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There really are two Americas - wealthy america and the rest of america. I'll bet if you split America into two sets of counties, the graph would be much differ

There really are two Americas - wealthy america and the rest of america. I'll bet if you split America into two sets of counties, the graph would be much different -- one would be a super-outlier and the other a super-laggard. I know this personally, as I've spent 21yrs of my life in one half, and another 20 in the other half. I've also lived overseas for several years, and they also have stratas, but much less pronounced than here in the US.

xwdv 6y ago
Which half made you happier?
- TuringNYC 6y ago
  TLDR: i'd take unhappy-rich over hungry-poor any day. But the best thing would be the happy medium where you are comfortable enough to afford food/schooling but not in a social class where there are obscene social expectations to spend -- so your question is a fair one. I think the key thing was getting past the lower rungs of the Maslow hierarchy. It is very difficult to concentrate on schooling (or anything) when you are hungry or sick. I was constantly hungry when we didnt have free public school meals. A close relative had TB, due to poor healthcare where the hospital/system didn't seem to give a darn. The worst thing is how horrible normal people treated you (even teachers at public school.) I was constantly sick, probably due to poor nutrition. College was great, I will still poor, but the prospects were getting better and all the basics were covered (no longer hungry; decent healthcare). This allowed more happiness because you knew it would be over soon. With better jobs comes more stress -- the expectations (perhaps justified) that one should have a home, that one should have a school for children w/o crime/gangs -- and bigger mortgages, bigger spending. I live fairly conservatively despite decent career success, but I can see how I could "become unhappy trying to reach happiness" ... all that said, i'd take unhappy-rich to hungry-poor any day.
  - medium_burrito 6y ago
    Yeah, that's exactly it- once you have safety, food, shelter and good health and the expectation those will remain, that's amazing. Personally I've decided to forgo as many personal luxuries as possible (ie don't fly first class, no boat besides a shitty canoe, no peasant steel case rolex, no car worth > $20k in an effort to retire with a few million in liquid assets on top of my house by my early 40s. Having no worries is the ultimate luxury. Alternatively, if I lived in California where the weather is mild perhaps I would just go full Diogenes.
    - MeinBlutIstBlau 6y ago
      My goal is to retire to Germany and become a German citizen if I can't get rich here. At least I won't die in my 60's because I can't afford healthcare.
- voodootrucker 6y ago
  Due to work, I spent: - 3 months in Japan - 3 Months in Germany - 3 months in the US - 3 months in India The transition was alarming. I see bits of both Germany and India in the US. Unfortunately (having grown up in America) I see the trend as towards India. I don't mean this as a cultural slight, but as a cultural observation. I've seen high-trust vs low-trust societies brought up many times on HN. Traffic was most pronounced. In Germany, they obeyed the rules to the extent they wouldn't J-walk even if there was no traffic. In America, you'd look both ways then cross. In India might makes right, big cars get the right of way, pedestrians have to be aggressive and just make their way, eyeballing cars down with a death stare of determination. Anyway all this is to say, it seems like there are two types of wealth: - In India, you can found a startup, make money, buy a Ferrari, but that would be a terrible move because if you drive it anywhere on public roads you will go max 30kph, and it will get destroyed on the roads - In Germany, you can have a modest Skoda and still hit 200 kph on their impeccable freeways with confidence that the person in the right lane will never, ever change lanes without a signal and mirror check So, my personal take, and I realize that this is highly reductionist, but I hope, relevant is that there are two types of wealth: 1. a type where society is wealthy, and that translates into well being for the individual and the whole 2. a type where wealth is relative, and the wealthy take joy not in having an absolute sense of wealth (as in compared to a German), but as in "my neighbor lives in a shack and I live in a gated tower high rise" I fear America is at a cross roads and will make a choice that makes us poor in a global sense.
  - ddingus 6y ago
    I found your take thought provoking. HN is always a surprise.
  - bleepblorp 6y ago
    Another way to describe the difference between Germany and India is that's the difference between a rich society and a poor society that has (a few) rich people in it. This distinction also correlates with multiple factors of collective well-being, including life expectancy, and income inequality. America made the choice in the 1980s, with the arrival of Reagan, to transition from being a rich society to being a poor society that has a fair number of rich people in it. Income inequality has deteriorated since then, the quality of public services/public infrastructure has severely degraded, and social trust is rapidly eroding. It's almost certainly too late to change course.
kinkrtyavimoodh 6y ago
Coastal America and rest of America might be a better way to cut it.
- geogra4 6y ago
  I don't think its so geographically aligned like that. Plenty of rich areas in Chicago, Houston, Dallas, Phoenix etc.
  - kinkrtyavimoodh 6y ago
    While that is true, I think that some of these things are tied to local culture too, which is why the Coastal distinction does have some merit. If you generally are in the Bay Area or LA you rarely see the level of obesity you see in say Houston despite the fact that both areas despite being rich have their fair share of the poor too. Similarly for smoking. It's exceedingly rare to see public smoking in the Bay Area. Similarly for diets. When traveling in the South I was amazed at just how ridiculously unhealthy the average food eaten by the average person there was. Everything deep fried, laden with calories, consumed along with sugary drinks.
    - deleted 6y ago
      [deleted]
    - Apocryphon 6y ago
      It's still regional rather than simply everyone vs. coastal. Not sure if it's fair to lump in the wealthier Rocky Mountain states like Colorado or Utah in with say the butter and cornfed Midwest.
  - lotsofpulp 6y ago
    Data is 5 to 6 years old: County level: https://www.worldlifeexpectancy.com/usa/life-expectancy-by-county https://www.worldlifeexpectancy.com/usa/life-expectancy-by-c... State and county level: https://www.cdc.gov/nchs/data-visualization/life-expectancy/index.html https://www.cdc.gov/nchs/data-visualization/life-expectancy/...
julienb_sea 6y ago
For healthcare, you can probably segment America a little more generously into insured vs uninsured. If you are insured in America, your healthcare is reasonably good. Lower quality plans may have more restrictive networks or higher deductibles and maximums, but these are manageable and neither are truly barriers to care.
- bryan11 6y ago
  You could segment them in three sets: well insured, people with catastrophic health plans, and uninsured. Many employers are switching to high deductible health plans and that deductible may be thousands of dollars, i.e. catastrophic plans. When going to a doctor for a simple diagnosis or bloodwork can easily cost $400 to $1000, many put off doctor visits unless it's an emergency. It can easily become a choice between a doctor visit or a car repair. Preventative checkups are gone and insurance is only something one uses with an emergency room visit or major health issue.
  - TuringNYC 6y ago
    That's a great explanation. It also shows how short-sighted such plans us at a national macro level -- because an ounce of prevention can prevent hundreds of thousands in future future bills. A perfect example is vitamin deficiency and the very serious effects such deficiencies can have, and how inexpensive the preventative care is.
    - kube-system 6y ago
      It is getting better. The ACA mandates coverage for some preventative care.
  - Thorentis 6y ago
    $400 for just a bloodtest at a GP? That's insane. All free in Australia, from the initial visit, to the blood taking, to the follow up.
    - 6y ago
socialdemocrat 6y ago
But even that isn't even true. The US system doesn't even benefit the wealthy. For profit health care means a lot of over-treatment which causes several problems in US health care which kills people: - Something like 2x as much surgery done in the US than in other countries, because it is profitable, not because it is needed. So perfectly health people are cut open, because they got a good insurance which can pay for it. - Opioid crisis. Again having health insurance is a problem, not a benefit in this case. That turns you into a money bag, they can push opioids on. - Antibiotic resistance. America is all about getting more of everything. Quantity over quality, which unfortunately also means excessive use of antibiotics making Antibiotic resistance a major problem. The US system really isn't working for anyone. It means those who cannot pay get too little treatment, and those who can pay get too much. If only there was a way to even it out...
- zusoomro 6y ago
  Do you have any citations / resources that can be used to read more about your perspective here?
- StanislavPetrov 6y ago
  >The US system doesn't even benefit the wealthy. That's a ridiculous statement, it benefits the wealthy massively. We can argue over whether or not these benefits would be even more massive without over-treatment, but there is no doubt about the overall benefits to the wealthy. >A Harvard analysis of 1.4 billion Internal Revenue Service records on income and life expectancy that showed staggering differences in life expectancy between the richest and poorest also found evidence that low-income residents in wealthy areas, such as New York City and San Francisco, have life expectancies significantly longer than those in poorer regions. https://news.harvard.edu/gazette/story/2016/04/for-life-expectancy-money-matters/ https://news.harvard.edu/gazette/story/2016/04/for-life-expe...
- pbadg3r 6y ago
  If you're wealthy maybe you're also savvy enough to deal with the system. When a few second opinions with doctor friends are only a phone call away it's not hard to imagine better outcomes better. I recall an article on HN where a dev quit his job to do cancer research when he was diagnosed, and spent the next year getting to top 1% level in cancer analysis for his subtype. That's disposable income in action. Fatal opioid use is less common with wealthy folks, and great diet + exercise + friends (easier if you're rich) are all good prevention mechanisms against antibiotic resistant bacteria.

xwdv 6y ago

Which half made you happier?

TuringNYC 6y ago
TLDR: i'd take unhappy-rich over hungry-poor any day. But the best thing would be the happy medium where you are comfortable enough to afford food/schooling but not in a social class where there are obscene social expectations to spend -- so your question is a fair one. I think the key thing was getting past the lower rungs of the Maslow hierarchy. It is very difficult to concentrate on schooling (or anything) when you are hungry or sick. I was constantly hungry when we didnt have free public school meals. A close relative had TB, due to poor healthcare where the hospital/system didn't seem to give a darn. The worst thing is how horrible normal people treated you (even teachers at public school.) I was constantly sick, probably due to poor nutrition. College was great, I will still poor, but the prospects were getting better and all the basics were covered (no longer hungry; decent healthcare). This allowed more happiness because you knew it would be over soon. With better jobs comes more stress -- the expectations (perhaps justified) that one should have a home, that one should have a school for children w/o crime/gangs -- and bigger mortgages, bigger spending. I live fairly conservatively despite decent career success, but I can see how I could "become unhappy trying to reach happiness" ... all that said, i'd take unhappy-rich to hungry-poor any day.
- medium_burrito 6y ago
  Yeah, that's exactly it- once you have safety, food, shelter and good health and the expectation those will remain, that's amazing. Personally I've decided to forgo as many personal luxuries as possible (ie don't fly first class, no boat besides a shitty canoe, no peasant steel case rolex, no car worth > $20k in an effort to retire with a few million in liquid assets on top of my house by my early 40s. Having no worries is the ultimate luxury. Alternatively, if I lived in California where the weather is mild perhaps I would just go full Diogenes.
  - MeinBlutIstBlau 6y ago
    My goal is to retire to Germany and become a German citizen if I can't get rich here. At least I won't die in my 60's because I can't afford healthcare.
voodootrucker 6y ago
Due to work, I spent: - 3 months in Japan - 3 Months in Germany - 3 months in the US - 3 months in India The transition was alarming. I see bits of both Germany and India in the US. Unfortunately (having grown up in America) I see the trend as towards India. I don't mean this as a cultural slight, but as a cultural observation. I've seen high-trust vs low-trust societies brought up many times on HN. Traffic was most pronounced. In Germany, they obeyed the rules to the extent they wouldn't J-walk even if there was no traffic. In America, you'd look both ways then cross. In India might makes right, big cars get the right of way, pedestrians have to be aggressive and just make their way, eyeballing cars down with a death stare of determination. Anyway all this is to say, it seems like there are two types of wealth: - In India, you can found a startup, make money, buy a Ferrari, but that would be a terrible move because if you drive it anywhere on public roads you will go max 30kph, and it will get destroyed on the roads - In Germany, you can have a modest Skoda and still hit 200 kph on their impeccable freeways with confidence that the person in the right lane will never, ever change lanes without a signal and mirror check So, my personal take, and I realize that this is highly reductionist, but I hope, relevant is that there are two types of wealth: 1. a type where society is wealthy, and that translates into well being for the individual and the whole 2. a type where wealth is relative, and the wealthy take joy not in having an absolute sense of wealth (as in compared to a German), but as in "my neighbor lives in a shack and I live in a gated tower high rise" I fear America is at a cross roads and will make a choice that makes us poor in a global sense.
- ddingus 6y ago
  I found your take thought provoking. HN is always a surprise.
- bleepblorp 6y ago
  Another way to describe the difference between Germany and India is that's the difference between a rich society and a poor society that has (a few) rich people in it. This distinction also correlates with multiple factors of collective well-being, including life expectancy, and income inequality. America made the choice in the 1980s, with the arrival of Reagan, to transition from being a rich society to being a poor society that has a fair number of rich people in it. Income inequality has deteriorated since then, the quality of public services/public infrastructure has severely degraded, and social trust is rapidly eroding. It's almost certainly too late to change course.

kinkrtyavimoodh 6y ago

Coastal America and rest of America might be a better way to cut it.

geogra4 6y ago
I don't think its so geographically aligned like that. Plenty of rich areas in Chicago, Houston, Dallas, Phoenix etc.
- kinkrtyavimoodh 6y ago
  While that is true, I think that some of these things are tied to local culture too, which is why the Coastal distinction does have some merit. If you generally are in the Bay Area or LA you rarely see the level of obesity you see in say Houston despite the fact that both areas despite being rich have their fair share of the poor too. Similarly for smoking. It's exceedingly rare to see public smoking in the Bay Area. Similarly for diets. When traveling in the South I was amazed at just how ridiculously unhealthy the average food eaten by the average person there was. Everything deep fried, laden with calories, consumed along with sugary drinks.
  - deleted 6y ago
    [deleted]
  - Apocryphon 6y ago
    It's still regional rather than simply everyone vs. coastal. Not sure if it's fair to lump in the wealthier Rocky Mountain states like Colorado or Utah in with say the butter and cornfed Midwest.
- lotsofpulp 6y ago
  Data is 5 to 6 years old: County level: https://www.worldlifeexpectancy.com/usa/life-expectancy-by-county https://www.worldlifeexpectancy.com/usa/life-expectancy-by-c... State and county level: https://www.cdc.gov/nchs/data-visualization/life-expectancy/index.html https://www.cdc.gov/nchs/data-visualization/life-expectancy/...

julienb_sea 6y ago

For healthcare, you can probably segment America a little more generously into insured vs uninsured. If you are insured in America, your healthcare is reasonably good. Lower quality plans may have more restrictive networks or higher deductibles and maximums, but these are manageable and neither are truly barriers to care.

bryan11 6y ago
You could segment them in three sets: well insured, people with catastrophic health plans, and uninsured. Many employers are switching to high deductible health plans and that deductible may be thousands of dollars, i.e. catastrophic plans. When going to a doctor for a simple diagnosis or bloodwork can easily cost $400 to $1000, many put off doctor visits unless it's an emergency. It can easily become a choice between a doctor visit or a car repair. Preventative checkups are gone and insurance is only something one uses with an emergency room visit or major health issue.
- TuringNYC 6y ago
  That's a great explanation. It also shows how short-sighted such plans us at a national macro level -- because an ounce of prevention can prevent hundreds of thousands in future future bills. A perfect example is vitamin deficiency and the very serious effects such deficiencies can have, and how inexpensive the preventative care is.
  - kube-system 6y ago
    It is getting better. The ACA mandates coverage for some preventative care.
- Thorentis 6y ago
  $400 for just a bloodtest at a GP? That's insane. All free in Australia, from the initial visit, to the blood taking, to the follow up.
  - 6y ago

socialdemocrat 6y ago

But even that isn't even true. The US system doesn't even benefit the wealthy. For profit health care means a lot of over-treatment which causes several problems in US health care which kills people: - Something like 2x as much surgery done in the US than in other countries, because it is profitable, not because it is needed. So perfectly health people are cut open, because they got a good insurance which can pay for it. - Opioid crisis. Again having health insurance is a problem, not a benefit in this case. That turns you into a money bag, they can push opioids on. - Antibiotic resistance. America is all about getting more of everything. Quantity over quality, which unfortunately also means excessive use of antibiotics making Antibiotic resistance a major problem. The US system really isn't working for anyone. It means those who cannot pay get too little treatment, and those who can pay get too much. If only there was a way to even it out...

zusoomro 6y ago
Do you have any citations / resources that can be used to read more about your perspective here?
StanislavPetrov 6y ago
>The US system doesn't even benefit the wealthy. That's a ridiculous statement, it benefits the wealthy massively. We can argue over whether or not these benefits would be even more massive without over-treatment, but there is no doubt about the overall benefits to the wealthy. >A Harvard analysis of 1.4 billion Internal Revenue Service records on income and life expectancy that showed staggering differences in life expectancy between the richest and poorest also found evidence that low-income residents in wealthy areas, such as New York City and San Francisco, have life expectancies significantly longer than those in poorer regions. https://news.harvard.edu/gazette/story/2016/04/for-life-expectancy-money-matters/ https://news.harvard.edu/gazette/story/2016/04/for-life-expe...
pbadg3r 6y ago
If you're wealthy maybe you're also savvy enough to deal with the system. When a few second opinions with doctor friends are only a phone call away it's not hard to imagine better outcomes better. I recall an article on HN where a dev quit his job to do cancer research when he was diagnosed, and spent the next year getting to top 1% level in cancer analysis for his subtype. That's disposable income in action. Fatal opioid use is less common with wealthy folks, and great diet + exercise + friends (easier if you're rich) are all good prevention mechanisms against antibiotic resistant bacteria.