5 ms·

What precisely is causing Americans to die so much earlier than Europeans? I know obesity, healthcare access and gun violence play a factor, but is there anythi

What precisely is causing Americans to die so much earlier than Europeans? I know obesity, healthcare access and gun violence play a factor, but is there anything else?

toomuchtodo 3y ago
Despair. https://en.wikipedia.org/wiki/Disease_of_despair https://en.wikipedia.org/wiki/Disease_of_despair https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2788767 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
- Analemma_ 3y ago
  The "deaths of despair" narrative has been found really wanting: https://www.slowboring.com/p/the-deaths-of-despair-narrative-is https://www.slowboring.com/p/the-deaths-of-despair-narrative... and it's probably time to throw it out entirely. The tl;dr is that most of the effect disappears when you use age-adjusted death rates instead of arbitrary buckets (whose average age goes up over time) and adjust for things like obesity, gun violence, and car accidents.
  - deleted 3y ago
    [deleted]
balderdash 3y ago
Suicide and overdoses
wetpaws 3y ago
[dead]
WalterBright 3y ago
Drug abuse.
deleted 3y ago
[deleted]
dirtyhippiefree 3y ago
Vacation time.
- hristov 3y ago
  Lest someone assume the parent is a snide comment, Europeans tend to have significantly longer vacations.
WendyTheWillow 3y ago
Add in drug abuse, those are pretty huge (though gun violence isn't a real influencer here, just doesn't put up the numbers heart disease does).
- jrumbut 3y ago
  Gun violence is a major influencer of life expectancy in America. The average American would live a couple of years longer without gun deaths (including suicide and accidents). https://time.com/5471069/guns-life-expectancy/ https://time.com/5471069/guns-life-expectancy/ The reason that it has such an outsized effect is because it tends to happen early in life.
  - WendyTheWillow 3y ago
    Oh right, suicide. But wouldn't at least a portion of those suicides still be suicides without guns?
    - orwin 3y ago
      Not successful ones. The issue with not having an available loaded gun is that you have to plan your death.
      - WendyTheWillow 3y ago
        Obtaining a gun is planning in the exact same way walking to the top of a roof or grabbing a fist full of pills is planning.
        orwin 3y ago
        Raking a fistful of pill fail often, with little consequences (unlike a bullet, who might fail but consequences are painful). Jumping is rare, the only case I know of was someone with bone cancer who suffered a lot (I'm kinda remember her but I was very young when she died). Bullets are a common way to go for people with hunting background. There is a reason why 'revolving credits' were called 'revolver credits' in my area before they were basically outlawed (I'm from the countryside).
yathern 3y ago
It's the first two - 0.01% of us die to guns, which isn't nothing - but not enough to move averages significantly. Maybe also cars? I assume Americans drive more than most other countries.
- dmoy 3y ago
  Well, maybe like 1% of deaths if you include suicides as "gun violence" (kinda weird, but is often stated), maybe 2% if you focus on only men. But yea, it's a literal nonfactor in aggregate life expectancy. Amdahl's law applies here too.
  - nl 3y ago
    According to [1], "homicide, suicide and gun deaths" is the 2nd highest factor in explaining the difference. [1] https://twitter.com/jburnmurdoch/status/1641799922583326720/photo/1 https://twitter.com/jburnmurdoch/status/1641799922583326720/...
    - dmoy 3y ago
      I can't read the underlying article, but that graph a minimum is not saying "2nd highest factor". It notes both drugs (lowers gap to 2.9) and metabolic diseases (lowers gap to 2.2) as both more of a factor than suicide & homicide (only lowers gap to 3.2). Which tracks, given that suicide is like 50k per year, homicide is 20k per year (unstated: "gun deaths" that aren't homicide or suicide are orders of magnitude lower), drug deaths are over 100k per year, and metabolic diseases dwarf all of the above. So, no, what you wrote is wrong.
      - nl 3y ago
        Oh I've read it the wrong way around! Yes you are correct!
        dmoy 3y ago
        Also it's unclear if there are other factors worth tracking, since the graph only lists a few. Heart disease, cancer, stroke, respiratory disease (not including covid), accidents (which I suppose includes drug OD), Alzheimer's, and diabetes all have higher death rates that the combination of all suicide+homicide (which again, is sort of strange to join together). The first two alone are 600k+ each. A bunch of those affect primarily the elderly though, so won't hit the average life expectancy as hard. If you track homicide separately, it's not even in the top 20 of causes of death. Suicide is not in the top 10.
wilg 3y ago
If you want actual analysis of this, I'd suggest: - https://www.slowboring.com/p/tackling-americas-weirdly-short-life https://www.slowboring.com/p/tackling-americas-weirdly-short... - https://www.noahpinion.blog/p/americans-are-coping-ourselves-to https://www.noahpinion.blog/p/americans-are-coping-ourselves...
- paulddraper 3y ago
  > Tackling America's weirdly short life expectancy Shows US higher than Poland. Okay.
  - wilg 3y ago
    I don't understand your complaint, isn't that accurate? > Indeed, life expectancy in the United States is so bad that the relevant comparison class is a set of much poorer countries like Chile and Poland — countries that are richer than the world average but aren’t even close to the top.
deleted 3y ago
[deleted]
greesil 3y ago
Covid.
- deleted 3y ago
  [deleted]
paulddraper 3y ago
Americans live on average 2 years less than Europeans. [1] 37% of US adults and 16% of EU adults are obese (2014). [2] Even moderate obesity reduces life expectancy by 3 years. Severe obesity is 10 years. [3] Factor in the not-obsese-but-overweight, and you explain basically the entire difference. [1] https://www.cnn.com/2016/02/09/health/american-life-expectancy-shorter-than-europeans/index.html https://www.cnn.com/2016/02/09/health/american-life-expectan... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670332/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670332/ [3] https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-years-life-expectancy https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-...
- riquito 3y ago
  More recent stats US [1] Percent of adults aged 20 and over with obesity: 41.9% (2017-March 2020) Percent of adults aged 20 and over with overweight, including obesity: 73.6% EU [2] [3] Obese: 16% Percent of adults aged 18 and over with overweight, including obesity: 52.7% [1] https://www.cdc.gov/nchs/fastats/obesity-overweight.htm https://www.cdc.gov/nchs/fastats/obesity-overweight.htm [2] https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Overweight_and_obesity_-_BMI_statistics#Obesity_in_the_EU:_gender_differences https://ec.europa.eu/eurostat/statistics-explained/index.php... [3] https://ec.europa.eu/eurostat/databrowser/view/hlth_ehis_bm1e/default/table?lang=en https://ec.europa.eu/eurostat/databrowser/view/hlth_ehis_bm1...
  - atmavatar 3y ago
    It doesn't help that virtually all foods in the US have added sugar. If some day I read about vegetables and livestock being genetically engineered to increase sugar content as well, I would be completely unsurprised.
- orwin 3y ago
  You should compare with similar economies, so Germany and Spain (France has less industry so the almost 80 yo life expectancy for men is 'easier').
lmm 3y ago
Car culture is a big one. No pedestrian collision safety regulation at all, extremely low driving standards (and pervasive illegal driving without a license even so), and long car commutes as standard.
salamandersss 3y ago
Black and Native American life expectancy drag it down a fair bit. A median European dropped in US only loses a few years. In fact this goes for lots of stuff; drop someone from Norway in America and their chance of dying by gun doesn't change much either.
- jandrewrogers 3y ago
  On the other side, Japanese-Americans are basically the longest lived people on the planet. Medical outcomes are generally excellent in the US, so when they intersect with healthy, safe lifestyles the results are good. Poor and dangerous lifestyles do a lot of heavy lifting in the US when it comes to life expectancy.
mynameishere 3y ago
https://www.stlouisfed.org/on-the-economy/2022/january/evolution-racial-gap-us-life-expectancy https://www.stlouisfed.org/on-the-economy/2022/january/evolu...
InTheArena 3y ago
Fentanyl, a male suicide crisis and a strong cultural taboo around male mental health, bad responses to COVID-19, poor medical system, and social attitudes strongly attack tackling health care issues for men as somehow oppressive to women. (Compare and contrast funding for prostate cancer and breast cancer in the USA).
- salamandersss 3y ago
  [flagged]
  - nl 3y ago
    These seem to apply in other countries too though.
    - salamandersss 3y ago
      I have no idea. For instance does France require special flight clearance after taking antidepressants even for non-psych gastrointestinal issues?
      - nl 3y ago
        Seems pretty likely: > the European Commission adopted Commission Regulation (EU) 2018/1042 of 23 July 2018, which lays down rules for Member States to carry out alcohol testing (and additional testing for other psychoactive substances) of flight crew and cabin crew members operating on board aircraft using aerodromes on their territory. https://www.ecologie.gouv.fr/en/alcohol-and-drug-testing-field-civil-aviation https://www.ecologie.gouv.fr/en/alcohol-and-drug-testing-fie... I guess an antidepressant would count as a psychoactive substances. I don't speak enough French to read the act itself though.
rgmerk 3y ago
This thread (and the accompanying article) are very informative (and damning): https://twitter.com/jburnmurdoch/status/1641799627128143873?lang=en https://twitter.com/jburnmurdoch/status/1641799627128143873?... Drugs and road accidents are other disproportionate contributors to the US's awful life expectancy. At the risk of being a wiseass, at least some of this is Americans taking Ben Franklin's aphorism about liberty and safety far too seriously. Sometimes, trading some liberty for safety is entirely sensible.
- nl 3y ago
  For those who haven't looked, this analysis is very useful. Almost all the gap is caused by the higher rate of deaths of under 25yos in the US. From [1] the largest differences appears to be: 1) Road deaths 2) Homicide, suicide and gun deaths 3) Drug related deaths. [1] https://twitter.com/jburnmurdoch/status/1641799922583326720/photo/1 https://twitter.com/jburnmurdoch/status/1641799922583326720/...
  - nl 3y ago
    Actually I've read this the wrong way around. The biggest difference is actually cardio-matabolic diseases!
- nradov 3y ago
  "For Americans age 18-45, the leading cause of death is fentanyl overdose." https://www.getsmartaboutdrugs.gov/media/dea-administrator-record-fentanyl-overdose-deaths https://www.getsmartaboutdrugs.gov/media/dea-administrator-r... That is a sad situation, but giving up more liberty won't save those people. Freedom is more important than safety and I have no interest in living under an authoritarian police state.
  - rgmerk 3y ago
    Agreed on fentanyl, but there are other areas where nanny-stating saves lives. The evidence on higher tobacco and alcohol taxes, for instance, is pretty irrefutable. Or, moving up the implausibility scale in the American context, drastic reductions in the availability of handguns including the mass forfeiture of existing weapons (which has been done in a number of other developed countries). You may not like any of these, particularly the last, but the fact is that they would increase life expectancy significantly.
I_Am_Nous 3y ago
Trash food Stress Fear
hindsightbias 3y ago
Plastics.
resource0x 3y ago
All work and no fun
rayiner 3y ago
Drug overdoses.
Wildliferanger 3y ago
Well 20 years ago the US drinking culture and driving culture made car accidents a main driver especially in distorting the lower age demograpics. But in the past few years opiods is basically the top cause of death of adults before 45 which then is mostly heart disease. So the recent drop is almost entirely opiods. https://www.reddit.com/r/Damnthatsinteresting/comments/16umzgp/leading_cause_of_death_by_age_and_state_in_america/ https://www.reddit.com/r/Damnthatsinteresting/comments/16umz...
Ekaros 3y ago
Preventative health care on average. Europe might not be always great, but at least people aren't afraid to go to doctor early before things become too major. And it can really add years to life for lot of people.

What precisely is causing Americans to die so much earlier than Europeans? I know obesity, healthcare access and gun violence play a factor, but is there anything else?

toomuchtodo 3y ago

Despair. https://en.wikipedia.org/wiki/Disease_of_despair https://en.wikipedia.org/wiki/Disease_of_despair https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2788767 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

Analemma_ 3y ago
The "deaths of despair" narrative has been found really wanting: https://www.slowboring.com/p/the-deaths-of-despair-narrative-is https://www.slowboring.com/p/the-deaths-of-despair-narrative... and it's probably time to throw it out entirely. The tl;dr is that most of the effect disappears when you use age-adjusted death rates instead of arbitrary buckets (whose average age goes up over time) and adjust for things like obesity, gun violence, and car accidents.
- deleted 3y ago
  [deleted]

balderdash 3y ago

Suicide and overdoses

wetpaws 3y ago

[dead]

WalterBright 3y ago

Drug abuse.

deleted 3y ago

[deleted]

dirtyhippiefree 3y ago

Vacation time.

hristov 3y ago
Lest someone assume the parent is a snide comment, Europeans tend to have significantly longer vacations.

WendyTheWillow 3y ago

Add in drug abuse, those are pretty huge (though gun violence isn't a real influencer here, just doesn't put up the numbers heart disease does).

jrumbut 3y ago
Gun violence is a major influencer of life expectancy in America. The average American would live a couple of years longer without gun deaths (including suicide and accidents). https://time.com/5471069/guns-life-expectancy/ https://time.com/5471069/guns-life-expectancy/ The reason that it has such an outsized effect is because it tends to happen early in life.
- WendyTheWillow 3y ago
  Oh right, suicide. But wouldn't at least a portion of those suicides still be suicides without guns?
  - orwin 3y ago
    Not successful ones. The issue with not having an available loaded gun is that you have to plan your death.
    - WendyTheWillow 3y ago
      Obtaining a gun is planning in the exact same way walking to the top of a roof or grabbing a fist full of pills is planning.
      - orwin 3y ago
        Raking a fistful of pill fail often, with little consequences (unlike a bullet, who might fail but consequences are painful). Jumping is rare, the only case I know of was someone with bone cancer who suffered a lot (I'm kinda remember her but I was very young when she died). Bullets are a common way to go for people with hunting background. There is a reason why 'revolving credits' were called 'revolver credits' in my area before they were basically outlawed (I'm from the countryside).

yathern 3y ago

It's the first two - 0.01% of us die to guns, which isn't nothing - but not enough to move averages significantly. Maybe also cars? I assume Americans drive more than most other countries.

dmoy 3y ago
Well, maybe like 1% of deaths if you include suicides as "gun violence" (kinda weird, but is often stated), maybe 2% if you focus on only men. But yea, it's a literal nonfactor in aggregate life expectancy. Amdahl's law applies here too.
- nl 3y ago
  According to [1], "homicide, suicide and gun deaths" is the 2nd highest factor in explaining the difference. [1] https://twitter.com/jburnmurdoch/status/1641799922583326720/photo/1 https://twitter.com/jburnmurdoch/status/1641799922583326720/...
  - dmoy 3y ago
    I can't read the underlying article, but that graph a minimum is not saying "2nd highest factor". It notes both drugs (lowers gap to 2.9) and metabolic diseases (lowers gap to 2.2) as both more of a factor than suicide & homicide (only lowers gap to 3.2). Which tracks, given that suicide is like 50k per year, homicide is 20k per year (unstated: "gun deaths" that aren't homicide or suicide are orders of magnitude lower), drug deaths are over 100k per year, and metabolic diseases dwarf all of the above. So, no, what you wrote is wrong.
    - nl 3y ago
      Oh I've read it the wrong way around! Yes you are correct!
      - dmoy 3y ago
        Also it's unclear if there are other factors worth tracking, since the graph only lists a few. Heart disease, cancer, stroke, respiratory disease (not including covid), accidents (which I suppose includes drug OD), Alzheimer's, and diabetes all have higher death rates that the combination of all suicide+homicide (which again, is sort of strange to join together). The first two alone are 600k+ each. A bunch of those affect primarily the elderly though, so won't hit the average life expectancy as hard. If you track homicide separately, it's not even in the top 20 of causes of death. Suicide is not in the top 10.

wilg 3y ago

If you want actual analysis of this, I'd suggest: - https://www.slowboring.com/p/tackling-americas-weirdly-short-life https://www.slowboring.com/p/tackling-americas-weirdly-short... - https://www.noahpinion.blog/p/americans-are-coping-ourselves-to https://www.noahpinion.blog/p/americans-are-coping-ourselves...

paulddraper 3y ago
> Tackling America's weirdly short life expectancy Shows US higher than Poland. Okay.
- wilg 3y ago
  I don't understand your complaint, isn't that accurate? > Indeed, life expectancy in the United States is so bad that the relevant comparison class is a set of much poorer countries like Chile and Poland — countries that are richer than the world average but aren’t even close to the top.

deleted 3y ago

[deleted]

greesil 3y ago

Covid.

deleted 3y ago
[deleted]

paulddraper 3y ago

Americans live on average 2 years less than Europeans. [1] 37% of US adults and 16% of EU adults are obese (2014). [2] Even moderate obesity reduces life expectancy by 3 years. Severe obesity is 10 years. [3] Factor in the not-obsese-but-overweight, and you explain basically the entire difference. [1] https://www.cnn.com/2016/02/09/health/american-life-expectancy-shorter-than-europeans/index.html https://www.cnn.com/2016/02/09/health/american-life-expectan... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670332/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670332/ [3] https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-years-life-expectancy https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-...

riquito 3y ago
More recent stats US [1] Percent of adults aged 20 and over with obesity: 41.9% (2017-March 2020) Percent of adults aged 20 and over with overweight, including obesity: 73.6% EU [2] [3] Obese: 16% Percent of adults aged 18 and over with overweight, including obesity: 52.7% [1] https://www.cdc.gov/nchs/fastats/obesity-overweight.htm https://www.cdc.gov/nchs/fastats/obesity-overweight.htm [2] https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Overweight_and_obesity_-_BMI_statistics#Obesity_in_the_EU:_gender_differences https://ec.europa.eu/eurostat/statistics-explained/index.php... [3] https://ec.europa.eu/eurostat/databrowser/view/hlth_ehis_bm1e/default/table?lang=en https://ec.europa.eu/eurostat/databrowser/view/hlth_ehis_bm1...
- atmavatar 3y ago
  It doesn't help that virtually all foods in the US have added sugar. If some day I read about vegetables and livestock being genetically engineered to increase sugar content as well, I would be completely unsurprised.
orwin 3y ago
You should compare with similar economies, so Germany and Spain (France has less industry so the almost 80 yo life expectancy for men is 'easier').

lmm 3y ago

Car culture is a big one. No pedestrian collision safety regulation at all, extremely low driving standards (and pervasive illegal driving without a license even so), and long car commutes as standard.

salamandersss 3y ago

Black and Native American life expectancy drag it down a fair bit. A median European dropped in US only loses a few years. In fact this goes for lots of stuff; drop someone from Norway in America and their chance of dying by gun doesn't change much either.

jandrewrogers 3y ago
On the other side, Japanese-Americans are basically the longest lived people on the planet. Medical outcomes are generally excellent in the US, so when they intersect with healthy, safe lifestyles the results are good. Poor and dangerous lifestyles do a lot of heavy lifting in the US when it comes to life expectancy.

mynameishere 3y ago

https://www.stlouisfed.org/on-the-economy/2022/january/evolution-racial-gap-us-life-expectancy https://www.stlouisfed.org/on-the-economy/2022/january/evolu...

InTheArena 3y ago

Fentanyl, a male suicide crisis and a strong cultural taboo around male mental health, bad responses to COVID-19, poor medical system, and social attitudes strongly attack tackling health care issues for men as somehow oppressive to women. (Compare and contrast funding for prostate cancer and breast cancer in the USA).

salamandersss 3y ago
[flagged]
- nl 3y ago
  These seem to apply in other countries too though.
  - salamandersss 3y ago
    I have no idea. For instance does France require special flight clearance after taking antidepressants even for non-psych gastrointestinal issues?
    - nl 3y ago
      Seems pretty likely: > the European Commission adopted Commission Regulation (EU) 2018/1042 of 23 July 2018, which lays down rules for Member States to carry out alcohol testing (and additional testing for other psychoactive substances) of flight crew and cabin crew members operating on board aircraft using aerodromes on their territory. https://www.ecologie.gouv.fr/en/alcohol-and-drug-testing-field-civil-aviation https://www.ecologie.gouv.fr/en/alcohol-and-drug-testing-fie... I guess an antidepressant would count as a psychoactive substances. I don't speak enough French to read the act itself though.

rgmerk 3y ago

This thread (and the accompanying article) are very informative (and damning): https://twitter.com/jburnmurdoch/status/1641799627128143873?lang=en https://twitter.com/jburnmurdoch/status/1641799627128143873?... Drugs and road accidents are other disproportionate contributors to the US's awful life expectancy. At the risk of being a wiseass, at least some of this is Americans taking Ben Franklin's aphorism about liberty and safety far too seriously. Sometimes, trading some liberty for safety is entirely sensible.

nl 3y ago
For those who haven't looked, this analysis is very useful. Almost all the gap is caused by the higher rate of deaths of under 25yos in the US. From [1] the largest differences appears to be: 1) Road deaths 2) Homicide, suicide and gun deaths 3) Drug related deaths. [1] https://twitter.com/jburnmurdoch/status/1641799922583326720/photo/1 https://twitter.com/jburnmurdoch/status/1641799922583326720/...
- nl 3y ago
  Actually I've read this the wrong way around. The biggest difference is actually cardio-matabolic diseases!
nradov 3y ago
"For Americans age 18-45, the leading cause of death is fentanyl overdose." https://www.getsmartaboutdrugs.gov/media/dea-administrator-record-fentanyl-overdose-deaths https://www.getsmartaboutdrugs.gov/media/dea-administrator-r... That is a sad situation, but giving up more liberty won't save those people. Freedom is more important than safety and I have no interest in living under an authoritarian police state.
- rgmerk 3y ago
  Agreed on fentanyl, but there are other areas where nanny-stating saves lives. The evidence on higher tobacco and alcohol taxes, for instance, is pretty irrefutable. Or, moving up the implausibility scale in the American context, drastic reductions in the availability of handguns including the mass forfeiture of existing weapons (which has been done in a number of other developed countries). You may not like any of these, particularly the last, but the fact is that they would increase life expectancy significantly.

I_Am_Nous 3y ago

Trash food Stress Fear

hindsightbias 3y ago

Plastics.

resource0x 3y ago

All work and no fun

rayiner 3y ago

Drug overdoses.

Wildliferanger 3y ago

Well 20 years ago the US drinking culture and driving culture made car accidents a main driver especially in distorting the lower age demograpics. But in the past few years opiods is basically the top cause of death of adults before 45 which then is mostly heart disease. So the recent drop is almost entirely opiods. https://www.reddit.com/r/Damnthatsinteresting/comments/16umzgp/leading_cause_of_death_by_age_and_state_in_america/ https://www.reddit.com/r/Damnthatsinteresting/comments/16umz...

Ekaros 3y ago

Preventative health care on average. Europe might not be always great, but at least people aren't afraid to go to doctor early before things become too major. And it can really add years to life for lot of people.