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Cancer in America Is Way Down, for the Wealthy Anyway
- renholder 8y agoFor those of you who just want main point: There’s a caveat, however: Those gains have been reaped mostly by the well-off. While racial disparities have begun to narrow, the impact of limited access to treatment for the poorest Americans has increased wealth-based inequality, according to the American Cancer Society’s annual update on trends and statistics.
- andrenth 8y agoMetal cutlery was only available to the wealthy in the middle ages. At some point they became widely available for everyone. Such is the way with most technological advances, where the high price initially payed by the rich is turned into more productivity and lower production costs, resulting in greater availability.
- crushcrashcrush 8y agoSo you’re comparing, in absolute terms, the availability of cutlery in a “trickle down” sense to the availability of decent healthcare for every American? I’m ashamed to live on this earth with you.
- andrenth 8y agoNo, I'm saying: technology becomes cheaper and more available over time. As for you being ashamed: cry me a river.
- merpnderp 8y agoAre you ashamed to live on this earth with most of Europe which waited nearly 10 years to buy into proton radiation therapy after the US adopted it? For nearly a decade there were more therapy machines in my tiny low population poor state than all of the UK.
- mijamo 8y agoWell most of Europe ranka much better than the US on Healthcare so no.
- merpnderp 8y agoWith a much less healthy population the US sees significant cancer and heart disease treatment successes over most of Europe. The US may pay quite a bit more for these successes, but it's not exactly black and white on which is better. There's a reason the top five cancer centers in the world are in the US. Edit: Just realized my mistake. You are fine with trickle down healthcare in Europe, but are not fine with it in the US. There was absolutely nothing to be gained by engaging with someone so openly biased. My bad.
- DanBC 8y ago> the US sees significant cancer [...] treatment successes over most of Europe Does it? What's your source please.
- dang 8y agoPersonal attacks will get you banned here regardless of how wrong or provocative another comment is. Please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and post civilly and substantively, or not at all.
- happytoexplain 8y agoThat's a pretty dramatic oversimplification of one of the most disgusting, inhumane disasters in modern civilization: US healthcare.
- andrenth 8y agoUS healthcare is one of the most inhumane disasters in the history of modern civilization? What is this bubble you live in? Have you been to a third-world country? Have you been to a communist country?
- ihgan 8y agoI live in a third-world country, and we have public healthcare freely available for all
- andrenth 8y agoHow's the quality of this public healthcare? How long does it take for an appointment or surgery?
- ihgan 8y agoIt varies by state/city. In my state, basic care is ok: ER pretty much works, same weekend appointments for general practitioners, maybe more for specialists. I don't have direct experience whith surgery, but I had family members on cancer treatment, and the public health system was better in some cases than the private one.
- andrenth 8y agoWhere do you live, if you don’t mind me asking?
- scottlocklin 8y agoI agree that some perspective is required here, but it is pretty amazing how terrible it is. Like, we've been to the moon, have stuff like google to search through tons of information without leaving the bathroom, and people are trying to convince me we'll soon have useful quantum computers and autonomous vehicles, but it still takes me 3 hours to book a checkup with a doctor, and the soonest they can see me is 3 months from now. Then there's the billing system, which seems to have been devised to fill the maximum number of people's rice bowls. To say nothing of what happens to the uninsured. It's nuts.
- brucemoose 8y agoExcept the high healthcare prices are paid by the working class...
- InclinedPlane 8y agoExcept this hasn't been true since about 1980. Gains from economic growth have not been passed on to everyone. Health care is not available for everyone, especially. This isn't just a matter of technology. The "cost" of production of medical technologies has very little to do with their price, in the US anyway.
- andrenth 8y agoTo everyone, certainly not. To a lot more people? Definitely. Quality of life is better than ever before, worldwide. We shouldn't discard a system because it's not perfect. The alternative could be much worse.
- InclinedPlane 8y agoExactly! We should use the system the majority of the developed world relies on: socialized medicine.
- jka 8y agoThere's a grain of truth in here, and it's true that things available to the wealthy/elite tend to become available gradually to all over time. But that doesn't necessarily mean that things become _equal_ over time; it's rare to find wealthy people who will purchase the same kind of cutlery as the common person, to continue your analogy - for various reasons (fear of feeling inferior, ego, or just plain being oversold on it by marketing/salespeople). The point that the article appears to be making is that healthcare advances are applying for the wealthy - but in fact _reversing_ in some cases for the poor. That's not fair or desirable.
- fjp 8y agoAh yes, the past 40 years of wealth gains will trickle down on us any day now!
- wppick 8y agoI am currently reading the book "The Hundred-Year Lie: How to Protect Yourself from the Chemicals That Are Destroying Your Life" by Randall Fitzgerald. It details the crazy amount of synthetic or toxic chemicals in our daily lives, pesticides on our food, and a list of other pollutants to the body. Just from reading that this article it doesn't surprise me, and I would be surprised if this trend doesn't continue and accelerate. The poorest Americans are deceived into a false sense of wealth by being able to purchase cheap, synthetic, and toxic alternatives to quality products that only the well off can likely afford. Everything from natural furniture, organic foods, natural material clothing, cosmetics and care products, and medicine are much more costly than their toxic, cheap alternatives. This will also increase the divide between the wealth and the poor since the brain is affected by the chemicals that we are exposed to resulting in lack of concentration, poor memory, irritability, impulsiveness, and even the resulting gut bacteria affects the brain through the vagus nerve. The poorest Americans also have jobs, and live in areas which expose them to more pollutants than the wealthy, and the bigger issue is that a lot of these people don't even realize that this is an issue. Trust in institutions like the FDA, aggressive marketing by corporations like deceitful labeling of foods to try and make them "sound" healthy, and general lack of education make them super vulnerable and at the whims of the highly education, profit-obsessed, shareholder-serving, psychology-understanding, resource-rich, lobbying elite
- nradov 8y agoSynthetic doesn't imply toxic or harmful.
- bryanlarsen 8y ago"Synthetic doesn't imply toxic or harmful." No, but it does imply unknown. The big misconception IMO is that people think "natural" implies safe or known.
- nradov 8y agoHow does synthetic imply unknown?
- chibg10 8y agoThere is no data (or even a link to a study) in this article that gives the the reader any sense of what the mortality gap between the wealthy and poor is, or even how "wealthy" and "poor" are defined. I come away from this article with a better idea of the male/female mortality gap than the wealthy/poor gap (one of the article's two headline claims). I've noticed that politicized headlines in non-editorials that aren't suppprted by any facts or data are an increasing media trend in the past few years. I saw this in another article I commented on a few days ago. https://news.ycombinator.com/item?id=18794757 https://news.ycombinator.com/item?id=18794757 If it's a real problem (which I believe it probably is), journalists shouldn't ignore "show, don't tell" in their writing.
- Bartweiss 8y agoI agree that this is common and troubling. I ended up on this soapbox after a recent study showing academic-performance harm from fine particulate matter in the air. The article had no numbers, so the HN thread was full of (weirdly politicized) speculation about American intelligence. Meanwhile, the underlying study showed modest effects in parts of China where daily particulate levels average 10x higher than the very worst "stay indoors" days in America. It was an interesting study, but the headlines it produced were actively making people less informed. It's a particularly damning problem in this article because there are so many different ways to read this result. It could be that rich people get better or more intensive care after diagnosis. Or that they're more likely to get regular checkups and so are on average treated at an earlier stage. Or that with HPV vaccine not on the scheduled list, many insurers won't cover it and so the rich face less cervical cancer. Or simply that rich people are less likely to smoke and live with smokers. Or, especially since the long-term data here comes from a small set of disproportionately-urban regions, wealth is acting as a strong proxy for environmental exposure. And even lay readers can discern those things! If rich people have lower incidence, that's different than lower mortality per incidence. Major risk factors like smoking can be adjusted for. We're told that wealth used to correlate with cancer, but the only summary of the change is the vague "in part to changes in diet and smoking as well as screening and treatment rates". This article needed, at minimum, a graph of incidence and mortality by income.
- kolinko 8y agoWow, the disparity in male vs female incidence and mortality is astonishing - almost twice as many men as women get and die of cancer every year.
- hylaride 8y agoI wonder if it's because men are much more likely to smoke and drink heavily...
- RmDen 8y agoProbably also because unlike women..men will wait a long time to go to the doctor
- redbone 8y agoMore likely it's due to the fact that men are more likely to work in fields that force them into contact with carcinogens. Road workers, oil rig workers, construction workers, etc.
- belorn 8y agoSweden has significant reduced the number of smokers, and it is the only country where more women then men smoke. Alcohol usage has also significant dropped, and the difference in usage between women and men is within a couple of percentiles: 32.1% (Women) vs 34.6% (Men). The disparity in male vs female mortality is only slightly reduced. 3.3 years (Sweden) vs 4.5 years (USA). There was a sociology study from 2008 that even claimed that the disparity is artificial small in Sweden because women smoke more then men. They said that it should be much higher (in favor of women) if we removed smoking as a factor. In context smoking is also estimated to lower mortality by 14 years.
- cpursley 8y agoThere's also the male suicide rate, which is a multiple of the female rate.
- fedups 8y ago
- nonbel 8y agoFrom the source: >"Population‐based cancer incidence data in the United States have been collected by the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End Results (SEER) Program since 1973 and by the Centers for Disease Control and Prevention's (CDC's) National Program of Cancer Registries (NPCR) since 1995. The SEER program is the only source for historic population‐based incidence data. Long‐term (1975–2015) incidence and survival trends were based on data from the 9 oldest SEER areas (Connecticut, Hawaii, Iowa, New Mexico, Utah, and the metropolitan areas of Atlanta, Detroit, San Francisco–Oakland, and Seattle–Puget Sound), representing approximately 9% of the US population." https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21551 https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21551 So, looks like the headline chart[1] is only using data from the 9 original SEER regions (Connecticut, Hawaii, Iowa, New Mexico, Utah, and the metropolitan areas of Atlanta, Detroit, San Francisco–Oakland, and Seattle–Puget Sound). Also, some new data source was added in 1995, which is about when we see that peak in incidence/mortality. So we have some room for systematically biasing the data here, especially when we consider the various pitfalls of "age-adjustment". They also say much of the mid-1990s spike in incidence for males was due to detection of asymptomatic prostate cancer: >"Cancer incidence patterns reflect trends in behaviors associated with cancer risk and changes in medical practice, such as the use of cancer screening tests. The volatility in incidence for males reflects rapid changes in prostate cancer incidence rates, which spiked in the late 1980s and early 1990s (Fig. 3) due to a surge in the detection of asymptomatic disease as a result of widespread prostate‐specific antigen (PSA) testing among previously unscreened men" [1] https://wol-prod-cdn.literatumonline.com/cms/attachment/479916e1-e899-4965-a35d-7517620064cf/caac21551-fig-0002-m.jp https://wol-prod-cdn.literatumonline.com/cms/attachment/4799...
- AnimalMuppet 8y agoHypothesis: Some significant fraction of the wealthy/poor disparity is because the poor now smoke significantly more than the rich.
- babyslothzoo 8y agoAnd statistically speaking, the poor are overwhelmingly very obese, whereas the wealthy are fit/thin. Fitness is a new class indicator. Over 80% of Americans are obese or overweight, largely due to lifestyle choice, food addiction, and food abuse. Obesity and related disease are by far the leading cause of death and illness in the USA, it's an extraordinarily costly epidemic that nobody wants to acknowledge.
- djohnston 8y agocan i get a citation on that 80%? i know we're fat but..
- dagw 8y agoThe numbers I can find are closer to 70 than 80%, but still. The really scary number is that the obesity rate is closing in on 40%. So the majority of people who are overweight or obese are in fact obese! https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity https://www.niddk.nih.gov/health-information/health-statisti... https://www.cdc.gov/nchs/data/databriefs/db288.pdf https://www.cdc.gov/nchs/data/databriefs/db288.pdf
- haidut 8y agoNo, it is not! It is a carefully constructed and absolutely FRAUDULENT narrative. https://raypeatforum.com/community/threads/the-war-on-cancer-is-a-bust-no-real-progress-and-actually-a-regress.27174/ https://raypeatforum.com/community/threads/the-war-on-cancer... The War on Cancer has been an absolute bust and it has gobbled up trillions in taxpayers' money with NOTHING to show for it. This money would have been better spent on improving the food supply, the social safety net, and quality of life for the average American. Big Media is one giant lying machine. As much as I do not agree with Trump on many of his policies, he is spot on on the "fake news" phenomenon and it happens across all the entire political spectrum. CNN is just as guilty as Fox News.