used to have protections, elaborate and impermeable to questioning, which protected us from seeing how unappealing the inevitable decline and end can really be.
We have sadly lost our values as people. We don’t value community in the same way as it was before the internet for example.
We should not give into despair, although many already have.
And now we have no child labor, no draft (or even civil service to get people out and mingling with a diverse range of their fellow citizens for the good of the country), the weekend thanks to unions, civil rights, entertainment and knowledge at our fingertips... it's horrible. Why plant the tree, especially if I don't get to enjoy its shade? :c I'm picking up my toys and going home!