I didn't read every word of the article but are they really controlling for net worth?
> And people in the Left Coast’s poorest quartile of counties live 2.4 years longer than those in the richest quartile counties in the Deep South.
That's super indirect it doesn't mean that there is a regional effect. Maybe a rich quartile county in the deep south has one multibillionaire who has good healthcare and a hundred thousand poor people who have bad healthcare because they are poor. Or maybe the poorest quartile counties in that 'left coast' region are still richer than the richest quartile counties in the 'deep south' region, probably not but they don't say.
The top quartile in Georgia starts at around 75k where it’s 86k in California. Hell the median income in Georgia is 61,500$ in a state with a relatively low cost of living.
You have to add in the costs of health insurance premiums/deductibles/out of pocket maximums to get to a sort of comparable figure.
Easily $400 to $1,200 per person per month depending on age, plus probability of $3k to $7k deductible, plus probability of $5k to $10k out of pocket maximum.
Although, US pay statistics exclude the employer subsidized portion of the health insurance premiums (usually ~70%), but they also exclude the monetary cost of the volatility due to it being tied to your employment.
Also, these costs will be more heavily subsidized by employers for higher paid populations, and less subsidized for low paid populations.
If you’re going to look on a county by county basis some parts of the Deep South are really poor. But by slicing off the top quartile overall you cut out the poverty and are looking at a very different population.
Further without the extreme property prices you see in costal cities a family pulling in 75k has very different living expenses.
You are really grasping at straws here. This is an instance where applying Occam’s Razor applies. At any rate, whatever the causes it is still the case that there are regional differences in life expectancy.
Places like South Florida with some of the highest life expectancy in the nation must be because retirees with ample money for good healthcare congregate there.
If you've made it to your golden years it's because you haven't subcommed to the drugs guns depression and sedentary lifestyle that's kneecapping a generation of people
yeah - I see a big disconnect between these average ages, and the really unhealthy lives that some (lots) of adults live. I don't think "average" is useful, rather it covers politically volatile ID
The thesis that this has anything to do with medical technology seems wrong. Life expectancy around the world has a lot more to do with lifestyle than with technology or available money to get it. Americans generally have terrible lifestyles.
Yeah, this life expectancy divide is just a map of obesity. Even the counties referenced in TFA up through South and North Dakota echo the obesity prevalence.
A friend gifted me a copy of this book (American Nations) and I quit reading it because, while somewhat novel, these regional distinctions make no practical sense. There is a wide, substantial difference between someone from Minnesota or Iowa and someone from New York or New Mexico. I get why the author drew the distinctions that way, but they aren't useful or meaningful.
Is it really that surprising though? Conservative areas reject federal money for healthcare initiatives, and engage in other anti-healthcare policies. Unless you believe healthcare policies are actively negative to lifespan, this is entirely unsurprising.
Could "conservative areas" be a [unintended] euphemism?
The article cites a Univ. of Cincinatti study: "Their conclusion: “Whiteness encourages whites to reject policies designed to help the poor and reduce inequality because of animosity toward people of color as well as being unaware that the poor include a great many white people.” "
I will also point out that this kind of quote being allowed into a "scientific" study is exhibit A for why conservatives are rejecting the scientific establishment, throwing out the baby with the bathwater.
Once you take some distance from the subjects and gaze upon the production of these 'academics' you start to notice that their entire corpus is circumreferential with hardly any references going in from the outside other than to point out the fallacies of those 'studies'. The entirety of '-studies' subjects lives inside a world of its own where self-proclaimed 'experts' in self-invented 'fields' produce 'studies' which are then referenced by other 'academics' in their own 'studies'. This has created a vast corpus of nonsense [1] which is cited by activist-politicians as 'scientific proof' of the validity of their endeavours. Most of these '-studies' might as well have been produced by LLMs and it is not hard to predict someone will train a model to come up with new 'studies' to prove this point.
Those same conservatives happily supported the Southern Strategy which is what this sentence references. One political party made this a basis for their platform for decades. These are the results of that strategy.
Imagine a university publishing an article with the following phrase:
Blackness encourages blacks to reject policies designed to help ${some group} and ${some political target} because of animosity toward whites as well as being unaware that ${some group} include a great many black people.
That university would be burned at the stake for being racist neocolonialists.
What's good for the goose is good for the gander - any time an 'academic' starts about 'whiteness' she should be called out for being just the racist stereotype she claims to want to fight. She is a racist, pure and simple, and racists are not welcome. No matter how many circumreferential 'studies' she will cite, no matter how many other 'academics' she has on her side, let the facts speak for themselves.
The surprise is that they should find this surprising.
The stereotype is that the people in the longer-lived regions say "These are the things that lead to a longer life" and the people in the shorter-lived regions say "Don't tell us what to do!"
That's not to affirm the stereotypes, but rather to say that this is what the stereotypes would lead me to expect. I suppose it's a surprise that the one would be correct at all, since there's so much misinformation about how to be healthy. But the basics (eat less junk food, exercise, and get appropriate medical care) do seem to work, at least a little.
By now, every smoker and tobacco chewer on earth knows that to continue doing it will lower their expected lifespan. I'm all for getting quality information to people so that they can make the best decisions, but I think we've reached a point where this is no longer the main issue.
Or, perhaps it's not really an issue in the first place. Imagine a society that optimized for their average life expectancy. It could ban all vices and unhealthy foods and put people in "health prisons" when they don't pass BMI benchmarks. Obviously, not many people would want to live in this country, despite it having the highest life expectancy.
My point is that people's internal value function, on average, probably isn't life expectancy or even health outcomes. Those may be important, but people make tradeoffs every day. That doesn't mean they're not doing things that maximize their real value function, even if they have access to the best information.
In the stereotypes I'm discussing, the people with bad health outcomes reject every suggestion with the slightest inconvenience for them -- or even if it doesn't inconvenience them. Every novelty is portrayed as "health prison", or the equivalent on other topics.
In other words, according to the stereotypes, the internal value function is about rejection. This is a kind of checkmate, a game designed for them to win. Which would lead many to want to leave to it, but it does have effects on people who don't fit the stereotypes and have other priorities (including longer lifespans and more healthy-feeling lifestyles).
> “Your health is only 10 percent influenced by the medical environment and maybe 20 or 30 percent in behavioral choices.
And then a paragraph later, this:
“There’s a reason why the Southeastern portion of this country is called the Stroke Belt: It’s because the rates of stroke per capita are substantially higher there and mirrored by rates of cardiovascular disease, diabetes, obesity and other risk factors.”
Cardiovascular diseases can be mitigated via diet and other choices. That's not sociopolitical. It's personal, and certainly more than 20 to 30%.
Even in the areas with a higher life expectancy ceiling, that ceiling is lower than it could be. Regardless of where, we're eating and sedentary'ing ourselves into early and earlier graves.
To frame it as these "premature deaths" are ok because other premature deaths are worse is a deceptive and dangerous narrative. Premature is premature and we shouldn't be rationalizing like this.
I feel it is a mix of personal and social. I live in an walkable urban area around other healthy people. It is much easier to live a healthy lifestyle when all your friends and family are doing it and the infrastructure is set up for it.
When I visit my inlaws in Texas I always gain a bit of weight because you have to drive everywhere and the food is more calorie dense.
>>> Greater Appalachia (pop. 59 million)
Settlers overwhelmingly from war-ravaged Northern Ireland, Northern England and Scottish lowlands were deeply committed to personal sovereignty and intensely suspicious of external authority.
>>> The geography of U.S. life expectancy — and the policy environments that determine it — is the result of differences that are regional, cultural and political, with roots going back centuries to the people who arrived on the continent with totally different ideas about equality, the proper role of government, and the correct balance point between individual liberty and the common good. Once you understand how the country was colonized — and by whom — a number of insights into Americans’ overall health and longevity are revealed, along with some paths to improve the situation.
Right – my comment about academic navel gazing was a critique of the article itself – which to me seems more self-promotional than academic anyway. The author references his own work no less then a dozen times, and fails to realize that he's applying the same colonial ideology he purports to skewer.
There are similar patterns elsewhere, so I would not call it surprising. Take England, for example. Despite being a relatively tiny country, some regions have significantly higher life expectancy than others. In that case, it has been linked to infant mortality and health [1]
Impossible to correct for all the variables in effect here. You can't even safely say that the politics of one region vs. another have been the same over two centuries.
I have lived in each of the regions that they divided the US into. For all of it's research and verbiage, I am surprised that the article fails to directly mention two common sense factors:
1. Regional and cultural diet habits:
>“There’s a reason why the Southeastern portion of this country is called the Stroke Belt: It’s because the rates of stroke per capita are substantially higher there and mirrored by rates of cardiovascular disease, diabetes, obesity and other risk factors.”
Well isn't a major causality of these risk factors the fact that the common diet of this region consists of every protein source being either deep fried or extremely fatty pork cuts? All of the deep fried foods are breaded (adding carbs) and all the fatty pork cuts are slathered in sugary sauce. Thus all of the common foods give you a terrible ratio of macro nutrients.
2. Access and tolerability of outdoor spaces:
The prevalence of biting insects and extreme humidity make it extremely uncomfortable to do any serious outdoor exercise in many of the poor health regions. Paths and trail accessibility is abysmal in many of these poor health regions as well.
Both of these factors effect the native born locals and keep the healthier people out.
38 comments
[ 3.8 ms ] story [ 90.0 ms ] thread> And people in the Left Coast’s poorest quartile of counties live 2.4 years longer than those in the richest quartile counties in the Deep South.
That's super indirect it doesn't mean that there is a regional effect. Maybe a rich quartile county in the deep south has one multibillionaire who has good healthcare and a hundred thousand poor people who have bad healthcare because they are poor. Or maybe the poorest quartile counties in that 'left coast' region are still richer than the richest quartile counties in the 'deep south' region, probably not but they don't say.
The top quartile in Georgia starts at around 75k where it’s 86k in California. Hell the median income in Georgia is 61,500$ in a state with a relatively low cost of living.
Easily $400 to $1,200 per person per month depending on age, plus probability of $3k to $7k deductible, plus probability of $5k to $10k out of pocket maximum.
Although, US pay statistics exclude the employer subsidized portion of the health insurance premiums (usually ~70%), but they also exclude the monetary cost of the volatility due to it being tied to your employment.
Also, these costs will be more heavily subsidized by employers for higher paid populations, and less subsidized for low paid populations.
Further without the extreme property prices you see in costal cities a family pulling in 75k has very different living expenses.
yeah - I see a big disconnect between these average ages, and the really unhealthy lives that some (lots) of adults live. I don't think "average" is useful, rather it covers politically volatile ID
https://3.bp.blogspot.com/-IuAaSjijj2g/V8XGTciCe0I/AAAAAAAA4...
A friend gifted me a copy of this book (American Nations) and I quit reading it because, while somewhat novel, these regional distinctions make no practical sense. There is a wide, substantial difference between someone from Minnesota or Iowa and someone from New York or New Mexico. I get why the author drew the distinctions that way, but they aren't useful or meaningful.
https://healthmap.wordpress.com/2016/08/11/gallons-of-soft-d...
The article cites a Univ. of Cincinatti study: "Their conclusion: “Whiteness encourages whites to reject policies designed to help the poor and reduce inequality because of animosity toward people of color as well as being unaware that the poor include a great many white people.” "
[1] https://en.wikipedia.org/wiki/Grievance_studies_affair
https://en.wikipedia.org/wiki/Southern_strategy#:~:text=In%2....
Blackness encourages blacks to reject policies designed to help ${some group} and ${some political target} because of animosity toward whites as well as being unaware that ${some group} include a great many black people.
That university would be burned at the stake for being racist neocolonialists.
What's good for the goose is good for the gander - any time an 'academic' starts about 'whiteness' she should be called out for being just the racist stereotype she claims to want to fight. She is a racist, pure and simple, and racists are not welcome. No matter how many circumreferential 'studies' she will cite, no matter how many other 'academics' she has on her side, let the facts speak for themselves.
The stereotype is that the people in the longer-lived regions say "These are the things that lead to a longer life" and the people in the shorter-lived regions say "Don't tell us what to do!"
That's not to affirm the stereotypes, but rather to say that this is what the stereotypes would lead me to expect. I suppose it's a surprise that the one would be correct at all, since there's so much misinformation about how to be healthy. But the basics (eat less junk food, exercise, and get appropriate medical care) do seem to work, at least a little.
Or, perhaps it's not really an issue in the first place. Imagine a society that optimized for their average life expectancy. It could ban all vices and unhealthy foods and put people in "health prisons" when they don't pass BMI benchmarks. Obviously, not many people would want to live in this country, despite it having the highest life expectancy.
My point is that people's internal value function, on average, probably isn't life expectancy or even health outcomes. Those may be important, but people make tradeoffs every day. That doesn't mean they're not doing things that maximize their real value function, even if they have access to the best information.
In other words, according to the stereotypes, the internal value function is about rejection. This is a kind of checkmate, a game designed for them to win. Which would lead many to want to leave to it, but it does have effects on people who don't fit the stereotypes and have other priorities (including longer lifespans and more healthy-feeling lifestyles).
> “Your health is only 10 percent influenced by the medical environment and maybe 20 or 30 percent in behavioral choices.
And then a paragraph later, this:
“There’s a reason why the Southeastern portion of this country is called the Stroke Belt: It’s because the rates of stroke per capita are substantially higher there and mirrored by rates of cardiovascular disease, diabetes, obesity and other risk factors.”
Cardiovascular diseases can be mitigated via diet and other choices. That's not sociopolitical. It's personal, and certainly more than 20 to 30%.
Even in the areas with a higher life expectancy ceiling, that ceiling is lower than it could be. Regardless of where, we're eating and sedentary'ing ourselves into early and earlier graves.
To frame it as these "premature deaths" are ok because other premature deaths are worse is a deceptive and dangerous narrative. Premature is premature and we shouldn't be rationalizing like this.
When I visit my inlaws in Texas I always gain a bit of weight because you have to drive everywhere and the food is more calorie dense.
See page 13 to see a better breakdown:
https://www.nimhd.nih.gov/docs/collab/lifeExpectStudy2022jun...
Moreover, it's in the article:
>>> Greater Appalachia (pop. 59 million) Settlers overwhelmingly from war-ravaged Northern Ireland, Northern England and Scottish lowlands were deeply committed to personal sovereignty and intensely suspicious of external authority.
>>> The geography of U.S. life expectancy — and the policy environments that determine it — is the result of differences that are regional, cultural and political, with roots going back centuries to the people who arrived on the continent with totally different ideas about equality, the proper role of government, and the correct balance point between individual liberty and the common good. Once you understand how the country was colonized — and by whom — a number of insights into Americans’ overall health and longevity are revealed, along with some paths to improve the situation.
[1] https://www.manchester.ac.uk/discover/news/growing-divide-in...
1. Regional and cultural diet habits:
>“There’s a reason why the Southeastern portion of this country is called the Stroke Belt: It’s because the rates of stroke per capita are substantially higher there and mirrored by rates of cardiovascular disease, diabetes, obesity and other risk factors.”
Well isn't a major causality of these risk factors the fact that the common diet of this region consists of every protein source being either deep fried or extremely fatty pork cuts? All of the deep fried foods are breaded (adding carbs) and all the fatty pork cuts are slathered in sugary sauce. Thus all of the common foods give you a terrible ratio of macro nutrients.
2. Access and tolerability of outdoor spaces:
The prevalence of biting insects and extreme humidity make it extremely uncomfortable to do any serious outdoor exercise in many of the poor health regions. Paths and trail accessibility is abysmal in many of these poor health regions as well.
Both of these factors effect the native born locals and keep the healthier people out.