6 ms·

Tackling America's weirdly short life expectancy should be a priority

36 points by barry-cotter 3y ago

cjs_ac 3y ago
As someone who lives outside America and has a poor opinion of America's healthcare system, I think that life expectancy is meaningless without discussing quality of life for octogenarians. Even with the slight decrease, Americans' life expectancy remains just short of 79 years, but what is it like to be that old? Modern medicine and infrastructure has extended the body's lifespan, but no such improvement has been made for the brain's lifespan. I remember going to visit my grandfather on the dementia ward, surrounded by the equally addled. I remember the toll on my grandmother of caring for him before he went into professional care, to the point that she died before him, younger than him. I have to ask, was the money spent, the labour expended by professional carers, worth it? I'm not sure that when my time comes, that I want money to be spent keeping my body alive while my brain degenerates. If one can't enjoy those extra years, what is the point of having them?
- causality0 3y ago
  Quite so. It's fascinating how we take a compassionate, rational approach when it comes to not letting our pets spend the remainder of their lives in misery yet we cannot extend the same care to ourselves.
  - mensetmanusman 3y ago
    We can, we have just learned from history we haven't been able to not abuse such power.
  - Qem 3y ago
    I wouldn't call it compassionate. The pets can't have a word on it. I think it's egotistical. Pets make us fun. When they stop being a fun source, we kill them and replace with "puppy-mill" sourced younger ones, while congratulating ourselves for our "piety". We force-sterilize them, for our own convenience. Just like slavery was once considered normal by slave-owners, but now we all see it as a barbaric practice, I think future generations will look down upon us, for the way we used to treat animals.
    - JumpCrisscross 3y ago
      > pets can't have a word on it. I think it's egotistical. "End-of-life care accounts for about 10-12% of all healthcare spending" [1], though "spending in the last three calendar years of life reached 24.5 percent in Taiwan," suggesting "high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions" [2]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282187/#:~:text=According%20to%20one%20estimate%2C%20end,%24%2029%20billion%2C%20respectively2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282187/#:~:tex.... [2] https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0174 https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0174
- giraffe_lady 3y ago
  > I'm not sure that when my time comes, that I want money to be spent keeping my body alive while my brain degenerates. If one can't enjoy those extra years, what is the point of having them? Famously an opinion held mostly by people for whom this choice is remote and abstract. In practice what we find is that when this reality is imminent, people overwhelmingly choose to live. Regardless of what they claimed they would want when they were younger and healthier.
  - Qem 3y ago
    It makes me sad the way people discount elderly people lives, as some lesser form of life not worth living anymore. It makes me skeptical about most proposals to regulate euthanasia, because once it's normalized, I suspect social pressure will start to build-up and press seniors to request it, even when they don't really want.
- Qem 3y ago
  > Modern medicine and infrastructure has extended the body's lifespan, but no such improvement has been made for the brain's lifespan. IIRC, it was discovered recently just the shingles vaccine reduces the probability of dementia by 20%.
  - Auracle 3y ago
    Many vaccines have been shown to reduce the chance of Alzheimer’s, along with good sleep - which is important for your immune system.
- nradov 3y ago
  So what are you proposing? Assisted suicide laws require the patient to be of sound mind. One dementia has set in they can't legally consent.
tptacek 3y ago
Spoiler: it's opiates, guns, and, most especially, cars.
- candiddevmike 3y ago
  I think you could argue those three things are cause by our dysfunctional government, with no solution in sight.
- frowawayxd 3y ago
  i feel like you’re missing the elephant in the room.
- mym1990 3y ago
  Uhh, it’s definitely our lifestyle and healthcare system, which promotes passive treatment rather than early identification of diseases, primarily heart disease, diabetes, and cancer. Alzheimer’s too but early identification of this is still not a reasonable expectation atm. Also, fwiw, the article talks a lot in terms of comparisons and where gains can be had in relative terms. But in absolute terms, those 4 items above are still going to be the most crucial to really moving the needle on life expectancy. You named all the really headline grabbing ones though, so good job on that!
  - tptacek 3y ago
    You disagree with the article then, not me, because that's what it's about.
    - mym1990 3y ago
      Well in that case your headline is as good as the tabloids, thanks!
      - tptacek 3y ago
        Did you come to a different conclusion about the actual content of this article than I did?
NelsonMinar 3y ago
One piece of America's low average life expectancy is our high infant mortality rates. We have the highest mortality rate of any wealthy nations at 5.4 infant deaths per 1000 live births. (Compare 2-3 / 1000 in Western Europe [2]). And that rate is highly correlated to race and ethnicity, nearly double for infants born to Black parents [3]. 1: https://www.cnn.com/2018/01/08/health/child-mortality-rates-by-country-study-intl/index.html https://www.cnn.com/2018/01/08/health/child-mortality-rates-... 2: https://worldpopulationreview.com/country-rankings/infant-mortality-rate-by-country https://worldpopulationreview.com/country-rankings/infant-mo... 3: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm https://www.cdc.gov/reproductivehealth/maternalinfanthealth/...
- giraffe_lady 3y ago
  Notably dramatically reduced for minorities, like many other grim american racial/medical stats, when the doctors are also a minority. Another reason why the supreme court university decision is a direct attack on already vulnerable groups.
  - deleted 3y ago
    [deleted]
- tptacek 3y ago
  Be a little careful here, because different countries count infant mortality differently. Mortality later in life is cut-and-dried, but infant mortality isn't some countries categorize stillbirths differently, for instance.
  - olddustytrail 3y ago
    Specifically which European nations count infant mortality differently? I keep hearing this claim but I've never seen anything to back it up. And it would have to be pretty much all of them to account for the difference, right?
    - 3y ago
nayuki 3y ago
> land use policy is implicated in a decent chunk of this. America’s fatalities per kilometer driven are very average, but we drive a lot more than anyone else, including residents of Canada and Australia Nice call-out there!
michaelteter 3y ago
This is not a healthcare problem, this is a lifestyle problem. The US has led the world in lifestyle changes, which I would argue are almost entirely economically (capitalistic business) driven. Incomplete and in no particular order, there are the government diet guidelines which have at times been primarily driven by certain industries (agricultural organizations including corn growers, sugarcane growers, dairy producers), including pharmaceutical industries... And then the energy industry + auto industry, which has led to more time sitting in cars, combined with the explosion of the fast food industry... And the soft drink industry where Coke began by promoting its drink as a health elixir... and on and on. Of course, the "solutions" to many of the mistakes have been more industries pushing fixes like artificial sweeteners, "health" drinks, energy/sports drinks, low-fat processed foods, diet pills and fads, and other finance-based attempts to sell a new thing rather than address the real problems. The rest of the world will follow suit in terms of health decline. It's already evident, as other countries adopt US patterns of prepackaged foods, fast foods, sugar (and fake sugar) drinks, cars, etc. An easy way to spot this is to go to a country (like Netherlands, where I've been for some years). The older folks tend to be generally lean; many old folks here still bicycle. The < 30 crowd, particularly the 12-20 crowd is fatter and more American shaped. Go to parts of Asia and you see the same thing. As comfort, convenience, and easy bad (cheap) choices expand, so do the bodies of the people. The younger ones who grow up with this have a different lifestyle than their parents or grandparents. While the older populations are indeed getting less healthy (increased body mass, reduced exercise), the change is slower for a number of reasons. Meanwhile, the kids who grow up with this new lifestyle start on a bad trajectory and know no alternative. WALL-E pretty much illustrated the final state of the current trajectory we are on, both in health and ecologic terms.
- JimtheCoder 3y ago
  "The < 30 crowd, particularly the 12-20 crowd is fatter and more American shaped." I am going to rid my vocabulary of the word "fat" and just refer to people as "American Shaped" from now on...
- tptacek 3y ago
  This is an article that is largely about how the life expectancy gap in the US isn't defined by health outcomes, but rather drugs, guns, and, most especially, cars.
localplume 3y ago
[dead]
lkbm 3y ago
One thing that stands out for me in this article is Figure 3: Europe shows a significant mortality of adults 20-65 drop from 2005 to 2018. What has improved there? Improvements in cancer treatments seem like it would mostly show up in the 65+ range. Is it mostly lower air pollution + fewer traffic accidents?
jmclnx 3y ago
One nit I have about Life Expectancy, it should also include quality of life. By that I mean, it you are unable to take care of yourself, I think Life Expectancy should be adjusted to take account of life quality. For example, if you are in a Nursing Home or if you are bed ridden, I would say your "life" is reduced by half the amount of time spent there. But as other said, infant mortality is a big factor. With the US abortion bans in some places, I expect infant mortality to rise. IIRC, on ave, Right Wing controlled already have the highest infant mortality rates.
trashface 3y ago
Its mostly a result of chronic low income. Inflation has raised the ceiling for income, but the floor is still zero and many people (including me) are close to that. Job security has gone to shit even for college grads and decent paying jobs are heavily gate-kept, most people in bottom 40% of income distribution don't even have a chance of getting one of those. Low income = lower quality diet, less access to health care, lower quality housing and ultimately (for some) drug use and other hardship-related problems. This is also why it will never be addressed, as low-income issues have not been a priority in America for a long time (the most recent budget bill made it harder for SNAP recipients) and right now states are kicking millions of people off medicaid because they didn't complete paperwork.
- tptacek 3y ago
  Do you see the article saying that, and, if so, where?
  - trashface 3y ago
    No, I didn't read it again. I read it last year when matt first wrote it (its a year old). My impression is he is generally out of touch with this issue and other income-related issues, he needs to get out of DC more.
    - tptacek 3y ago
      He's reporting other people's statistical analysis of life expectancy; should they get out of DC more, too?
- brigadier132 3y ago
  > Low income = lower quality diet I don't buy it. Most of Europe has lower income than the US but the quality of their food is just vastly superior. Just watch this video https://www.instagram.com/reel/CtzaSnGMIEN/?igshid=MzRlODBiNWFlZA%3D%3D https://www.instagram.com/reel/CtzaSnGMIEN/?igshid=MzRlODBiN... I suspect it's a combination of low quality food and not walking.
bannedbybros 3y ago
[dead]
ttpphd 3y ago
Uh. Ahem. Clears throat In a very Matty voice: different places have different life expectancies and that's ok.
monero-xmr 3y ago
America has very decentralized governance and the states have a lot of power, especially when it comes to the medical system and Medicaid. You need to assess 50 states more like 50 countries when comparing them. Massachusetts has a higher population than Norway. There is a lot of nuance - we also allow millions of illegal immigrants every year, who can themselves get drivers licenses and access state resources, which further makes any discussion very difficult. I find statistics that try to aggregate such a huge and dynamic population very suspicious. I do know that Canadians stream across the border to America when they are told their life saving procedures are months or years in the queue.
deleted 3y ago
[deleted]
andrewl 3y ago
Among the surprises in this article were these: “The US appears to screen more vigorously for cancer than Europe and people in the US who are diagnosed with cancer have higher 5-year survival probabilities.” There is a similar, though not quite as strong, pattern with cardiovascular disease — it is treated more aggressively on average in the U.S., and survival odds are better. A detailed survey of prostate cancer evidence shows that “The combination of earlier detection and aggressive treatment in the US has produced greatly improved survival chances for men diagnosed with prostate cancer.” Similarly for breast cancer, America does more early screening and more aggressive treatment with the result that “the US has experienced a significantly faster decline in breast cancer mortality than comparison countries.” The abstract of the paper they came from (which is linked in the article) is: Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.
seanmcdirmid 3y ago
Ya. The USA’s problem is mostly due to income inequality and a lack of will to correct nutrition disorders at the level of society.
- Georgelemental 3y ago
  > The USA’s problem is mostly due to income inequality The post specifically refutes this: Europeans live longer than Europeans at all income levels.
  - seanmcdirmid 3y ago
    > Europeans live longer than Europeans at all income levels. That isn't what I am claiming though. Specifically, that higher income inequality leads to poorer outcomes on average, not that all income levels would somehow have similar outcomes. In this case, it is the income inequality in the states (with a lack of a social safety net to redistribute much income as in Europe) that causes the worse outcomes, not the income level itself. In Europe, a social safety net provides you with similar healthcare at lower income levels anyways, which isn't true in the US (perhaps we should rename income inequality into wellness inequality?).
keernan 3y ago
Tackling Americans' weirdly short life expectancy should be a priority. But America's weirdly short life expectancy should be an equal priority.

36 points by barry-cotter 3y ago

As someone who lives outside America and has a poor opinion of America's healthcare system, I think that life expectancy is meaningless without discussing quality of life for octogenarians. Even with the slight decrease, Americans' life expectancy remains just short of 79 years, but what is it like to be that old? Modern medicine and infrastructure has extended the body's lifespan, but no such improvement has been made for the brain's lifespan. I remember going to visit my grandfather on the dementia ward, surrounded by the equally addled. I remember the toll on my grandmother of caring for him before he went into professional care, to the point that she died before him, younger than him. I have to ask, was the money spent, the labour expended by professional carers, worth it? I'm not sure that when my time comes, that I want money to be spent keeping my body alive while my brain degenerates. If one can't enjoy those extra years, what is the point of having them?

causality0 3y ago
Quite so. It's fascinating how we take a compassionate, rational approach when it comes to not letting our pets spend the remainder of their lives in misery yet we cannot extend the same care to ourselves.
- mensetmanusman 3y ago
  We can, we have just learned from history we haven't been able to not abuse such power.
- Qem 3y ago
  I wouldn't call it compassionate. The pets can't have a word on it. I think it's egotistical. Pets make us fun. When they stop being a fun source, we kill them and replace with "puppy-mill" sourced younger ones, while congratulating ourselves for our "piety". We force-sterilize them, for our own convenience. Just like slavery was once considered normal by slave-owners, but now we all see it as a barbaric practice, I think future generations will look down upon us, for the way we used to treat animals.
  - JumpCrisscross 3y ago
    > pets can't have a word on it. I think it's egotistical. "End-of-life care accounts for about 10-12% of all healthcare spending" [1], though "spending in the last three calendar years of life reached 24.5 percent in Taiwan," suggesting "high aggregate medical spending is due not to last-ditch efforts to save lives but to spending on people with chronic conditions" [2]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282187/#:~:text=According%20to%20one%20estimate%2C%20end,%24%2029%20billion%2C%20respectively2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282187/#:~:tex.... [2] https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0174 https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0174
giraffe_lady 3y ago
> I'm not sure that when my time comes, that I want money to be spent keeping my body alive while my brain degenerates. If one can't enjoy those extra years, what is the point of having them? Famously an opinion held mostly by people for whom this choice is remote and abstract. In practice what we find is that when this reality is imminent, people overwhelmingly choose to live. Regardless of what they claimed they would want when they were younger and healthier.
- Qem 3y ago
  It makes me sad the way people discount elderly people lives, as some lesser form of life not worth living anymore. It makes me skeptical about most proposals to regulate euthanasia, because once it's normalized, I suspect social pressure will start to build-up and press seniors to request it, even when they don't really want.
Qem 3y ago
> Modern medicine and infrastructure has extended the body's lifespan, but no such improvement has been made for the brain's lifespan. IIRC, it was discovered recently just the shingles vaccine reduces the probability of dementia by 20%.
- Auracle 3y ago
  Many vaccines have been shown to reduce the chance of Alzheimer’s, along with good sleep - which is important for your immune system.
nradov 3y ago
So what are you proposing? Assisted suicide laws require the patient to be of sound mind. One dementia has set in they can't legally consent.

tptacek 3y ago

Spoiler: it's opiates, guns, and, most especially, cars.

candiddevmike 3y ago
I think you could argue those three things are cause by our dysfunctional government, with no solution in sight.
frowawayxd 3y ago
i feel like you’re missing the elephant in the room.
mym1990 3y ago
Uhh, it’s definitely our lifestyle and healthcare system, which promotes passive treatment rather than early identification of diseases, primarily heart disease, diabetes, and cancer. Alzheimer’s too but early identification of this is still not a reasonable expectation atm. Also, fwiw, the article talks a lot in terms of comparisons and where gains can be had in relative terms. But in absolute terms, those 4 items above are still going to be the most crucial to really moving the needle on life expectancy. You named all the really headline grabbing ones though, so good job on that!
- tptacek 3y ago
  You disagree with the article then, not me, because that's what it's about.
  - mym1990 3y ago
    Well in that case your headline is as good as the tabloids, thanks!
    - tptacek 3y ago
      Did you come to a different conclusion about the actual content of this article than I did?

NelsonMinar 3y ago

One piece of America's low average life expectancy is our high infant mortality rates. We have the highest mortality rate of any wealthy nations at 5.4 infant deaths per 1000 live births. (Compare 2-3 / 1000 in Western Europe [2]). And that rate is highly correlated to race and ethnicity, nearly double for infants born to Black parents [3]. 1: https://www.cnn.com/2018/01/08/health/child-mortality-rates-by-country-study-intl/index.html https://www.cnn.com/2018/01/08/health/child-mortality-rates-... 2: https://worldpopulationreview.com/country-rankings/infant-mortality-rate-by-country https://worldpopulationreview.com/country-rankings/infant-mo... 3: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm https://www.cdc.gov/reproductivehealth/maternalinfanthealth/...

giraffe_lady 3y ago
Notably dramatically reduced for minorities, like many other grim american racial/medical stats, when the doctors are also a minority. Another reason why the supreme court university decision is a direct attack on already vulnerable groups.
- deleted 3y ago
  [deleted]
tptacek 3y ago
Be a little careful here, because different countries count infant mortality differently. Mortality later in life is cut-and-dried, but infant mortality isn't some countries categorize stillbirths differently, for instance.
- olddustytrail 3y ago
  Specifically which European nations count infant mortality differently? I keep hearing this claim but I've never seen anything to back it up. And it would have to be pretty much all of them to account for the difference, right?
  - 3y ago

nayuki 3y ago

> land use policy is implicated in a decent chunk of this. America’s fatalities per kilometer driven are very average, but we drive a lot more than anyone else, including residents of Canada and Australia Nice call-out there!

michaelteter 3y ago

This is not a healthcare problem, this is a lifestyle problem. The US has led the world in lifestyle changes, which I would argue are almost entirely economically (capitalistic business) driven. Incomplete and in no particular order, there are the government diet guidelines which have at times been primarily driven by certain industries (agricultural organizations including corn growers, sugarcane growers, dairy producers), including pharmaceutical industries... And then the energy industry + auto industry, which has led to more time sitting in cars, combined with the explosion of the fast food industry... And the soft drink industry where Coke began by promoting its drink as a health elixir... and on and on. Of course, the "solutions" to many of the mistakes have been more industries pushing fixes like artificial sweeteners, "health" drinks, energy/sports drinks, low-fat processed foods, diet pills and fads, and other finance-based attempts to sell a new thing rather than address the real problems. The rest of the world will follow suit in terms of health decline. It's already evident, as other countries adopt US patterns of prepackaged foods, fast foods, sugar (and fake sugar) drinks, cars, etc. An easy way to spot this is to go to a country (like Netherlands, where I've been for some years). The older folks tend to be generally lean; many old folks here still bicycle. The < 30 crowd, particularly the 12-20 crowd is fatter and more American shaped. Go to parts of Asia and you see the same thing. As comfort, convenience, and easy bad (cheap) choices expand, so do the bodies of the people. The younger ones who grow up with this have a different lifestyle than their parents or grandparents. While the older populations are indeed getting less healthy (increased body mass, reduced exercise), the change is slower for a number of reasons. Meanwhile, the kids who grow up with this new lifestyle start on a bad trajectory and know no alternative. WALL-E pretty much illustrated the final state of the current trajectory we are on, both in health and ecologic terms.

JimtheCoder 3y ago
"The < 30 crowd, particularly the 12-20 crowd is fatter and more American shaped." I am going to rid my vocabulary of the word "fat" and just refer to people as "American Shaped" from now on...
tptacek 3y ago
This is an article that is largely about how the life expectancy gap in the US isn't defined by health outcomes, but rather drugs, guns, and, most especially, cars.

localplume 3y ago

[dead]

lkbm 3y ago

One thing that stands out for me in this article is Figure 3: Europe shows a significant mortality of adults 20-65 drop from 2005 to 2018. What has improved there? Improvements in cancer treatments seem like it would mostly show up in the 65+ range. Is it mostly lower air pollution + fewer traffic accidents?

jmclnx 3y ago

One nit I have about Life Expectancy, it should also include quality of life. By that I mean, it you are unable to take care of yourself, I think Life Expectancy should be adjusted to take account of life quality. For example, if you are in a Nursing Home or if you are bed ridden, I would say your "life" is reduced by half the amount of time spent there. But as other said, infant mortality is a big factor. With the US abortion bans in some places, I expect infant mortality to rise. IIRC, on ave, Right Wing controlled already have the highest infant mortality rates.

trashface 3y ago

Its mostly a result of chronic low income. Inflation has raised the ceiling for income, but the floor is still zero and many people (including me) are close to that. Job security has gone to shit even for college grads and decent paying jobs are heavily gate-kept, most people in bottom 40% of income distribution don't even have a chance of getting one of those. Low income = lower quality diet, less access to health care, lower quality housing and ultimately (for some) drug use and other hardship-related problems. This is also why it will never be addressed, as low-income issues have not been a priority in America for a long time (the most recent budget bill made it harder for SNAP recipients) and right now states are kicking millions of people off medicaid because they didn't complete paperwork.

tptacek 3y ago
Do you see the article saying that, and, if so, where?
- trashface 3y ago
  No, I didn't read it again. I read it last year when matt first wrote it (its a year old). My impression is he is generally out of touch with this issue and other income-related issues, he needs to get out of DC more.
  - tptacek 3y ago
    He's reporting other people's statistical analysis of life expectancy; should they get out of DC more, too?
brigadier132 3y ago
> Low income = lower quality diet I don't buy it. Most of Europe has lower income than the US but the quality of their food is just vastly superior. Just watch this video https://www.instagram.com/reel/CtzaSnGMIEN/?igshid=MzRlODBiNWFlZA%3D%3D https://www.instagram.com/reel/CtzaSnGMIEN/?igshid=MzRlODBiN... I suspect it's a combination of low quality food and not walking.

bannedbybros 3y ago

[dead]

ttpphd 3y ago

Uh. Ahem. Clears throat In a very Matty voice: different places have different life expectancies and that's ok.

monero-xmr 3y ago

America has very decentralized governance and the states have a lot of power, especially when it comes to the medical system and Medicaid. You need to assess 50 states more like 50 countries when comparing them. Massachusetts has a higher population than Norway. There is a lot of nuance - we also allow millions of illegal immigrants every year, who can themselves get drivers licenses and access state resources, which further makes any discussion very difficult. I find statistics that try to aggregate such a huge and dynamic population very suspicious. I do know that Canadians stream across the border to America when they are told their life saving procedures are months or years in the queue.

deleted 3y ago

[deleted]

andrewl 3y ago

Among the surprises in this article were these: “The US appears to screen more vigorously for cancer than Europe and people in the US who are diagnosed with cancer have higher 5-year survival probabilities.” There is a similar, though not quite as strong, pattern with cardiovascular disease — it is treated more aggressively on average in the U.S., and survival odds are better. A detailed survey of prostate cancer evidence shows that “The combination of earlier detection and aggressive treatment in the US has produced greatly improved survival chances for men diagnosed with prostate cancer.” Similarly for breast cancer, America does more early screening and more aggressive treatment with the result that “the US has experienced a significantly faster decline in breast cancer mortality than comparison countries.” The abstract of the paper they came from (which is linked in the article) is: Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.

seanmcdirmid 3y ago

Ya. The USA’s problem is mostly due to income inequality and a lack of will to correct nutrition disorders at the level of society.

Georgelemental 3y ago
> The USA’s problem is mostly due to income inequality The post specifically refutes this: Europeans live longer than Europeans at all income levels.
- seanmcdirmid 3y ago
  > Europeans live longer than Europeans at all income levels. That isn't what I am claiming though. Specifically, that higher income inequality leads to poorer outcomes on average, not that all income levels would somehow have similar outcomes. In this case, it is the income inequality in the states (with a lack of a social safety net to redistribute much income as in Europe) that causes the worse outcomes, not the income level itself. In Europe, a social safety net provides you with similar healthcare at lower income levels anyways, which isn't true in the US (perhaps we should rename income inequality into wellness inequality?).

keernan 3y ago

Tackling Americans' weirdly short life expectancy should be a priority. But America's weirdly short life expectancy should be an equal priority.