4 ms·

Let's quickly interpret this to further our pre-existing agenda (healthcare, guns, environment, vaccination, inequality, obama, immigration...)

drzaiusapelord 10y ago
I think there's a clear link here: http://stateofobesity.org/rates/ http://stateofobesity.org/rates/ Obesity is still a big problem and shaves off years of our lives. I think having an anti-obesity agenda is a wonderful thing and shouldn't be trivialized.
- lintiness 10y ago
  so all of a sudden from 2014 to 2015, obesity?
  - drzaiusapelord 10y ago
    A lot of boomers are reaching end of life ages and dying off, raising mortality. Their obesity issues and the vast number of boomers out there are raising the rate. Some data: http://www.nejm.org/doi/full/10.1056/NEJMoa055643#t=article http://www.nejm.org/doi/full/10.1056/NEJMoa055643#t=article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831354/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831354/
    - digikata 10y ago
      You would expect the number of deaths to rise due to demographics, but just the distribution alone should not affect the rate. Now because a group is demographically together, that group of peers may have collectively had a significantly different integrated set of life experiences than previous groups - different food and food habits, different environmental exposures, work environments, etc. (all of which could add up to more obesity). So the dip could be the first sign that those integrated differences add up to a shift. Though, re: obesity, aren't there a number of papers that seem to say that some extra weight in your latter years may be an indicator of better survivability for some medical events?
    - munificent 10y ago
      It's not very clear, but I think the article discusses that. It says the death rate above 65 is unaffected, so this is not coming from the aging boomers dying off. It's middle-aged people.
  - joe_the_user 10y ago
    I suppose I assume a commentator on hn should have a basic idea of how to interpret statistics. Of course it's not a matter that last year things were good, this year things are bad. What this signals is a "tipping point", where the continuous medical and public health improvements that have added to life expectancy (usually for those 60+)can no longer keep up with the various factors causing increased death at a young and especially middle age (how important obesity is among these is another issue).
    - lintiness 10y ago
      OH NOES!
eli_gottlieb 10y ago
Well, without mentioning an agenda, stress causes heart disease. Obviously if we could do something so that people could stress less, exercise more, and eat fresh food more often rather than processed food, heart disease would drop and people would die less.
- tcj_phx 10y ago
  > Well, without mentioning an agenda, stress causes heart disease. Stress impairs the body's ability to function optimally - think "fight or flight response" vs. "relaxation response" [1]. [1] https://en.wikipedia.org/wiki/The_Relaxation_Response#Fight-or-flight https://en.wikipedia.org/wiki/The_Relaxation_Response#Fight-... I think it's probably more accurate to hypothesize that inflammation causes heart disease.
- owly 10y ago
  Absolutely agree. Stress IS the killer.
- yummyfajitas 10y ago
  There are quite a few things we could do in this direction. For example, we could provide mandatory calisthenics classes for people on medicaid - think some sort of watered down military PT class. If you need medicaid, you need to show up daily and do jumping jacks. Similarly, we could replace food stamps/welfare/etc with a government-issued basket of healthy vegetables, complete with printed instructions on how to cook them. Utah has been having great success helping the poor with (secularized) Mormon style paternalism. Perhaps the rest of us can learn from them. http://www.npr.org/2015/12/10/459100751/utah-reduced-chronic-homelessness-by-91-percent-heres-how http://www.npr.org/2015/12/10/459100751/utah-reduced-chronic...
  - eli_gottlieb 10y ago
    >Similarly, we could replace food stamps/welfare/etc with a government-issued basket of healthy vegetables, complete with printed instructions on how to cook them. While many people don't have good cooking instruments where they live, I do think making at least part of food aid into a direct provision of healthy fruits and veggies, including those which can be eaten raw-at-worst, would be a large improvement. Honestly, at this stage, government-run cafeterias serving healthy food for free to anyone in need would be a massive improvement. It's a pity that people have such negative feelings about "paternalism" that they'd rather give out food stamps for buying rice and beans at inflated convenience-store prices than actually let the government provide healthy food directly.
thinkcontext 10y ago
One would have hoped Obamacare would have caused an increase in longevity, what with the dramatic decrease in the uninsured. Particularly, the expansion of Medicaid which allowed the poor to gain treatment for chronic conditions like diabetes which they had not had previous access to. But I suppose for that to show up in death statistics would play out over a much longer time scale.
- yummyfajitas 10y ago
  The best data we have (an actual randomized control trial) suggests the medicaid expansion did not affect objective measures of health. https://www.nber.org/oregon/ https://www.nber.org/oregon/ It did, however, affect various subjective measures. People feel good about going to the doctor and having an insurance card even if it doesn't help them. It's possible there is a long term, small, hard to measure effect, but we have little evidence of it.
  - coldtea 10y ago
    Well, "Medicaid substantially reduced the prevalence of depression", which IS a health effect. It also helped people treat their conditions and illnesses (the increased visits, etc). What it didn't no is have lifestyle-level health effects ("had no statistically significant effects on blood pressure, cholesterol, or cardiovascular risk") which I don't see why anyone would expect it to have. For one, they just checked after 2 years -- not a significant time unless somebody starts dedicated and determined lifestyle changes. Those people remained poor and retained their lifestyle habits regarding exercise, food etc (which is what accounts for blood pressure, cholesterol, etc). They just get better access to healthcare. If Medicare gave them leisure time, a private chef or high end restaurant gift cards, and a personal trainer it would be a different story...
    - yummyfajitas 10y ago
      Depression is a subjective measure, not an objective one. It's clear that giving people insurance makes them feel better. Increased visits is a cost (about $1200/recipient), not a benefit. I agree that we should have run the Oregon experiment a lot longer and tied the implementation of Obamacare to the outcome.
draw_down 10y ago
Right, it's better not to think anything at all. Wouldn't want to have an agenda, yuck! Ptooey!
DefaultUserHN 10y ago
>Let's quickly interpret this to further our pre-existing agenda (healthcare, guns, environment, vaccination, inequality, obama, immigration...)
- grzm 10y ago
  Please contribute substantively, and with extra civility and care on inflammatory topics, or not at all.
deleted 10y ago
[deleted]

drzaiusapelord 10y ago

I think there's a clear link here: http://stateofobesity.org/rates/ http://stateofobesity.org/rates/ Obesity is still a big problem and shaves off years of our lives. I think having an anti-obesity agenda is a wonderful thing and shouldn't be trivialized.

lintiness 10y ago
so all of a sudden from 2014 to 2015, obesity?
- drzaiusapelord 10y ago
  A lot of boomers are reaching end of life ages and dying off, raising mortality. Their obesity issues and the vast number of boomers out there are raising the rate. Some data: http://www.nejm.org/doi/full/10.1056/NEJMoa055643#t=article http://www.nejm.org/doi/full/10.1056/NEJMoa055643#t=article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831354/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831354/
  - digikata 10y ago
    You would expect the number of deaths to rise due to demographics, but just the distribution alone should not affect the rate. Now because a group is demographically together, that group of peers may have collectively had a significantly different integrated set of life experiences than previous groups - different food and food habits, different environmental exposures, work environments, etc. (all of which could add up to more obesity). So the dip could be the first sign that those integrated differences add up to a shift. Though, re: obesity, aren't there a number of papers that seem to say that some extra weight in your latter years may be an indicator of better survivability for some medical events?
  - munificent 10y ago
    It's not very clear, but I think the article discusses that. It says the death rate above 65 is unaffected, so this is not coming from the aging boomers dying off. It's middle-aged people.
- joe_the_user 10y ago
  I suppose I assume a commentator on hn should have a basic idea of how to interpret statistics. Of course it's not a matter that last year things were good, this year things are bad. What this signals is a "tipping point", where the continuous medical and public health improvements that have added to life expectancy (usually for those 60+)can no longer keep up with the various factors causing increased death at a young and especially middle age (how important obesity is among these is another issue).
  - lintiness 10y ago
    OH NOES!

eli_gottlieb 10y ago

Well, without mentioning an agenda, stress causes heart disease. Obviously if we could do something so that people could stress less, exercise more, and eat fresh food more often rather than processed food, heart disease would drop and people would die less.

tcj_phx 10y ago
> Well, without mentioning an agenda, stress causes heart disease. Stress impairs the body's ability to function optimally - think "fight or flight response" vs. "relaxation response" [1]. [1] https://en.wikipedia.org/wiki/The_Relaxation_Response#Fight-or-flight https://en.wikipedia.org/wiki/The_Relaxation_Response#Fight-... I think it's probably more accurate to hypothesize that inflammation causes heart disease.
owly 10y ago
Absolutely agree. Stress IS the killer.
yummyfajitas 10y ago
There are quite a few things we could do in this direction. For example, we could provide mandatory calisthenics classes for people on medicaid - think some sort of watered down military PT class. If you need medicaid, you need to show up daily and do jumping jacks. Similarly, we could replace food stamps/welfare/etc with a government-issued basket of healthy vegetables, complete with printed instructions on how to cook them. Utah has been having great success helping the poor with (secularized) Mormon style paternalism. Perhaps the rest of us can learn from them. http://www.npr.org/2015/12/10/459100751/utah-reduced-chronic-homelessness-by-91-percent-heres-how http://www.npr.org/2015/12/10/459100751/utah-reduced-chronic...
- eli_gottlieb 10y ago
  >Similarly, we could replace food stamps/welfare/etc with a government-issued basket of healthy vegetables, complete with printed instructions on how to cook them. While many people don't have good cooking instruments where they live, I do think making at least part of food aid into a direct provision of healthy fruits and veggies, including those which can be eaten raw-at-worst, would be a large improvement. Honestly, at this stage, government-run cafeterias serving healthy food for free to anyone in need would be a massive improvement. It's a pity that people have such negative feelings about "paternalism" that they'd rather give out food stamps for buying rice and beans at inflated convenience-store prices than actually let the government provide healthy food directly.

thinkcontext 10y ago

One would have hoped Obamacare would have caused an increase in longevity, what with the dramatic decrease in the uninsured. Particularly, the expansion of Medicaid which allowed the poor to gain treatment for chronic conditions like diabetes which they had not had previous access to. But I suppose for that to show up in death statistics would play out over a much longer time scale.

yummyfajitas 10y ago
The best data we have (an actual randomized control trial) suggests the medicaid expansion did not affect objective measures of health. https://www.nber.org/oregon/ https://www.nber.org/oregon/ It did, however, affect various subjective measures. People feel good about going to the doctor and having an insurance card even if it doesn't help them. It's possible there is a long term, small, hard to measure effect, but we have little evidence of it.
- coldtea 10y ago
  Well, "Medicaid substantially reduced the prevalence of depression", which IS a health effect. It also helped people treat their conditions and illnesses (the increased visits, etc). What it didn't no is have lifestyle-level health effects ("had no statistically significant effects on blood pressure, cholesterol, or cardiovascular risk") which I don't see why anyone would expect it to have. For one, they just checked after 2 years -- not a significant time unless somebody starts dedicated and determined lifestyle changes. Those people remained poor and retained their lifestyle habits regarding exercise, food etc (which is what accounts for blood pressure, cholesterol, etc). They just get better access to healthcare. If Medicare gave them leisure time, a private chef or high end restaurant gift cards, and a personal trainer it would be a different story...
  - yummyfajitas 10y ago
    Depression is a subjective measure, not an objective one. It's clear that giving people insurance makes them feel better. Increased visits is a cost (about $1200/recipient), not a benefit. I agree that we should have run the Oregon experiment a lot longer and tied the implementation of Obamacare to the outcome.

draw_down 10y ago

Right, it's better not to think anything at all. Wouldn't want to have an agenda, yuck! Ptooey!

DefaultUserHN 10y ago

>Let's quickly interpret this to further our pre-existing agenda (healthcare, guns, environment, vaccination, inequality, obama, immigration...)

grzm 10y ago
Please contribute substantively, and with extra civility and care on inflammatory topics, or not at all.

deleted 10y ago

[deleted]