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Why is life expectancy in the US lower than in other rich countries? (2020)
- bediger4000 4y agoInteresting. Thanks for posting. If true, one could reasonably conclude that anything that makes money (smoking, guns, opioids) is allowed to continue even if it has bad effects, and anything that costs (pre-natal care) is neglected, even if it has good effects.
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- kitkat_new 4y agocars
- collinc777 4y agoWe fat
- pempem 4y agoso summarizing thus far: - lack of access to affordable care - lack of legislation protecting the populous from crap food
- lotsofpulp 4y agoI am imagining Oreos and Big Gulp drinks assaulting people as they walk past by forcing themselves into their victims' mouths.
- durakot 4y agoImagine a country where second grade kids in mid-western states, myself included, would be led by teachers in class to sing songs that go "pizza hut, pizza hut, kentucky fried chicken and a pizza hut..."
- lotsofpulp 4y agoSounds like those kids need protection from crap teachers, not crap food.
- whatshisface 4y agoImagine ads persuading people and you've got closer to the truth.
- lotsofpulp 4y agoI would not be opposed to taxpayer funded ads for people to eat fewer carbs and more healthy stuff. Show unattractive people stuffing cookies into their face and attractive people eating sprouted mung beans or something.
- whatshisface 4y agoHow would you make that program fair and balanced between all specialty farmers?
- lotsofpulp 4y agoI would not care about farmers at all. Farmers can respond to supply and demand. Society’s goal would be to increase demand of healthy foods, and decrease demand of unhealthy foods.
- whatshisface 4y agoRunning on a platform of doing a big study and deciding policy scientifically is like running on a platform of wanting to spend more time with your family: people will like you for it, and vote for someone else.
- pempem 4y ago???? If you have the opportunity travel to Belgium or Germany and just order a burger. Notice the difference. Its not just "attractive people stuffing their face with mung beans" its literally availability of food and regulation.
- lotsofpulp 4y agoNo one is forced to eat an unhealthy burger. Advertise the unhealthy burgers as unhealthy, increase demand for healthy burger (or healthier, since there might not really be a healthy burger). Advertise the sugar and sodium and carb and sat content prominently.
- ARandomerDude 4y agoSilence, peasant! Silicon Valley and Washington D.C. can run your life better than you can.
- mathverse 4y agoAs a european i only see 2 types of americans. Those that are fat and those that are super fit. Rarely I see someone with just an avg body.
- ARandomerDude 4y agoThis may also be reflective of the demographic of people who are willing to spend money to travel to Europe. We certainly have a lot of fat (and fit) people in the US, but anecdotally most people I know are somewhere in between.
- rootusrootus 4y agoI don't know many people that are either super fit, or super fat. A few of each. Perhaps 99% of my friends & family group is just average people. Could stand to lose 10 or 20 pounds, no doubt, but that's not at all unique to America.
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- mbrodersen 4y agoWhat you think of as “average” is actually obese/unhealthy. It is “average” because of most Americans being overweight/obese. Look at photos form the US taken 40 years ago and you will see what healthy non-obese people look like.
- pempem 4y agoAs an American (who believes they are average but who's to say) I would push you to correlate this with class as well. Stores like whole foods, erewhon, etc. have better produce quite literally and better products. 'good' food is simply more expensive than foods that are fattening. its a policy problem.
- rightbyte 4y agoI really disagree. Walmart is fine and healthy food is cheaper than unhealthy. Walmart sell carrots and potatos too. Way better than my supermarkets at home. The main problem is people on a poor diet buying expensive premade stuff with alot of fat and sugar in it. A policy problem I have noticed however is pizza and hamburgers with soda as every day meals in the school cafeteria, as a choice for the pupils. That is just insane from a health perspective.
- grapeskin 4y agoIn all honesty, this is a huge one. Having gone around Europe a couple weeks ago, I noticed store and restaurant staff would greet some people in English and some in the local language, very rarely seeming to use the wrong language. Sitting on one particularly busy restaurant street, the pattern suddenly became obvious to me: people over a certain weight were always greeted in English. People who were middle aged and not obese were always greeted in the local language. As an American myself, weights I’ve grown accustomed to as “normal” really are inconceivably big by world standards. It made me realize that even though obesity rates may be high around the world, the amount of weight by which they’re obese are completely different leagues.
- rootusrootus 4y agoI don't buy it. Some areas of the US have obesity rates similar to western Europe (and let's be honest, when your obesity rate is 1 in 4, you don't get to brag about it being low). I suspect there are other indicators that an experienced person could use to identify nationalities without requiring a verbal conversation first.
- mbrodersen 4y agoThe problem is not fat. The problem is insulin resistance. You can be skinny and extremely unhealthy (non-alcoholic fatty liver for example).
- 31835843 4y agoWhen looking at statistics like this, it’s somewhat unhelpful to consider the US one country. Because of the low density of the population + essentially no federal government, the US is really a few different regions with vastly different outcomes.
- nradov 4y agoUS federal government spending is about 30% of GDP. That's pretty far from "no federal government".
- loudthing 4y agoWith a good chunk of that money being allocated to getting young Americans killed (i.e. military spending).
- nradov 4y agoMilitary expenditure is only 3.7% of GDP.
- vkou 4y agoYes, but their deaths pay for a global hegemony, a friendly trade climate, and access to other countries' natural resources. Also, you're forgetting all the money that flows directly back into your states, through infrastructure spending, federal services, federal share of funding state services, etc. (Which is a convoluted way of moving money from 'have' states into 'have-not' states.)
- googlryas 4y agoWe spend so much on the military exactly so we don't have to send young Americans in to meat grinders. How many Americans have been killed in the past 20 years during military operations? Approximately 10,000. If that's all the young American deaths we get for trillions of dollars in spending, that is not a great bang for your buck at all. Hell, more than twice that amount died in one day on September 17, 1862.
- whoomp12342 4y agoaccess to affordable health care.
- igouy 4y ago"Many of the important factors – smoking, obesity, violence, poverty – are not about providing better healthcare for those that need it, but about preventing poor health outcomes in the first place."
- csw-001 4y agoWe spend a lot on our healthcare system because we spend so little on our public health systems. An ounce of prevention…
- nradov 4y agoI think we should provide every US legal resident with affordable access to health care, but the lack of it doesn't significantly impact life expectancy at the aggregate population level. Only about 10% lack medical insurance. Other factors like obesity, substance abuse, lack of exercise, and preventable trauma are far bigger factors pushing down national life expectancy.
- peoplefromibiza 4y agoSince the conclusions are at the end of the article, there's no need to guess Every country should and can do better in this respect, but a particular weakness of the US is a lack of success in preventing poor health. Many of the important factors – smoking, obesity, violence, poverty – are not about providing better healthcare for those that need it, but about preventing poor health outcomes in the first place. The failure to prevent poor health is a factor that is contributing to both developments shown in the first chart. They worsen the health of the American population and they are expensive for the healthcare system.
- humanwhosits 4y agoLack of access to free healthcare?
- igouy 4y ago"Many of the important factors – smoking, obesity, violence, poverty – are not about providing better healthcare for those that need it, but about preventing poor health outcomes in the first place."
- txsoftwaredev 4y agoOne issue is having an open border that allows trafficking of deadly drugs. "Between 2020 and 2021, nearly 79,000 people between 18 and 45 years old — 37,208 in 2020 and 41,587 in 2021 — died of fentanyl overdoses, the data analysis from opioid awareness organization Families Against Fentanyl shows." We also push vaccines during a pandemic that was primarily killing the obese in the greatest numbers but no mention of exercise and a reasonable diet.
- notch656a 4y agoIt's not the accessibility of deadly drugs as much as the unknown variability in the drugs addicts use, causing them to unexpectedly overdose. One could make a compelling argument these drug deaths are actually because the borders aren't freely open to wholesale lab produced narcotics.
- chmod775 4y ago>One issue is having an open border that allows trafficking of deadly drugs By this logic the US should have higher life expectancy than the countries it's being compared to. >We also push vaccines during a pandemic that was primarily killing the obese in the greatest numbers but no mention of exercise and a reasonable diet. When you're trying to explain differences you should focus on things that are actually... different. Obesity, maybe. Vaccines, not so much.
- txsoftwaredev 4y agoMy point was the messaging from the various "authorities" in the US. They only pushed vaccines, they never said that it's time to focus on your weight and exercise.
- corrral 4y agoSaying "lose weight" doesn't work. Ask some doctors—once their eyes stop rolling, they'll tell you how rarely counseling patients about weight loss has any effect. Further, it certainly won't help much when you're dealing with a timeframe best measured in months.
- danschumann 4y agoGuns, drugs, and rock n roll? Basically Hunter S Thompson effect...
- loudmax 4y agoComparing the US average life expectancy to the average of other rich countries is tricky because the US population is so much bigger and more diverse than most other countries. If US data were broken down by state, we'd probably see life expectancy in some states more like rich northwestern European countries, and some states more like poor southeastern European countries. For all that, US healthcare is still uniquely optimized to maximize cost.
- spaniard89277 4y agoI'd say it's mostly a question of lifestyle. You can have all paliative halthcare you want, what matters is regular exercise, good diet and I guess other factors like pollution.
- peoplefromibiza 4y ago> Comparing the US average life expectancy to the average of other rich countries is tricky because the US population is so much bigger and more diverse I read this argument a lot, in various formulations. The truth is that the the US State with the higher life expectancy is Hawaii [1] at 82.3 years, comparable to New Zealand, that ranks 19th (or 16th depending on the year taken in consideration 2021 [2] or 2022 [3]) in the list of countries by life expectancy. The 4th State in the list, Minnesota, is already out of the first 30. That's why on average US score pretty badly, even worse than some undeveloped countries. [1] https://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_life_expectancy https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ... [2] https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy https://en.wikipedia.org/wiki/List_of_countries_by_life_expe... [3] https://www.worldometers.info/demographics/life-expectancy/ https://www.worldometers.info/demographics/life-expectancy/
- EricE 4y agoFunny how Hawaii, due to it's geographic isolation, probably doesn't suffer from illegal immigration to the extent as other states.
- lolpython 4y ago
- ejb999 4y agodrugs and the standard American diet - its not rocket science. over 36% of the country is obese, compared to germany at 22%, finland at 22%, belgium at 22% norway at 23%, spain at 24%, poland at 23% etc. Maybe other reason as well, but improving the american diet would improve health more than anything else. Food companies should be sued like tobacco companies were for the poison they peddle.
- rootusrootus 4y agoSome areas of the US have obesity rates in the 20s. Some in the 40s. Generalizing 330 million people is hard.
- onos 4y agoOr we could use a carrot: eg don’t smoke and not overweight —> tax break.
- ejb999 4y agoI prefer: Let insurance companies offer discounts to those that don't smoke and are not overweight; I get a discount for being a good driver, why shouldn't there be a discount for not living a lifestyle that is likely to use more medical care?
- rootusrootus 4y agoHow does life expectancy compare between, say, the Pacific Northwest, and the Deep South? I'd like to see that first before I homogenize the entire US and compare to a small country in Europe. E.g. obesity rates vary considerably around the US.
- HNDen21 4y agoPeople living in cities like New York City also live longer.... They walk a lot compared to suburbs where you have to drive everywhere
- rootusrootus 4y agoThat could be true, though as a suburbanite myself, I have to say that what we seem to do most is walk & run. It's just not forced. After the first few miles of walking per day, I don't think the extra really contributes significantly more health benefits.
- batshibstein 4y agoIt's more the downside of automobile usage, statistically, than the upside of exercise, although I'm sure both factor in.
- dmoy 4y agoWashington State life expectancy is like 80 years. Alabama is maybe 75. The best US states are at about the EU average.
- rootusrootus 4y agoThat sounds like a good, if informal argument that obesity is a primary factor. Or maybe exercise, which is certainly going to be correlated with obesity. You can be fit and still overweight, for sure, but only to a limited extent.
- notch656a 4y agoIf you drop a bunch of Danes, Swiss, or many of these other people in the US their life expectancy in the US would be almost as good. This life expectancy graph should include nations from which US draws much more disproportionately, such as Mexico, Africa (former slaves), Central American nations, etc. For instance, Hispanics have much greater life expectancy in the US vs many of the nations from which they draw. US provides a lot of these opportunities where nations like Switzerland less proportionately provide. And to the person who pretended like they didn't understand that most slaves came from African regions with low life expectancy, they know they're playing the disingenuous game where they try to pretend the US hasn't greatly risen the life expectancy (presently) of these offspring vs had they been born in their forefather's nation. Including these African nations on the chart would show that, but someone (perhaps racist since they chose not to include Africa) with an agenda left them out. -------------- >Also what does being descended from someone who worked as a slave have to do with anything A nice attempt to play dumb and act like these slaves didn't disproportionately come from nations with low life expectancy, in which their descendants quite likely would now live had they not been unjustly removed from their homes. Of course commenter knew this all along, but tried to bait the question.
- MrsPeaches 4y agoSee sister comment re Hispanics: https://news.ycombinator.com/item?id=31911584 https://news.ycombinator.com/item?id=31911584 Also what does being descended from someone who worked as a slave have to do with anything?
- pkaye 4y agoHere is a life expectancy breakdown by state with comparison to other countries. Interestingly Hispanics have higher life expectancy than whites. https://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_life_expectancy https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ...
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- jdlyga 4y agoThe rich areas of the US do have high life expectancy. New York, New Jersey, Massachusetts, etc. But there are a lot of very poor regions too that drag the average down. For a european equivalent, take western europe and group it with eastern europe and that's basically the United States. But you can absolutely compare Switzerland with New Jersey (Switzerland is twice as big, but the populations are shockingly almost the same).
- peoplefromibiza 4y agoNew Jersey has a life expectancy between French Guiana and Maldives (39th and 40th worldwide), Massachusetts is comparable to Puerto Rico. > But you can absolutely compare Switzerland with New Jersey Switzerland ranks 4th Worldwide, with 4 year longer average life expectancy, vs NJ that scores between 39th and the 40th place, as aforementioned.
- rnk 4y agoWe all know in the us. Lack of universal affordable health care for all, a social safety network that treats people with illness, loss of income, life challenges, etc. Plenty of people see the lack of these things are great things about America.
- nostromo 4y agoThese articles always tend to focus on small and/or homogenous countries. Comparing the US to many of these countries (Japan, Iceland, Israel, Finland) is comparing apples and oranges. A better example is Brazil, which is very diverse, like the US, with people from different cultures all over the world, and also large geographically and in terms of population. Like the US, Brazil has high wealth inequality, high homicide rates, low social cohesion, etc. These kinds of countries have to find new solutions. Sao Paulo or New York is not going to become Tokyo overnight -- they're just fundamentally different.
- swatcoder 4y agoCan you elaborate on how you see cultural diversity causing lowered life expectancy? I’m not saying you’re wrong, but the nature/mechanism of any causal connection isn’t obvious on its face. Do you have something specific in mind?
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- slg 4y agoWhy is diversity and size of the country more important to life expectancy than other criteria such as wealth of the country? The US is a much richer country than Brazil, roughly 10th in per capita GDP vs 90th depending on what list you use. That wealth should theoretically allow for better healthcare.
- EricE 4y agoHow many immigrants - at the lower end of the socio-economic spectrum - does Brazil let in each year?
- sfuller808 4y ago
- oezi 4y agoAnd why would immigrants have lower life-expectancy? Why would the immigration to the US skew the result if we compare for instance with immigrants to Europe (mostly from Africa/Asia). It seems it is a comparable rate.
- nathias 4y agoI have never seen an old fat person.
- rootusrootus 4y agoDefine old? I've seen plenty of fat people in their 80s.
- nathias 4y agoI mean 50+ I've seen a lot of kind of fat and flabby but not really obese ones ...
- csw-001 4y agoReally? We like to elect them President from time to time…
- mbg721 4y agoYou gotta bring up Taft again?? Geez,
- jlawson 4y agoIt's foolish to compare statistics about all Americans to small homogenous countries like Norway or Japan, as though the difference comes from policy. The people are completely different. How do the outcomes of Norwegians compare to those of Norwegian-Americans? How do the outcomes of Japanese compare to those of Japanese-Americans? Here we can start seeing the effects of policy.
- bartkappenburg 4y ago/offtopic What happened to the ranking of this post? It was top 3 (yeah!) and now it’s suddenly 40+ … How can this happen? Dang?
- NDizzle 4y agoExcess... drive by one of your local dialysis centers. I wonder what percentage of diabetics are type 1 in the US? Has to be a tiny percent, just using my eyeballs and looking around.
- areyousure 4y agoIn case anyone is curious, https://www.diabetes.org/about-us/statistics/about-diabetes https://www.diabetes.org/about-us/statistics/about-diabetes suggests that ~5% of diabetics in the United States have type 1 diabetes, but estimates vary within roughly a factor of two.
- EricE 4y agoI love how they completely ignore demographics - show me other "rich countries" that have the influx of immigration - especially to those with immigration skewed towards the lower end of the economic spectrum - that is at epidemic proportions as we are facing in the US now.
- mbrodersen 4y agoAustralia.
- nickd2001 4y agoOne glaring omission from that article seems to me to be lack of environmental protection e:g in USA all manner of food additives are allowed that EU for example would ban. Bovine growth hormone is allowed. I'm not sure if it's that, or soft drinks, that makes some Americans so huge. There are many people in other countries that are sedentary , live unhealthy lifestyles, drive everywhere, but the true hugeness of some people seems to me uniquely American. Pesticides like glyphosphate are allowed in USA. Waste water from fracking poured on the road and finds its way into the water system. When I, as a Brit, worked in USA for a while 25 yrs ago, I noticed people constantly complaining about allergies, and also a rather large number of people that had had cancer (albeit the health system seemed to have sorted them out and got them better). This wasn't something I heard so widely discussed back home and I surmised it was due to chemicals. Since then, I think the UK has got worse and more people here complain of allergies now, presumably due to imported food or domestic use of chemicals.
- shawndrost 4y agoIt's very surprising to see so little mention of race/ethnicity forces in this article, since I understand that to be a large part of the answer to the headline question. There is a gap of a couple years between Americans from Asian, Latino, White, and Black/Native ethnicities (in that descending order). https://nationalequityatlas.org/indicators/Life_expectancy#/?geo=01000000000000000 https://nationalequityatlas.org/indicators/Life_expectancy#/... For Asian- or Latin Americans, life expectancy is comparable or favorable vs respective countries of ethnic background. This remains true for richer countries; Chinese-Americans have a life expectancy of 86.8 vs 85 in Hong Kong and 75 in mainland China. Meanwhile, Black and Native Americans live several years fewer than other Americans, and (at only 14% of population) account for ~1.6 years of the ~3.4 year life expectancy difference between the US and the G7. White Americans, esp rural, seem significantly worse off than European countries. These differences in racial outcomes seem to persist when controlling for SES: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849870/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849870/ (Not that any of my comment is in conflict with the causes pointed to in the article -- smoking, obesity, homicides, etc.)
- ChrisArchitect 4y ago(2020) Previous discussion from 2 years ago: https://news.ycombinator.com/item?id=25193796 https://news.ycombinator.com/item?id=25193796
- screye 4y agoIs American life expectancy lower after controlling for obesity and malnutrition ? The 2 most affected communities are also the 2 most obese.
- PeterWhittaker 4y agoA few comments opine upon the seeming unfairness of comparing the US to countries considered more “homogeneous”. OK, let’s compare the US to its similar North American neighbour, Canada, using the info in the article. The US still lags by a considerable margin. Thems of us north of the border are somewhere between surprised and appalled at how little the US population and leadership seems to care about how much worse off Americans are than their peers in other countries. Y’all have a lot more wealth, sure, but a lot more poverty, a lot more deathfrom treatable conditions, and a lot more incarcerated, for what it’s worth.
- TMWNN 4y ago>OK, let’s compare the US to its similar North American neighbour, Canada, using the info in the article. >The US still lags by a considerable margin. Canada's racial makeup is, more or less, white + Asian. Blacks—the group with the lowest life expectancy in the US—are almost nonexistent in Canada.
- PeterWhittaker 4y agoNon-existent? 4% of the population, according to StatsCan, compared with 12% in the US. Not sure that 4% is small enough to not matter, equally unsure that 12% is large enough to skew results as heavily as you would seem to suggest.
- myroon5 4y agoOrdered by rough annual differences per 100,000: Infant mortality: 540-340=200 (only considering infant population) Obesity: 69-29=40 Smoking: 92-58=34 Opioids: 14-1=13 Road accidents: 11-4=7 Suicide: 16-11=5 Homicide: 5-1=4 Infant mortality is either by far the largest rate difference if you consider the relevant population to be only infants or the smallest rate difference if you consider the relevant population to be the population at large https://ourworldindata.org/grapher/infant-mortality https://ourworldindata.org/grapher/infant-mortality https://ourworldindata.org/grapher/suicide-mortality-rate https://ourworldindata.org/grapher/suicide-mortality-rate Shocking how quickly opioids became a major life expectancy difference in a couple decades while every other rate other than suicide is decreasing over time, especially since it's nowhere as prevalent in the other countries Promising how much smoking rate has dropped in America, obviously some lag so hopefully that brings smoking mortality down a lot in the future
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