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Life-Expectancy Inequality Grows in America
- guard-of-terra 11y agoSimilar dynamics arose in late 60s in the USSR and 20 years later it disintegrated.
- lucozade 11y agoFortunately, since then, someone spotted that causation and correlation occasionally differ. Phew. Bullet dodged.
- guard-of-terra 11y agoI was actually implying two non-interrelated casuations of same trend.
- _yosefk 11y agoSimilar dynamics in what way? Certainly there was no nominal wealth inequality in the USSR (there were of course people with wads of illegally obtained cash, and there were classes of people with access to a lot of things [which money couldn't legally buy] that the majority could not access, but officially wealth and income were very similar for everyone, in particular you couldn't legally own most sorts of assets traditionally held by investors, including real estate. So I wonder what sort of inequality correlated with life expectancy inequality in the USSR in the late 60s.)
- guard-of-terra 11y agoInequality of education, inequality of place of living (city vs town vs village, different republics)
- yummyfajitas 11y agoI love how every reporter writing about this study implies that these gaps are somehow related to income inequality and health care. It makes so much sense, right? In fact, the study directly contradicts this. See figure 8 - both income inequality and health care were not shown to have a significant effect. https://jama.jamanetwork.com/article.aspx?articleid=2513561 https://jama.jamanetwork.com/article.aspx?articleid=2513561
- Retric 11y agoThis study does not show what you suggest. The problem is when you have several causes for the same effect some of all of them can fall below the noise floor. Being poor means slightly worse health care, worse food, increased risk of violence, etc etc. Trying to seperate each of them out in a statistically meaningful way is difficult and expencive.
- yummyfajitas 11y agoYes, the effects could be small rather than zero. Either way, why are reporters implying (while being careful not to explicitly state) that inequality and health care are significant? Essentially your complaint is that NHST could be more realistic and doesn't deal well with tiny effect sizes.
- llamataboot 11y agoOne might even say, "separating them out" uses fancy regression models to obscure rather than explain the data. Being poor DOES mean all those things and likely health outcomes are overdetermined. We know that reducing inequality reduces all of these things - so let's just reduce inequality!
- Tycho 11y agoThere is a staggering degree of beating-around-the-bush in these articles we've been seeing.
- justaman 11y agoThats the name of the game now. Class warfare and racism get clicks. If there is no graph in an article about research it cant have my respect.
- medymed 11y agoThere may be some reverse causation--in a country where devastating and chronic illness frequently bankrupts people, it's not too surprising that at least this subset of poor people would be living quite a bit shorter than the average citizen.
- minikites 11y agoStatus quo bias is a hell of a thing. Imagine if we had firefighter insurance and the most common cause of bankruptcy was their home burning down. That's pretty much where we are with medicine and it's often justified by victim blaming (They shoudn't have eaten that! They should have exercised more!).
- hodwik 11y agoYou're rhetorically associating systemic injustice against black people with critiquing fat people. You understand that right? The phrase is from the book Blaming the Victim, about the legacy of slavery. I'd avoid using that tactic out in the world.
- ams6110 11y agoThat's a reach. I think the phrase "victim blaming" is mainstream enough to have zero racial connotations (I never knew there was one until I read your claim). Often comes up in discussions of rape/sexual assault where race is not a factor at all.
- hodwik 11y agoOkay, then he's comparing fat people with rape victims. Is that better?
- jdietrich 11y agoThe disparity is still significant in countries with state-funded healthcare. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/inequalities-in-life-expectancy-kings-fund-aug15.pdf http://www.kingsfund.org.uk/sites/files/kf/field/field_publi...
- cmdrfred 11y agoIn a pay to play healthcare system, those who can pay the most get the best toys. An important study but it shouldn't surprise anyone.
- frgewut 11y agoIt doesn't seem so obvious to me, e.g. in Cuba much less money is spent, but results are similar. http://www.forbes.com/sites/judystone/2014/12/22/cuba-cost-effective-healthcare/#15ac5eb55990 http://www.forbes.com/sites/judystone/2014/12/22/cuba-cost-e...
- pessimizer 11y ago> In a pay to play healthcare system...
- drzaiusapelord 11y agoMaybe people with money take care of themselves better? All my lower income acquaintances and friends are fat and never work out. They drive everywhere and are generally very unhealthy. It just blows my mind to see what they eat at restaurants. There's a real issue here about the lack of proper eating and exercise. The middle class or higher group people in my life often take care of their health, work out, eat right, etc. They ride bikes, stay active, walk a lot, etc. The idea that its purely healthcare dollars at work here is unrealistic to me. I think there's more at play here and the knee-jerk answers that are political correct is often wrong. Especially post Obamacare, where so many are now insured and go the same doctors and hospitals everyone else goes to.
- llamataboot 11y agoThink have some strange causation going on here. Have you ever had to figure out how many calories you could get per dollar -- let me tell you it looks a lot more like Taco Bell than grass-fed meat and a kale smoothie. Have you ever had to work 2 terrible mind-numbing boring jobs for 60 hours a week and then threw a couple kids or even grandkids into the mix? Not a lot of spare money or time to get a gym membership. There's also social norms, a lack of future orientation (that is a well known effect of living in poverty), etc. Being poor is unhealthy -- blaming its effects on individual's not "being responsible and eating and exercising right" is an individual cop-out for a structural problems.
- 300bps 11y agoStopped reading here: A child born in 1900—little more than a century ago—was likely, on average, to die by the age of thirty. This is so misleading, suggesting that people typically died before they were 30. The misleading average here is caused by infant mortality. That's the #1 way that life expectancy has risen in the last 116 years. To illustrate how big we've reduced infant mortality, look at this: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm From 1915 through 1997, the infant mortality rate declined greater than 90% to 7.2 per 1000
- jackcosgrove 11y agoThis is the same problem with claims that life expectancy in the middle ages was 25 years or so.
- mpweiher 11y ago“A medical journal article reporting that income is significantly associated with life expectancy is a call to arms,..." Yet the gender disparity is much greater (and rising), and that is a call to...[crickets]
- rubidium 11y agoHere's the worldwide data: http://www.who.int/entity/bulletin/volumes/90/8/BLT-11-097378-F2.jpg http://www.who.int/entity/bulletin/volumes/90/8/BLT-11-09737... and artile: http://www.who.int/bulletin/volumes/90/8/11-097378/en/ http://www.who.int/bulletin/volumes/90/8/11-097378/en/ Short version: low income is worse for everyone, but (not surprisingly) more worse for men than women. For high income, men and women have almost achieved parity.
- mpweiher 11y agoThat's interesting. The article talks about "shortfall", not about absolute lifespan. What is the baseline for that shortfall? It almost looks like it might be the gender-segregated data for "high income", which would explain why those have (a) no shortfall at all and (b) no gender disparity. Reading the article, it does look like the "shortfall" is gendered, being based on gender-specific maxima.
- jpwagner 11y ago"The reasons for the difference are not clear, although the authors point out that cities like New York often have aggressive anti-smoking policies and make it harder for people to eat trans fats, and drink sugary sodas—which are implicated in common diseases like obesity and diabetes" Anti-smoking in NYC is ~14 years old and the sugary-soda crackdown is less than 4 years old. How can these policies be proven to contribute to life-span data?
- LanceH 11y agoWhile the policies may not be causative, the attitudes which allowed these bills to pass may have been present for much longer.
- VLM 11y agoGentrification pushes out poor people, therefore you can ban things poor people like without backlash, and naturally fewer poor people means fewer sick people, if most financial problems come from medical expenses and medical expenses mostly come from sickness, then making it hard for poor/bankrupt people to live there will naturally result in the remainder being healthier on average. I would theorize the demographics of NYC are anything but constant. Or it could be a bias toward authoritarianism naturally results in health, although the cause and effect on that one is a bit fuzzy. The obesity rate in NYC is about 1 in 3 but in Denver its about 1 in 5, and Denver isn't X% more authoritarian than NYC.
- trhway 11y agowhen you think about medical advances in the next 20-40 years, especially the custom ones which would require money, one would be wondering how much a today's healthy person with a lot of money, like Zuck, would live... Probably as long as they want :)
- tzs 11y agoMedical advances have greatly increased the average life span, and are likely to continue to do so. However, there has been very little change in the maximum lifespan, and there is not really any good reason to believe that this will change over the next 20-40 years.
- pc2g4d 11y ago> The researchers, led by Raj Chetty, a professor of economics at Stanford University, analyzed more than 1.4 billion federal tax returns, as well as mortality data from the Social Security Administration, from the years 2001 to 2014. In that period, the life expectancy of the richest five per cent of Americans increased by roughly three years. For the poorest five per cent, there was no increase. I find it hard to believe that over a period of 13 years a particular group of Americans lived three years longer on average because they could afford more and better healthcare. That's a very significant jump, and to me it seems more likely to be explained by differences in the composition of the top 5 percent. Did it become more white, more educated, more urban, etc.? Can anyone who read the original paper comment on whether that was explored at all?