3 ms·

The benefits of some advances are questionable, but the benefits of others seem to be more definite The leading cause of death in the US in 1980 was heart dise

The benefits of some advances are questionable, but the benefits of others seem to be more definite The leading cause of death in the US in 1980 was heart disease. It is still the leading cause of death today. However, the absolute number of deaths due to heart disease has declined by 17% from 1980 to 2015. This is despite the population growing by 42%. That is pretty amazing. I don't have data on exactly what contributed to this decline in heart disease deaths, but I'd bet it is better drugs. The first statin was approved in 1987. ACE / ARB inhibitors were approved in the 1980s and 1990s. Again I don't have data on exactly what caused the decrease in cardiovascular disease deaths but would love to hear if others do. Nutrition and lifestyle (less smoking?) could have played a role as well, but diabetes deaths have increased a lot, so I don't think lifestyles have become too much healthier The second leading cause of death is cancer. The number of deaths from cancer has roughly tracked population growth. The third leading cause of death in 1980, stroke, has seen absolute numbers of deaths drop by 18% from 1980 to 2015

tomp 8y ago
> The number of deaths from cancer has roughly tracked population growth. Is this a good metric though? It seems to me that (1) once you get cancer, you always have cancer, and (2) if nothing else kills you, cancer does. So maybe a better metric would be, the lifespan of people with cancer?
883771773929 8y ago
> ... exactly what caused the decrease in cardiovascular disease deaths but would love to hear if others do. Unfortunately I don't have data either, but I do have a hypothesis that may or may not end up surviving scrutiny when the relevant data becomes available. If someone can refute these ideas, please contribute. The ultimate cause: demographics changed. The recent decades have seen native populations reduce their fertility in the US. This is analogous to ecological succession of pioneering species colonizing barren land building up new soils by quickly flourishing and in turn crowded out in competition as other species take hold in niches opened by the pioneers laying a rich framework however being unsuccessful at sustaining dominance due to the energetic and fitness costs of extreme adaptation in resource poor environments that are unable to be useful traits relative to other species that can quickly capitalize on existing infrastructure when there's no need to divert capacity to build anew when resources become abundant. Today when applied to populations of humans in the US, the same principal goes under names like "white flight" as fleeing urbanization to recreate past conditions that were more favorable in competition strategies, "gentrification" when enclaves of urban areas decay and are then susceptible to recolonization efforts, and "immigration" to relieve bottlenecks in reproduction and the resulting scar of exposed barren land and poor nutrient circulation in the ecosystem that are caused by pioneer individuals stockpiling reserves without reinvesting in reseeding efforts. Heart disease is typically a progressive terminal stage of diabetes and other metabolic disorders that intertwine risk factors such as poor nutrition, excessive calorie consumption and resulting unhealthy body fat percentages, alcohol abuse, cigarette use, and high stress. Looking closure at the medical literature, I'd actually reconsider the idea that statins produce beneficial health outcomes, but I won't get into that in this comment. The point here is that in heart disease being the cumulative effects over a lifetime and diabetes as a _leading_ (not trailing) indicator of population risk for heart disease, what you're really seeing is the transition of health since WW2 when war rationing forced the agricultural and food processing industries to change course in providing massive amount of calories at low cost and effective propaganda and marketing to ensure sustained demand when the war was over to not shock the economy back into depression. Heavily processed foods like spam, American cheese, and canned/dried foods are technological means to make food supplies go further with less waste and higher caloric density. Add in things like pushing cigarette consumption heavily after the war and you get the perfect storm that kills off a large percentage of the lower class baby boomer generation early in life by around the 1980s. What's left since then are the middle and upper class baby boomers whose children reproduce in far lower numbers, being replaced with immigrants. Those immigrants come here with very different cultures regarding food consumption, nutrition, and healthcare that for a period of time did decrease the incidence of influence of the cultural epidemic of war-era food technology. Usually after one generation though, immigrant families transition to the already establish cultural expectations and shift dietary and consumption patterns. Therefore you get the next surge of diabetes as the form of the next incarnation of the cycle. In a few decades you'll see another recurrance in more prevelent heart disease.

tomp 8y ago

> The number of deaths from cancer has roughly tracked population growth. Is this a good metric though? It seems to me that (1) once you get cancer, you always have cancer, and (2) if nothing else kills you, cancer does. So maybe a better metric would be, the lifespan of people with cancer?

883771773929 8y ago

> ... exactly what caused the decrease in cardiovascular disease deaths but would love to hear if others do. Unfortunately I don't have data either, but I do have a hypothesis that may or may not end up surviving scrutiny when the relevant data becomes available. If someone can refute these ideas, please contribute. The ultimate cause: demographics changed. The recent decades have seen native populations reduce their fertility in the US. This is analogous to ecological succession of pioneering species colonizing barren land building up new soils by quickly flourishing and in turn crowded out in competition as other species take hold in niches opened by the pioneers laying a rich framework however being unsuccessful at sustaining dominance due to the energetic and fitness costs of extreme adaptation in resource poor environments that are unable to be useful traits relative to other species that can quickly capitalize on existing infrastructure when there's no need to divert capacity to build anew when resources become abundant. Today when applied to populations of humans in the US, the same principal goes under names like "white flight" as fleeing urbanization to recreate past conditions that were more favorable in competition strategies, "gentrification" when enclaves of urban areas decay and are then susceptible to recolonization efforts, and "immigration" to relieve bottlenecks in reproduction and the resulting scar of exposed barren land and poor nutrient circulation in the ecosystem that are caused by pioneer individuals stockpiling reserves without reinvesting in reseeding efforts. Heart disease is typically a progressive terminal stage of diabetes and other metabolic disorders that intertwine risk factors such as poor nutrition, excessive calorie consumption and resulting unhealthy body fat percentages, alcohol abuse, cigarette use, and high stress. Looking closure at the medical literature, I'd actually reconsider the idea that statins produce beneficial health outcomes, but I won't get into that in this comment. The point here is that in heart disease being the cumulative effects over a lifetime and diabetes as a _leading_ (not trailing) indicator of population risk for heart disease, what you're really seeing is the transition of health since WW2 when war rationing forced the agricultural and food processing industries to change course in providing massive amount of calories at low cost and effective propaganda and marketing to ensure sustained demand when the war was over to not shock the economy back into depression. Heavily processed foods like spam, American cheese, and canned/dried foods are technological means to make food supplies go further with less waste and higher caloric density. Add in things like pushing cigarette consumption heavily after the war and you get the perfect storm that kills off a large percentage of the lower class baby boomer generation early in life by around the 1980s. What's left since then are the middle and upper class baby boomers whose children reproduce in far lower numbers, being replaced with immigrants. Those immigrants come here with very different cultures regarding food consumption, nutrition, and healthcare that for a period of time did decrease the incidence of influence of the cultural epidemic of war-era food technology. Usually after one generation though, immigrant families transition to the already establish cultural expectations and shift dietary and consumption patterns. Therefore you get the next surge of diabetes as the form of the next incarnation of the cycle. In a few decades you'll see another recurrance in more prevelent heart disease.