4 ms·

When one corrects for obesity, this usually goes away. Put it another way, American obesity and metabolic disease can almost entirely account for the gap. Regu

When one corrects for obesity, this usually goes away. Put it another way, American obesity and metabolic disease can almost entirely account for the gap. Regulation prevents market forces from correcting the gap. For example, insurance cannot charge higher premiums based on weight or lifestyle health status.

frankbreetz 5y ago
Insurance does charge higher for smokers and that is certainly a "lifestyle health status".
Arnt 5y ago
I quote at length: "Infants in the U.S. are considerably more likely to die in the poorest counties than in the richest counties, and this is true for both Black and white babies. Black teenagers in the poorest U.S. areas are roughly twice as likely to die before they turn 20, compared with those in the richest U.S. counties. In Europe, by contrast, the mortality rate for teenagers in the richest and poorest areas is exactly the same—12 deaths per 100,000. In America, the problem is not just that poverty is higher; it’s that the effect of poverty on longevity is greater too." Are you suggesting that obesity makes a difference in the US but not in Europe? Or perhaps that obesity varies in the US but is uniform in Europe?
- djokkataja 5y ago
  Obesity rates are significantly higher in the United States than in Europe. https://ourworldindata.org/obesity#what-share-of-adults-are-obese https://ourworldindata.org/obesity#what-share-of-adults-are-...
  - Arnt 5y ago
    Yes, but if GP is right (and I understand correctly) then that should lead to a sloped graph for Europe and (significantly higher on the sheet) sheet another sloped graph for the US. Whereas what the report finds is a flat line for Europe and a sloped graph (higher up) for the US.
- bradknowles 5y ago
  The other factor in Europe is the healthcare system. They have universal healthcare, and we don’t. So, if you don’t have insurance in the US and you’re in a poor neighborhood, then yes — you’re likely to have a lower standard of care. But in Europe, everyone has state-provided insurance, and the quality of healthcare is much more consistent.
  - alkonaut 5y ago
    Most would agree that at least the richest in the US have better care than the lower percentile ms of Europeans. The outcomes according to the article suggests that even the richest don’t reach European longevity. There could be multiple factors overlapping here though I suspect. For all but the richest, public healthcare helps, but for the richest the obesity gap closes any benefit in healthcare (diminishing returns in better care easily overshadowed by even slightly worse lifestyles).
adonovan 5y ago
Until recently, insurance companies could refuse entirely to cover a "preexisting condition" such as obesity. Those market forces were good for noone but insurers.
sprafa 5y ago
Can you share sources/data? The fact that Americans are so obese it’s draining down their lifespan in a collective way is still something that sounds worthy of study.
truculent 5y ago
Those market forces are present in Europe?
djokkataja 5y ago
Obesity is a big factor cough but there are others. I found this article (https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low) that shows a number of factors that contribute to the higher American mortality rate. Unfortunately it does not cover ALL causes of death, though if you want, you could independently investigate that[1]. Compared to Western Europe, Americans die at higher rates from smoking, obesity, homicides, opioid overdoses, and road accidents. There are two other graphed factors that don't have an option to compare with "Western Europe", but on those, it's relatively plain that the United States has a significantly higher infant mortality rate and significantly less access to healthcare. And then there are suicide rates, which have increased some in the United States, but which are middle of the road compared to European countries (France is higher, Germany's about the same, Italy, the UK, and Norway are lower... I did not check these exhaustively). You'll have to click the button on the graph to change the country and then add up the rate by each age to get a comparison. I suppose the middle-range American suicide rate didn't fit the narrative of the article, but the author still wanted to highlight it as a concern given that it's been going up in the United States. (Unfortunately, not every graph shows the same set of countries compared to the United States, which makes me think the author chose to cherry pick countries for specific graphs, and I'm not sure why, because it doesn't seem necessary. For example, the graphs in the article allow you to choose additional countries and sometimes regions to add to the graph; if I add "Western Europe" to each graph where it's an available option, the trends that the author is illustrating are completely preserved.) [1] https://ourworldindata.org/causes-of-death https://ourworldindata.org/causes-of-death
- AnimalMuppet 5y ago
  Wait, France has a higher suicide rate than the US? I find that to be quite surprising.

frankbreetz 5y ago

Insurance does charge higher for smokers and that is certainly a "lifestyle health status".

Arnt 5y ago

I quote at length: "Infants in the U.S. are considerably more likely to die in the poorest counties than in the richest counties, and this is true for both Black and white babies. Black teenagers in the poorest U.S. areas are roughly twice as likely to die before they turn 20, compared with those in the richest U.S. counties. In Europe, by contrast, the mortality rate for teenagers in the richest and poorest areas is exactly the same—12 deaths per 100,000. In America, the problem is not just that poverty is higher; it’s that the effect of poverty on longevity is greater too." Are you suggesting that obesity makes a difference in the US but not in Europe? Or perhaps that obesity varies in the US but is uniform in Europe?

djokkataja 5y ago
Obesity rates are significantly higher in the United States than in Europe. https://ourworldindata.org/obesity#what-share-of-adults-are-obese https://ourworldindata.org/obesity#what-share-of-adults-are-...
- Arnt 5y ago
  Yes, but if GP is right (and I understand correctly) then that should lead to a sloped graph for Europe and (significantly higher on the sheet) sheet another sloped graph for the US. Whereas what the report finds is a flat line for Europe and a sloped graph (higher up) for the US.
bradknowles 5y ago
The other factor in Europe is the healthcare system. They have universal healthcare, and we don’t. So, if you don’t have insurance in the US and you’re in a poor neighborhood, then yes — you’re likely to have a lower standard of care. But in Europe, everyone has state-provided insurance, and the quality of healthcare is much more consistent.
- alkonaut 5y ago
  Most would agree that at least the richest in the US have better care than the lower percentile ms of Europeans. The outcomes according to the article suggests that even the richest don’t reach European longevity. There could be multiple factors overlapping here though I suspect. For all but the richest, public healthcare helps, but for the richest the obesity gap closes any benefit in healthcare (diminishing returns in better care easily overshadowed by even slightly worse lifestyles).

adonovan 5y ago

Until recently, insurance companies could refuse entirely to cover a "preexisting condition" such as obesity. Those market forces were good for noone but insurers.

sprafa 5y ago

Can you share sources/data? The fact that Americans are so obese it’s draining down their lifespan in a collective way is still something that sounds worthy of study.

truculent 5y ago

Those market forces are present in Europe?

djokkataja 5y ago

Obesity is a big factor cough but there are others. I found this article (https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low) that shows a number of factors that contribute to the higher American mortality rate. Unfortunately it does not cover ALL causes of death, though if you want, you could independently investigate that[1]. Compared to Western Europe, Americans die at higher rates from smoking, obesity, homicides, opioid overdoses, and road accidents. There are two other graphed factors that don't have an option to compare with "Western Europe", but on those, it's relatively plain that the United States has a significantly higher infant mortality rate and significantly less access to healthcare. And then there are suicide rates, which have increased some in the United States, but which are middle of the road compared to European countries (France is higher, Germany's about the same, Italy, the UK, and Norway are lower... I did not check these exhaustively). You'll have to click the button on the graph to change the country and then add up the rate by each age to get a comparison. I suppose the middle-range American suicide rate didn't fit the narrative of the article, but the author still wanted to highlight it as a concern given that it's been going up in the United States. (Unfortunately, not every graph shows the same set of countries compared to the United States, which makes me think the author chose to cherry pick countries for specific graphs, and I'm not sure why, because it doesn't seem necessary. For example, the graphs in the article allow you to choose additional countries and sometimes regions to add to the graph; if I add "Western Europe" to each graph where it's an available option, the trends that the author is illustrating are completely preserved.) [1] https://ourworldindata.org/causes-of-death https://ourworldindata.org/causes-of-death

AnimalMuppet 5y ago
Wait, France has a higher suicide rate than the US? I find that to be quite surprising.