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The Gap Between Rich and Poor Americans' Health Is Widening

145 points by Balgair 7y ago

ndiscussion 7y ago
Being healthy is cheap as can be, but the gap is indeed increasing. One need only spend 10 minutes at their favorite discount grocer checkout line to see why. I'm not sure what the answer is, but it's very sad. Why are we destroying our bodies? edit: this quote is getting at it, but seems to ignore the real problem. > Research shows that health care accounts for only 10% to 20% of overall health outcomes > when patients living in public housing have problems like pest infestations or lead paint, their team finds them attorneys to hold their landlords to account. > Such approaches, Moore says, can address social determinants on a local level. But they need to be implemented more widely. Do we have many people dying from lead and pests nowadays? To me it seems like we've adopted the uber model for health in the United States. Free market and damn the externalities. Resulting in a nice profit transfer from the working class to Mondelez et al.
- toomuchtodo 7y ago
  This doesn’t solve the problem of people who die of seizures, diabetes, or other ailments because they can’t afford their medication or insulin. Being lucky is not a healthcare strategy. There is a caravan of Americans who went to Canada to get affordable insulin [1]. From a “first world country”. The answer is universal healthcare. Everything else is rearranging deck chairs on the Titanic. [1] https://www.reuters.com/article/us-canada-health-insulin/american-caravan-arrives-in-canadian-birthplace-of-insulin-for-cheaper-medicine-idUSKCN1TU0T4 https://www.reuters.com/article/us-canada-health-insulin/ame...
  - ndiscussion 7y ago
    edit: type 2 Diabetes is a preventable condition, please see my parent edit. Even if it wasn't preventable, apparently only 20% of the disparity is due to unequal healthcare. We don't need better health care. We just need people to care about their health. to the people commenting that t1 is not preventable.. yes. I know that. I also know that type 2 is 23x more common in the US so it's really a nitpick imo: http://diabetes.org/diabetes-basics/statistics/ http://diabetes.org/diabetes-basics/statistics/
    - jedberg 7y ago
      > Diabetes is a preventable condition You should probably look into Type 1 diabetes.
    - toomuchtodo 7y ago
      Type 1 Diabetes is not. Please do not state misinformation. You can’t will a pancreas to cooperate.
      - ndiscussion 7y ago
        please see that we have 23x type 2 as type 1 in the US: http://diabetes.org/diabetes-basics/statistics/ http://diabetes.org/diabetes-basics/statistics/
        toomuchtodo 7y ago
        This still doesn’t address the wild inefficiencies in the US healthcare system causing us to spend more per capita than any other first world country with poorer outcomes. People should take care of their health, but that is not going to fix US healthcare (such as private insurance, pharma, and healthcare providers gouging healthcare consumers). Stab at the heart of the beast.
    - krisrm 7y ago
      Type 1 diabetes is not preventable, and it makes it necessary to take insulin. If there were a clear path to eliminate that 20% disparity, why shouldn't that path be pursued?
      - ndiscussion 7y ago
        Perhaps it should be pursued. Actually yes, I think it should. But I think the article is trying to imply that it all has to do with wealth as a cause, not wealth as a substitute identifier for a host of healthy habits. The healthy habits are not expensive, but mostly rich people seem to adopt them.
- hanniabu 7y ago
  Unhealthy foods are cheaper than healthy foods, partially due to sugar subsidies. This is what happens when corporations run the government. They lobby for things that are beneficial to their bottom line rather than what's better for the well being of the population.
  - skybrian 7y ago
    Or maybe sugar would be cheaper without government intervention? The U.S. government also maintains a minimum price for sugar via tariffs: https://en.wikipedia.org/wiki/U.S._Sugar_Program https://en.wikipedia.org/wiki/U.S._Sugar_Program
    - Retric 7y ago
      Their are several kinds of sugars. White sugar (Sucrose) is more familiar as a granular sweeter, but industry has no problem working with a cheaper liquid.
  - anonuser123456 7y ago
    That's right. Corporations are forcing people to stuff themselves with potato chips, Captain crunch and pop.
    - ZeroGravitas 7y ago
      They literally pay people to market these things to children. You actually name check a 44% sugar cereal that has a cartoon character as a mascot! The person who invented the flavor described it as having a quality she called "want-more-ishness".
      - umvi 7y ago
        So you are saying parents are at the mercy of the whims of their children when it comes to buying food?
        7y ago
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- JMTQp8lwXL 7y ago
  It's "cheap" if your labor is valued. I imagine the relationship between health consequences and income could somewhat be related to having multiple jobs, long hours, and being too tired to prioritize health after a long day. That fast food looks quick, convenient and affordable when you're going from one job to another and don't have much time or the additional money to spend on healthier fast casual eating options. I do not disagree that whole fruits and vegetables are, by and large, cheap and ubiquitous. If the health outcomes were tied to "cheap and ubiquitous" produce, we'd be off the charts. Yet, here we are. My point is workers who are barely scraping by are disadvantaged to not have the flexibility that higher-income earners do, to actually have the time/energy to cook a healthy meal. Or pay someone else to do it. They end up opting for meals that don't offer the macronutrient composition they need (e.g., frequently the issue is overconsumption of carbs), and are lacking in micronutrients as well (because there aren't enough fruit/vegetable servings in their diet).
  - dsfyu404ed 7y ago
    Most poor people eat out with a fraction of the frequency of richer people. Its finding the time and motivation to burn the calories you consume that's the hard part.
    - JMTQp8lwXL 7y ago
      And when not eating out, your fastest, most affordable option is processed foods, typically high in carbs and low in micronutrients. It's poor quality food. Regarding weight: it's more practical to limit calorie consumption than "burn" them through exercise. An hour of high-intensity cardio might only burn 200 calories. Eating less calories is easier. To get some volume, generous portions of fibrous vegetable help-- so your stomach doesn't feel empty.
      - opportune 7y ago
        Yeah, for most people who aren't obsessive calorie counters I really think eating more fibrous vegetables is the best way for them to make a healthy lifestyle change that would allow them to lose weight / maintain a healthy weight. I do it every time I go on a diet/cut. You can feel just as full eating 1lb of broccoli with a moderate amount of butter and salt (about 300kcal) as you do eating an entire bag of chips (about 1500 kcal). And making the broccoli is almost as convenient: you can get microwaveable bags that you just zap for x amount of time, empty into a bowl with some butter, add salt, mix and enjoy. Two minutes of actual effort, 10 minutes total time. I think a lot of it has to do with the way we arrange food in stores, profit margins for food producing businesses, availability (you can't usually get frozen broccoli at a gas station), what food gets marketed, etc. Really if you put even a small amount of effort in getting veggies to taste good they taste as good as most junk food and processed food. It may never taste as good as spicy cheese flavored corn chips but is still pretty good
- nosianu 7y ago
  > Do we have many people dying from lead and pests nowadays? You misunderstand the problem. You "die" from a heavy metal or other accumulating poisons only if you get an acute poisoning with a pretty large amount. But if you get only tiny amounts for decades you don't die. You just suffer form a lot of "minor" ailments, and most of the time nobody even attributes it to lead (or mercury or whatever). That's because the correlation with aging is almost 1 - after all this can go on for decades with imperceptibly tiny increases in issues, completely in line with aging. Your brain will function less well. Your eyes may be dry and other minor sight issues. Key word "minor", you will not have some big clear symptoms, you will have lots of small issues. A few more warts from decade to decade. A bit more psoriasis. A few cramps. You are more easily tired ("it's the stress"). Maybe some slight depression, occasionally, and you don't get anything done. You get more colds than ten years ago and they last longer. Allergies start and grow. Check my history, I posted about it, I had chronic (mercury) poisoning diagnosed, and only through luck and persistence. I have a long list of such symptoms that are all gone now even though I'm ten years older now than when I started (chelation) treatment, and which I myself, just like any doctor, always thought were "normal" issues that everybody has. That includes stuff like a nodule disappearing from my thyroid and the thyroid shrinking to normal size, to the great amazement of the endocrinologist, under chelation treatment within less than a year, after it had been there for over two decades. Needless to say, instead of asking questions and following up on how I achieved the miracle - nothing at all. And it wasn't some random miracle that cannot be explained, clearly this had to do with the chelation treatment, since that exact area became very active exactly after the 4th or 5th such treatment. Nobody cares. Anyway, your post shows one of the problems: If there isn't a big problem visible right away there is none. Heavy metal poisonings with tiny amounts over decades are next to impossible to prove, unless you are "lucky" and for some reason when you are tested you actually have quite a bit moving around in your blood (unusual for such chronic exposure, where most of it is stored in various organs). So nobody knows - wants to know? - how big the problem really is. My own doctor, researcher at a university clinic, is pretty pessimistic though.
kingkawn 7y ago
Keep pushing against the poor means the pendulum swing only gonna be more drastic
- e40 7y ago
  That's what I believe. Maybe it won't be a French Revolution type reaction, but it will continue to radicalize people, as the gap widens and magnitude and time.
  - kingkawn 7y ago
    Except this time the whole population of the planet is connected in near real-time, and the movement won’t be confined to one country.
anonuser123456 7y ago
Unpopular hypothesis: Executive function is causally correlated with health and wealth.
- ZeroGravitas 7y ago
  Ironically something negatively affected by lead exposure, yet the comment you reply to seems to be judging people in poor area's decisions as being a factor in theit health outcomes while at the same time minimising lead poisoning's impact.
  - anonuser123456 7y ago
    I don't blame poor people for their plight. I didn't bootstrap myself to high executive function, the universe just gave it to me. Those affected by environmental lead are no more in charge. But we have to get to the root cause of inequality to begin talking about a solution. Most people have poor health because they make poor decisions. So either we disallow them agency and act as their perpetual nanny, or accept the world isn't perfect and that distributions will be unequal. Throwing money at the problem won't help. You can spend unlimited healthcare dollars for no measurable benefit.
    - ncallaway 7y ago
      From your writing, it sounds like from your perspective there are only two outcomes: * Unacceptably nanny people * Do nothing and accept inequality in life, and make no mitigations to prevent it You have listed a lot of things that you think won't work. What do you think _will_ work, that allows people agency and doesn't require acting as their perpetual nanny?
- rootusrootus 7y ago
  That's probably not that unpopular. At least among people who haven't gotten significantly ill yet.
- jhayward 7y ago
  This isn't an actual contribution, it's trolling. Future executive function is highly correlated with high socio-economic status of childhood.
mensetmanusman 7y ago
America is set up like a strange satire. If you get unhealthy, you literally become poor to the song of 6 digits. A six digit reduction in wealth is enough to make over 90% of America poor.
- TheOtherHobbes 7y ago
  It's enough to bankrupt hundreds of thousands of Americans - every year. Your ill health and bankruptcy become someone else's yacht or private jet. It's pure vampirism. There is no other word for it.
  - mkr-hn 7y ago
    Vampires at least have a good reason to suck people dry.
denverkarma 7y ago
It’s really hard for me not to be skeptical of a study that starts with the premise of measuring everyone else against “the most privileged group,” aka. white men, and then calling their metric “health justice.” I don’t know the stats off the top of my head but I’ve heard many times that men’s health issues are under-studies relative to women’s — ie breast cancer versus prostate cancer. I’ve also seen that mental health problems affect men more than women, as well as behavioral problems with youth, and yet there’s no outcry for “health justice” for all the men with mental issues or men vastly overrepresented in the prison population. The study claims that health correlates most strongly with income, and that the gap between black and white has narrowed - and yet the study author claims there’s a “stunning lack of progress.” Most of America’s problems correlate most strongly with income and more weakly with race and gender, which isn’t surprising when income itself is uneven between race and gender demographics. Yet it feels to me like we’re constantly crying out about race and gender discrimination while paying much less attention to wealth and income which seem to be the root issue. Are there racists in the country? Do hate crimes happen? Yes, and we shouldn’t gloss over them. But are the country’s problems driven mostly by racial hatred? I don’t think so. I think the problem is we have done a lot to pull the ladder up behind the upper-middle class, everyone in the lower income brackets is getting screwed, and that disproportionately affects minorities and historically disadvantaged groups. I think if we could get more serious about putting the ladder back and investing in upward mobility for all, we could make a lot more progress on all the rest of the issues that are affecting the country.
- supercanuck 7y ago
  https://en.wikipedia.org/wiki/Institutional_racism https://en.wikipedia.org/wiki/Institutional_racism >It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.
- save_ferris 7y ago
  Statistically speaking, white men are far and away the highest income earners in America. They are literally the most privileged group. Until 2008, 44 of 44 of US presidents were white men. White men dominate the Fortune 500, Wall Street, and leadership in the government. The paper also explicitly defined health justice as "a measure of the correlation of health outcomes with income, race/ethnicity and sex; and a summary health equity metric.", which doesn't sound like much of an editorialization to me.
g00s3_caLL_x2 7y ago
This doesn't really make sense to me at all. The friends I have who are 'poor' have free or subsidized health care and get more to spend on groceries a month than what I can afford. They go see the Dr. on the drop of a dime for any little thing. We are not talking 1 or 2 people here either. I have several that are this way. What gives? They don't seem in bad heath really, but do kinda eat like crap. They will load their pantry up with mostly junk.
dakna 7y ago
I would like to encourage people to join a local community garden program and also let others know this option might exist in their hometown. I found it to be an invaluable way to grow healthy food and meet people from all walks of life. We grow veggies in our backyard too, but the public gardens are where you actually meet nice people outside of your economic class, which is far more rewarding on a personal level to me than driving around in an expensive car to an expensive mall to buy expensive stuff.
flahgd 7y ago
> Limitations of the study include the fact that the authors were not able to look at factors like immigration status Into the trash it goes.
- dang 7y ago
  Would you please stop posting unsubstantive and/or flamebaity comments to HN?
holbrad 7y ago
EDIT: Apologies for the rant, went a little overboard oh well. For the overwhelming majority of heavy hitting chronic diseases (Diabetes T2, Obesity, Heart Attacks, even likely cancer). They are completely preventable though diet and other lifestyle changes. Good food, grass fed meat, fish and fresh vegetables aren't that expensive people could afford it if they thought it was an actual priority. For those suffering from weight problems (In the UK the obesity rate is 27%! [1] Not even the overweight) I'd recommend for them to cut down on their frequency of meals and ensure that the one or two meals they have are healthy (Very low fructose, nutrient dense, keeps insulin low e.t.c.) It's the same with exercising, a gym membership isn't that much money cheap gyms exist. But you don't even need any money to do some simple body weight exercises, depending on what you do and your fitness level it can literally take 10 minutes. So it's not a lack of time or money for anyone but the absolute poorest, people just don't seem to care that much. I really don't know why ? [1] https://files.digital.nhs.uk/publication/0/0/obes-phys-acti-diet-eng-2018-rep.pdf https://files.digital.nhs.uk/publication/0/0/obes-phys-acti-...
- MuffinFlavored 7y ago
  > They are completely preventable though diet and other lifestyle changes. Does this mean that some of those Americans are to blame due to living such an unhealthy lifestyle?
  - holbrad 7y ago
    Personally I think they do shoulder some blame. But I certainly think things could be made significantly easier for the average person to do the right thing. Nutrition science is very complicated with very strong biases and conflicting results. It makes it difficult to actually know what to eat, the media doesn't help by regurgitating every single crappy study that has a catchy or provocative conclusion. (The rubbish getting published and the peer review process is another can of worms) There are many companies with a vested financial interest in selling appealing but unhealthy food. People are effected by advertising and what is easy, that isn't their fault. Exercises for staying reasonably healthy doesn't really get taught. Things could certainly be made easier, for the average person.
binichgross 7y ago
What? Again?
oneepic 7y ago
We Americans are living in a pretty stressful time as well (i.e. politically, financially, among other things). I can't name the study(ies) to show it, but psychology has told us that stressful environments correlate with poverty and other awful factors, which also cause even more stress, so people tend to go down and stay down in a vicious cycle, unless they make a significant effort to turn it all around. (for example, say your job stresses you out so much and takes so much time out of your day that you can't cook, then suppose you feel pressured enough that you settle for fast food, and exercise less. So you gain weight over time. Now your weight might just stress you out too; now you have to deal with the detriments of that, on top of your shitty job. Sounds hard...) So it makes sense to me that poor Americans's health is getting worse. For rich people, I'd have to assume they have the time/resources (possibly chefs) to get the healthy food and such that they need, so it's not changing much. EDIT: Oh, and from my experiences growing up in a pretty conservative environment: lots of Americans honestly feel there's too much confusing info out there about diets, workouts, etc. It's always in the news, so you get tired of hearing about it and how you're going to die at 40 because of the terrible things you're doing to your body (McDonalds every week, or whatever). Plus, we've seen so many diet/fitness program commercials on TV and heard so many stories of them not working. I think people are well aware they should make a change, but how to do so is such a noisy topic with mixed success, that it stresses them out just thinking about it. Even if you were to provide them a new, easier way to get fit, it would look exactly the same as all those fake diets and exercise programs they saw on TV. Who knows if your new shit's gonna work or not? They'd rather not even bother.
uwuhn 7y ago
Where are the actual income brackets? I clicked through the NPR article to the study itself and still can't find them. I also don't understand how self-reported health can be objectively valid for a study like this. E.g. if you believe you are healthy and never visit the doctor because you don't see a need to do so, but you have an undiscovered heart condition that causes your death a year after participating in the study. It also seems like the headline is somewhat deceiving given that the study does not differentiate between mental and physical health. I don't assign the same weight to missing work because you are sick or injured to missing work because you feel depressed that day(I have admittedly had plenty of the latter at my old job).
malandrew 7y ago
Why are we looking at self-reports instead of outcomes? If self reports remained constant since 1993 for the most privileged group and dropped for other groups, then all things being equal, outcomes should have dropped on average when you look at the entire population, but when you look at data about actual outcomes, they don't support this: https://www.healthsystemtracker.org/chart-collection/how-has-the-quality-of-the-u-s-healthcare-system-changed-over-time/ https://www.healthsystemtracker.org/chart-collection/how-has... Maybe people feel worse even though they are doing better but don't remember how things were 25+ years ago.
Giho 7y ago
From article: "But, Ramirez-Valles says, the study does a good job of showing that when it comes to health outcomes, "it's not always [immediately] about health." He says the study's findings indicate a need for two broad policy recommendations: a revision of the minimum wage and a rethinking of our current taxation system. "Income inequality is at the bottom of this," he says. "We need to target and attack [it] aggressively. Not only in this country, but worldwide." " When I read this I think of Thomas Pikettys research. https://en.m.wikipedia.org/wiki/Capital_in_the_Twenty-First_Century https://en.m.wikipedia.org/wiki/Capital_in_the_Twenty-First_... This concentration of wealth haven't happened over a night. I don't think the income difference is the only problem but also the accumulation of capital. The article seem to forget the difference between income versus spending in addition to start capital. How is the health of people with a lot of capital and a low income and high spending? Or is it not possible to have low income with a lot of capital? The rethinking of the taxation system, I do think Ramez has a point as income has higher taxation compared to capital. The amount of capital matters more than the amount of income.

145 points by Balgair 7y ago

Being healthy is cheap as can be, but the gap is indeed increasing. One need only spend 10 minutes at their favorite discount grocer checkout line to see why. I'm not sure what the answer is, but it's very sad. Why are we destroying our bodies? edit: this quote is getting at it, but seems to ignore the real problem. > Research shows that health care accounts for only 10% to 20% of overall health outcomes > when patients living in public housing have problems like pest infestations or lead paint, their team finds them attorneys to hold their landlords to account. > Such approaches, Moore says, can address social determinants on a local level. But they need to be implemented more widely. Do we have many people dying from lead and pests nowadays? To me it seems like we've adopted the uber model for health in the United States. Free market and damn the externalities. Resulting in a nice profit transfer from the working class to Mondelez et al.

toomuchtodo 7y ago
This doesn’t solve the problem of people who die of seizures, diabetes, or other ailments because they can’t afford their medication or insulin. Being lucky is not a healthcare strategy. There is a caravan of Americans who went to Canada to get affordable insulin [1]. From a “first world country”. The answer is universal healthcare. Everything else is rearranging deck chairs on the Titanic. [1] https://www.reuters.com/article/us-canada-health-insulin/american-caravan-arrives-in-canadian-birthplace-of-insulin-for-cheaper-medicine-idUSKCN1TU0T4 https://www.reuters.com/article/us-canada-health-insulin/ame...
- ndiscussion 7y ago
  edit: type 2 Diabetes is a preventable condition, please see my parent edit. Even if it wasn't preventable, apparently only 20% of the disparity is due to unequal healthcare. We don't need better health care. We just need people to care about their health. to the people commenting that t1 is not preventable.. yes. I know that. I also know that type 2 is 23x more common in the US so it's really a nitpick imo: http://diabetes.org/diabetes-basics/statistics/ http://diabetes.org/diabetes-basics/statistics/
  - jedberg 7y ago
    > Diabetes is a preventable condition You should probably look into Type 1 diabetes.
  - toomuchtodo 7y ago
    Type 1 Diabetes is not. Please do not state misinformation. You can’t will a pancreas to cooperate.
    - ndiscussion 7y ago
      please see that we have 23x type 2 as type 1 in the US: http://diabetes.org/diabetes-basics/statistics/ http://diabetes.org/diabetes-basics/statistics/
      - toomuchtodo 7y ago
        This still doesn’t address the wild inefficiencies in the US healthcare system causing us to spend more per capita than any other first world country with poorer outcomes. People should take care of their health, but that is not going to fix US healthcare (such as private insurance, pharma, and healthcare providers gouging healthcare consumers). Stab at the heart of the beast.
  - krisrm 7y ago
    Type 1 diabetes is not preventable, and it makes it necessary to take insulin. If there were a clear path to eliminate that 20% disparity, why shouldn't that path be pursued?
    - ndiscussion 7y ago
      Perhaps it should be pursued. Actually yes, I think it should. But I think the article is trying to imply that it all has to do with wealth as a cause, not wealth as a substitute identifier for a host of healthy habits. The healthy habits are not expensive, but mostly rich people seem to adopt them.
hanniabu 7y ago
Unhealthy foods are cheaper than healthy foods, partially due to sugar subsidies. This is what happens when corporations run the government. They lobby for things that are beneficial to their bottom line rather than what's better for the well being of the population.
- skybrian 7y ago
  Or maybe sugar would be cheaper without government intervention? The U.S. government also maintains a minimum price for sugar via tariffs: https://en.wikipedia.org/wiki/U.S._Sugar_Program https://en.wikipedia.org/wiki/U.S._Sugar_Program
  - Retric 7y ago
    Their are several kinds of sugars. White sugar (Sucrose) is more familiar as a granular sweeter, but industry has no problem working with a cheaper liquid.
- anonuser123456 7y ago
  That's right. Corporations are forcing people to stuff themselves with potato chips, Captain crunch and pop.
  - ZeroGravitas 7y ago
    They literally pay people to market these things to children. You actually name check a 44% sugar cereal that has a cartoon character as a mascot! The person who invented the flavor described it as having a quality she called "want-more-ishness".
    - umvi 7y ago
      So you are saying parents are at the mercy of the whims of their children when it comes to buying food?
      - 7y ago
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JMTQp8lwXL 7y ago
It's "cheap" if your labor is valued. I imagine the relationship between health consequences and income could somewhat be related to having multiple jobs, long hours, and being too tired to prioritize health after a long day. That fast food looks quick, convenient and affordable when you're going from one job to another and don't have much time or the additional money to spend on healthier fast casual eating options. I do not disagree that whole fruits and vegetables are, by and large, cheap and ubiquitous. If the health outcomes were tied to "cheap and ubiquitous" produce, we'd be off the charts. Yet, here we are. My point is workers who are barely scraping by are disadvantaged to not have the flexibility that higher-income earners do, to actually have the time/energy to cook a healthy meal. Or pay someone else to do it. They end up opting for meals that don't offer the macronutrient composition they need (e.g., frequently the issue is overconsumption of carbs), and are lacking in micronutrients as well (because there aren't enough fruit/vegetable servings in their diet).
- dsfyu404ed 7y ago
  Most poor people eat out with a fraction of the frequency of richer people. Its finding the time and motivation to burn the calories you consume that's the hard part.
  - JMTQp8lwXL 7y ago
    And when not eating out, your fastest, most affordable option is processed foods, typically high in carbs and low in micronutrients. It's poor quality food. Regarding weight: it's more practical to limit calorie consumption than "burn" them through exercise. An hour of high-intensity cardio might only burn 200 calories. Eating less calories is easier. To get some volume, generous portions of fibrous vegetable help-- so your stomach doesn't feel empty.
    - opportune 7y ago
      Yeah, for most people who aren't obsessive calorie counters I really think eating more fibrous vegetables is the best way for them to make a healthy lifestyle change that would allow them to lose weight / maintain a healthy weight. I do it every time I go on a diet/cut. You can feel just as full eating 1lb of broccoli with a moderate amount of butter and salt (about 300kcal) as you do eating an entire bag of chips (about 1500 kcal). And making the broccoli is almost as convenient: you can get microwaveable bags that you just zap for x amount of time, empty into a bowl with some butter, add salt, mix and enjoy. Two minutes of actual effort, 10 minutes total time. I think a lot of it has to do with the way we arrange food in stores, profit margins for food producing businesses, availability (you can't usually get frozen broccoli at a gas station), what food gets marketed, etc. Really if you put even a small amount of effort in getting veggies to taste good they taste as good as most junk food and processed food. It may never taste as good as spicy cheese flavored corn chips but is still pretty good
nosianu 7y ago
> Do we have many people dying from lead and pests nowadays? You misunderstand the problem. You "die" from a heavy metal or other accumulating poisons only if you get an acute poisoning with a pretty large amount. But if you get only tiny amounts for decades you don't die. You just suffer form a lot of "minor" ailments, and most of the time nobody even attributes it to lead (or mercury or whatever). That's because the correlation with aging is almost 1 - after all this can go on for decades with imperceptibly tiny increases in issues, completely in line with aging. Your brain will function less well. Your eyes may be dry and other minor sight issues. Key word "minor", you will not have some big clear symptoms, you will have lots of small issues. A few more warts from decade to decade. A bit more psoriasis. A few cramps. You are more easily tired ("it's the stress"). Maybe some slight depression, occasionally, and you don't get anything done. You get more colds than ten years ago and they last longer. Allergies start and grow. Check my history, I posted about it, I had chronic (mercury) poisoning diagnosed, and only through luck and persistence. I have a long list of such symptoms that are all gone now even though I'm ten years older now than when I started (chelation) treatment, and which I myself, just like any doctor, always thought were "normal" issues that everybody has. That includes stuff like a nodule disappearing from my thyroid and the thyroid shrinking to normal size, to the great amazement of the endocrinologist, under chelation treatment within less than a year, after it had been there for over two decades. Needless to say, instead of asking questions and following up on how I achieved the miracle - nothing at all. And it wasn't some random miracle that cannot be explained, clearly this had to do with the chelation treatment, since that exact area became very active exactly after the 4th or 5th such treatment. Nobody cares. Anyway, your post shows one of the problems: If there isn't a big problem visible right away there is none. Heavy metal poisonings with tiny amounts over decades are next to impossible to prove, unless you are "lucky" and for some reason when you are tested you actually have quite a bit moving around in your blood (unusual for such chronic exposure, where most of it is stored in various organs). So nobody knows - wants to know? - how big the problem really is. My own doctor, researcher at a university clinic, is pretty pessimistic though.

kingkawn 7y ago

Keep pushing against the poor means the pendulum swing only gonna be more drastic

e40 7y ago
That's what I believe. Maybe it won't be a French Revolution type reaction, but it will continue to radicalize people, as the gap widens and magnitude and time.
- kingkawn 7y ago
  Except this time the whole population of the planet is connected in near real-time, and the movement won’t be confined to one country.

anonuser123456 7y ago

Unpopular hypothesis: Executive function is causally correlated with health and wealth.

ZeroGravitas 7y ago
Ironically something negatively affected by lead exposure, yet the comment you reply to seems to be judging people in poor area's decisions as being a factor in theit health outcomes while at the same time minimising lead poisoning's impact.
- anonuser123456 7y ago
  I don't blame poor people for their plight. I didn't bootstrap myself to high executive function, the universe just gave it to me. Those affected by environmental lead are no more in charge. But we have to get to the root cause of inequality to begin talking about a solution. Most people have poor health because they make poor decisions. So either we disallow them agency and act as their perpetual nanny, or accept the world isn't perfect and that distributions will be unequal. Throwing money at the problem won't help. You can spend unlimited healthcare dollars for no measurable benefit.
  - ncallaway 7y ago
    From your writing, it sounds like from your perspective there are only two outcomes: * Unacceptably nanny people * Do nothing and accept inequality in life, and make no mitigations to prevent it You have listed a lot of things that you think won't work. What do you think _will_ work, that allows people agency and doesn't require acting as their perpetual nanny?
rootusrootus 7y ago
That's probably not that unpopular. At least among people who haven't gotten significantly ill yet.
jhayward 7y ago
This isn't an actual contribution, it's trolling. Future executive function is highly correlated with high socio-economic status of childhood.

mensetmanusman 7y ago

America is set up like a strange satire. If you get unhealthy, you literally become poor to the song of 6 digits. A six digit reduction in wealth is enough to make over 90% of America poor.

TheOtherHobbes 7y ago
It's enough to bankrupt hundreds of thousands of Americans - every year. Your ill health and bankruptcy become someone else's yacht or private jet. It's pure vampirism. There is no other word for it.
- mkr-hn 7y ago
  Vampires at least have a good reason to suck people dry.

denverkarma 7y ago

It’s really hard for me not to be skeptical of a study that starts with the premise of measuring everyone else against “the most privileged group,” aka. white men, and then calling their metric “health justice.” I don’t know the stats off the top of my head but I’ve heard many times that men’s health issues are under-studies relative to women’s — ie breast cancer versus prostate cancer. I’ve also seen that mental health problems affect men more than women, as well as behavioral problems with youth, and yet there’s no outcry for “health justice” for all the men with mental issues or men vastly overrepresented in the prison population. The study claims that health correlates most strongly with income, and that the gap between black and white has narrowed - and yet the study author claims there’s a “stunning lack of progress.” Most of America’s problems correlate most strongly with income and more weakly with race and gender, which isn’t surprising when income itself is uneven between race and gender demographics. Yet it feels to me like we’re constantly crying out about race and gender discrimination while paying much less attention to wealth and income which seem to be the root issue. Are there racists in the country? Do hate crimes happen? Yes, and we shouldn’t gloss over them. But are the country’s problems driven mostly by racial hatred? I don’t think so. I think the problem is we have done a lot to pull the ladder up behind the upper-middle class, everyone in the lower income brackets is getting screwed, and that disproportionately affects minorities and historically disadvantaged groups. I think if we could get more serious about putting the ladder back and investing in upward mobility for all, we could make a lot more progress on all the rest of the issues that are affecting the country.

supercanuck 7y ago
https://en.wikipedia.org/wiki/Institutional_racism https://en.wikipedia.org/wiki/Institutional_racism >It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.
save_ferris 7y ago
Statistically speaking, white men are far and away the highest income earners in America. They are literally the most privileged group. Until 2008, 44 of 44 of US presidents were white men. White men dominate the Fortune 500, Wall Street, and leadership in the government. The paper also explicitly defined health justice as "a measure of the correlation of health outcomes with income, race/ethnicity and sex; and a summary health equity metric.", which doesn't sound like much of an editorialization to me.

g00s3_caLL_x2 7y ago

This doesn't really make sense to me at all. The friends I have who are 'poor' have free or subsidized health care and get more to spend on groceries a month than what I can afford. They go see the Dr. on the drop of a dime for any little thing. We are not talking 1 or 2 people here either. I have several that are this way. What gives? They don't seem in bad heath really, but do kinda eat like crap. They will load their pantry up with mostly junk.

dakna 7y ago

I would like to encourage people to join a local community garden program and also let others know this option might exist in their hometown. I found it to be an invaluable way to grow healthy food and meet people from all walks of life. We grow veggies in our backyard too, but the public gardens are where you actually meet nice people outside of your economic class, which is far more rewarding on a personal level to me than driving around in an expensive car to an expensive mall to buy expensive stuff.

flahgd 7y ago

> Limitations of the study include the fact that the authors were not able to look at factors like immigration status Into the trash it goes.

dang 7y ago
Would you please stop posting unsubstantive and/or flamebaity comments to HN?

holbrad 7y ago

EDIT: Apologies for the rant, went a little overboard oh well. For the overwhelming majority of heavy hitting chronic diseases (Diabetes T2, Obesity, Heart Attacks, even likely cancer). They are completely preventable though diet and other lifestyle changes. Good food, grass fed meat, fish and fresh vegetables aren't that expensive people could afford it if they thought it was an actual priority. For those suffering from weight problems (In the UK the obesity rate is 27%! [1] Not even the overweight) I'd recommend for them to cut down on their frequency of meals and ensure that the one or two meals they have are healthy (Very low fructose, nutrient dense, keeps insulin low e.t.c.) It's the same with exercising, a gym membership isn't that much money cheap gyms exist. But you don't even need any money to do some simple body weight exercises, depending on what you do and your fitness level it can literally take 10 minutes. So it's not a lack of time or money for anyone but the absolute poorest, people just don't seem to care that much. I really don't know why ? [1] https://files.digital.nhs.uk/publication/0/0/obes-phys-acti-diet-eng-2018-rep.pdf https://files.digital.nhs.uk/publication/0/0/obes-phys-acti-...

MuffinFlavored 7y ago
> They are completely preventable though diet and other lifestyle changes. Does this mean that some of those Americans are to blame due to living such an unhealthy lifestyle?
- holbrad 7y ago
  Personally I think they do shoulder some blame. But I certainly think things could be made significantly easier for the average person to do the right thing. Nutrition science is very complicated with very strong biases and conflicting results. It makes it difficult to actually know what to eat, the media doesn't help by regurgitating every single crappy study that has a catchy or provocative conclusion. (The rubbish getting published and the peer review process is another can of worms) There are many companies with a vested financial interest in selling appealing but unhealthy food. People are effected by advertising and what is easy, that isn't their fault. Exercises for staying reasonably healthy doesn't really get taught. Things could certainly be made easier, for the average person.

binichgross 7y ago

What? Again?

oneepic 7y ago

We Americans are living in a pretty stressful time as well (i.e. politically, financially, among other things). I can't name the study(ies) to show it, but psychology has told us that stressful environments correlate with poverty and other awful factors, which also cause even more stress, so people tend to go down and stay down in a vicious cycle, unless they make a significant effort to turn it all around. (for example, say your job stresses you out so much and takes so much time out of your day that you can't cook, then suppose you feel pressured enough that you settle for fast food, and exercise less. So you gain weight over time. Now your weight might just stress you out too; now you have to deal with the detriments of that, on top of your shitty job. Sounds hard...) So it makes sense to me that poor Americans's health is getting worse. For rich people, I'd have to assume they have the time/resources (possibly chefs) to get the healthy food and such that they need, so it's not changing much. EDIT: Oh, and from my experiences growing up in a pretty conservative environment: lots of Americans honestly feel there's too much confusing info out there about diets, workouts, etc. It's always in the news, so you get tired of hearing about it and how you're going to die at 40 because of the terrible things you're doing to your body (McDonalds every week, or whatever). Plus, we've seen so many diet/fitness program commercials on TV and heard so many stories of them not working. I think people are well aware they should make a change, but how to do so is such a noisy topic with mixed success, that it stresses them out just thinking about it. Even if you were to provide them a new, easier way to get fit, it would look exactly the same as all those fake diets and exercise programs they saw on TV. Who knows if your new shit's gonna work or not? They'd rather not even bother.

uwuhn 7y ago

Where are the actual income brackets? I clicked through the NPR article to the study itself and still can't find them. I also don't understand how self-reported health can be objectively valid for a study like this. E.g. if you believe you are healthy and never visit the doctor because you don't see a need to do so, but you have an undiscovered heart condition that causes your death a year after participating in the study. It also seems like the headline is somewhat deceiving given that the study does not differentiate between mental and physical health. I don't assign the same weight to missing work because you are sick or injured to missing work because you feel depressed that day(I have admittedly had plenty of the latter at my old job).

malandrew 7y ago

Why are we looking at self-reports instead of outcomes? If self reports remained constant since 1993 for the most privileged group and dropped for other groups, then all things being equal, outcomes should have dropped on average when you look at the entire population, but when you look at data about actual outcomes, they don't support this: https://www.healthsystemtracker.org/chart-collection/how-has-the-quality-of-the-u-s-healthcare-system-changed-over-time/ https://www.healthsystemtracker.org/chart-collection/how-has... Maybe people feel worse even though they are doing better but don't remember how things were 25+ years ago.

Giho 7y ago

From article: "But, Ramirez-Valles says, the study does a good job of showing that when it comes to health outcomes, "it's not always [immediately] about health." He says the study's findings indicate a need for two broad policy recommendations: a revision of the minimum wage and a rethinking of our current taxation system. "Income inequality is at the bottom of this," he says. "We need to target and attack [it] aggressively. Not only in this country, but worldwide." " When I read this I think of Thomas Pikettys research. https://en.m.wikipedia.org/wiki/Capital_in_the_Twenty-First_Century https://en.m.wikipedia.org/wiki/Capital_in_the_Twenty-First_... This concentration of wealth haven't happened over a night. I don't think the income difference is the only problem but also the accumulation of capital. The article seem to forget the difference between income versus spending in addition to start capital. How is the health of people with a lot of capital and a low income and high spending? Or is it not possible to have low income with a lot of capital? The rethinking of the taxation system, I do think Ramez has a point as income has higher taxation compared to capital. The amount of capital matters more than the amount of income.