6 ms·

So from 1979 - 1999 mortality rates fell an average of 2% but have risen half a percent per year since then. If I had to guess it could be that the pressures o

by lujim 11y ago

So from 1979 - 1999 mortality rates fell an average of 2% but have risen half a percent per year since then. If I had to guess it could be that the pressures of stagnant incomes, skyrocketing higher health care costs, and more volatile economic conditions could be a bit of a pressure cooker for stress, poor diets, and increased alcohol/drug use.

_sword 11y ago
Adding to that, the authors of the article and the paper are constructing an argument that over-prescription of opiod painkillers is a significant component of the problem.
- JoeAltmaier 11y ago
  How about: they got more affluent, ate too much red meat and died of strokes?
  - sithadmin 11y ago
    What are you trying to get at here? If this is supposed to be sarcasm, I'm missing it.
  - lujim 11y ago
    Yeah could be that, but think stress. We started the millennium with a stock market crash, 9/11, the Concord crashed, the Space Shuttle broke up on reentry, two wars kicked off and just when things started calming down... the Great Recession. If you weren't laid off then you probably knew a few people that were. It seemed like everything we had built over the past two decades was failing us all at once. The 90's seemed like a time when you just watched Seinfeld on Thursday nights and watched your stocks go up in value. The 2000's and on have been a bit more stressful.
  - maxerickson 11y ago
    The morbidity statistics they are using would break out strokes as a category. The abstract for the paper says This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. ( http://www.pnas.org/content/early/2015/10/29/1518393112.abstract http://www.pnas.org/content/early/2015/10/29/1518393112.abst... ) So strokes probably don't explain it. In a previous discussion I speculated that military service (and thus combat) could be a contributing factor. It would be interesting to see how many of the suicides and overdoses were people who had experienced combat.
  - programmernews3 11y ago
    Complete straw man argument but not surprising from a self-hating liberal. The article details the increasing causes of mortality in this group.
- lujim 11y ago
  No doubt there. Over prescribing them leads to dependency, then the DEA terrifies doctors into abruptly cutting the doses for those already on them and those patients turn to more sinister alternatives like heroin.
- GoodOldNe 11y ago
  ER doc here. I think that this is absolutely a large contributor of these mortality trends. There are so many more factors than just users turning to IV drugs / overdosing on rx meds though, and I think that's what we're just now finding out -- things like anhedonia that occurs because of neural-level changes in brain wiring due to long-term use of opioids, hyperalgesia (increased sensing of pain) from the same thing, and more and more people developing an illness script around chronic pain that they see themselves as victims of, necesitating ever-escalating doses of analgesia (whether that's in the form of opiates, opioids, alcohol, other substances) to deal with. Really, really big problem that I think we're just waking up to deal with.
  - pnathan 11y ago
    > ...more and more people developing an illness script around chronic pain that they see themselves as victims of... Can you talk about this more? Some family members have routine complaints of chronic pain without a concrete physiological root cause, and I'd like to understand your comment further.
simonh 11y ago
Maybe, but the years from 79-99 were hardly stress free and actual standards of living and health care are still well above what they were in the late 70s. Or maybe the rate of improvement in living standards actually contributes more to life expectancy that the absolute level? That seems hard to believe though.
sremani 11y ago
Since the 80s whites as a group have diverged into blue-collar and white-collar groups. The socio-economic index of the blue-collar has been falling, and mortality has thus followed. My assumption the blue-collar group in bigger than the white-collar one, and hence the overall as a group is down. Charles Murray has some literature on this issue. I understand he is hated in Leftist circles, but the general observations have some merit.
- 6stringmerc 11y ago
  Not contradicting, actually I think supporting your point - check out this graphic noting the prescription demographics of painkillers: http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e25-4a6c-9957-63d75ac3ecbc/e34f4d33dd4f691d6faffc79f5ba05fd/cdc-painkiller-map620px.jpg http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e2... Source: http://www.cbsnews.com/news/the-states-with-the-worst-prescription-painkiller-problem/ http://www.cbsnews.com/news/the-states-with-the-worst-prescr...
  - tlack 11y ago
    A friend illustrated an interesting correlation: http://www.modernmethod.com/send/files/military-vs-pain.png http://www.modernmethod.com/send/files/military-vs-pain.png
- scarmig 11y ago
  Taking issue with a book he wrote two decades ago doesn't mean hating him. He's one of my favorite thinkers.

by lujim 11y ago

_sword 11y ago

Adding to that, the authors of the article and the paper are constructing an argument that over-prescription of opiod painkillers is a significant component of the problem.

JoeAltmaier 11y ago
How about: they got more affluent, ate too much red meat and died of strokes?
- sithadmin 11y ago
  What are you trying to get at here? If this is supposed to be sarcasm, I'm missing it.
- lujim 11y ago
  Yeah could be that, but think stress. We started the millennium with a stock market crash, 9/11, the Concord crashed, the Space Shuttle broke up on reentry, two wars kicked off and just when things started calming down... the Great Recession. If you weren't laid off then you probably knew a few people that were. It seemed like everything we had built over the past two decades was failing us all at once. The 90's seemed like a time when you just watched Seinfeld on Thursday nights and watched your stocks go up in value. The 2000's and on have been a bit more stressful.
- maxerickson 11y ago
  The morbidity statistics they are using would break out strokes as a category. The abstract for the paper says This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. ( http://www.pnas.org/content/early/2015/10/29/1518393112.abstract http://www.pnas.org/content/early/2015/10/29/1518393112.abst... ) So strokes probably don't explain it. In a previous discussion I speculated that military service (and thus combat) could be a contributing factor. It would be interesting to see how many of the suicides and overdoses were people who had experienced combat.
- programmernews3 11y ago
  Complete straw man argument but not surprising from a self-hating liberal. The article details the increasing causes of mortality in this group.
lujim 11y ago
No doubt there. Over prescribing them leads to dependency, then the DEA terrifies doctors into abruptly cutting the doses for those already on them and those patients turn to more sinister alternatives like heroin.
GoodOldNe 11y ago
ER doc here. I think that this is absolutely a large contributor of these mortality trends. There are so many more factors than just users turning to IV drugs / overdosing on rx meds though, and I think that's what we're just now finding out -- things like anhedonia that occurs because of neural-level changes in brain wiring due to long-term use of opioids, hyperalgesia (increased sensing of pain) from the same thing, and more and more people developing an illness script around chronic pain that they see themselves as victims of, necesitating ever-escalating doses of analgesia (whether that's in the form of opiates, opioids, alcohol, other substances) to deal with. Really, really big problem that I think we're just waking up to deal with.
- pnathan 11y ago
  > ...more and more people developing an illness script around chronic pain that they see themselves as victims of... Can you talk about this more? Some family members have routine complaints of chronic pain without a concrete physiological root cause, and I'd like to understand your comment further.

simonh 11y ago

Maybe, but the years from 79-99 were hardly stress free and actual standards of living and health care are still well above what they were in the late 70s. Or maybe the rate of improvement in living standards actually contributes more to life expectancy that the absolute level? That seems hard to believe though.

sremani 11y ago

Since the 80s whites as a group have diverged into blue-collar and white-collar groups. The socio-economic index of the blue-collar has been falling, and mortality has thus followed. My assumption the blue-collar group in bigger than the white-collar one, and hence the overall as a group is down. Charles Murray has some literature on this issue. I understand he is hated in Leftist circles, but the general observations have some merit.

6stringmerc 11y ago
Not contradicting, actually I think supporting your point - check out this graphic noting the prescription demographics of painkillers: http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e25-4a6c-9957-63d75ac3ecbc/e34f4d33dd4f691d6faffc79f5ba05fd/cdc-painkiller-map620px.jpg http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e2... Source: http://www.cbsnews.com/news/the-states-with-the-worst-prescription-painkiller-problem/ http://www.cbsnews.com/news/the-states-with-the-worst-prescr...
- tlack 11y ago
  A friend illustrated an interesting correlation: http://www.modernmethod.com/send/files/military-vs-pain.png http://www.modernmethod.com/send/files/military-vs-pain.png
scarmig 11y ago
Taking issue with a book he wrote two decades ago doesn't mean hating him. He's one of my favorite thinkers.