5 ms·

Wealthy Americans have death rates on par with poor Europeans

120 points by zdw 2y ago

mdtrooper 2y ago
https://en.wikipedia.org/wiki/Public_health https://en.wikipedia.org/wiki/Public_health
deleted 2y ago
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Nicholas_C 2y ago
Not surprising given our diet and car-dependent culture. From the article: >While less access to health care and weaker social structures can explain the gap between the wealthy and poor in the US, it doesn't explain the differences between the wealthy in the US and the wealthy in Europe, the researchers note. There may be other systemic factors at play that make Americans uniquely short-lived, such as diet, environment, behaviors, and cultural and social differences.
jklinger410 2y ago
[flagged]
- deleted 2y ago
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pixelpoet 2y ago
Those tariffs on Denmark and Switzerland in particular (major medicine producers) aren't going to help...
- Luc 2y ago
  Pharmaceuticals are exempted at the moment.
- sureglymop 2y ago
  Well, Switzerland cowardly decided not to react or retaliate, even though those tariffs make no sense. I don't know why we expect a reasonable response here, if you ask me this is a huge red flag and warning that the US is not a trustworthy trade partner.
  - lesuorac 2y ago
    > Well, Switzerland cowardly decided not to react or retaliate, even though those tariffs make no sense. I'm not sure that reactionary tarifs are the correct action. Flagging products as American or pulling them from the selves seems much more affective. If you counter-tariff you just tax your own citizens. If you decrease supply then it actually hurts US.
    - ashoeafoot 2y ago
      The usual swiss reaction to news of this magnitude is to dig bunkers several kilometres down .
- sleepyguy 2y ago
  At least 50% of generics come from India, and they import 80% of the Active Pharmaceutical Ingredients from China. If China or India stop pharmaceutical shipments to the USA, there would be extreme shortages, and the die off would be biblical in proportions.
renewiltord 2y ago
Realistically I’ll take my 82.6 years in San Francisco over 78.1 in Berlin, 85.39 in Madrid, or 80.4 in London. The tradeoffs are better for me and I don’t want to make America into Spain to get those last 3 years to Madrid. It’s all right. 82 is a good life.
- toomuchtodo 2y ago
  To each their own. I’m headed to Spain to live, not to grind unnecessarily. You only get one life, and most of how we spend our days outside of family and loved ones doesn’t matter. I’ll have a glass of Sangria for you (a lie, I’ll take the whole pitcher and drink while reading HN). America gets what it deserves: self defeating turmoil and churn disguised as effort and progress, while objectively being a worse place to exist (happiness, health outcomes, etc). Line goes up, but life is suffering. To win is to know what Enough is.
  - ty6853 2y ago
    On a per capita adjusted basis UAE/Dubai blows about every other place out the water for number of incoming rich migration (even on absolute basis they are near top). Much easier to get an investor visa, far lower taxes on business income, you can easily import servants and trade duties are miniscule. Everything is available if you are rich because all you must do is fill out some relatively simple paperwork and whoever you want appears. It looks like in this age for the rich the optimum is something closer to dictator capitalism, as democracies start to embrace more regulation and social redistribution schemes. Singapore and Dubai have been winning choices so long as the people in power don't change their mind and start splitting skulls.
    - toomuchtodo 2y ago
      The Middle East human rights situation is in conflict with my belief and value system. Agency and autonomy are important, as well as shared responsibility and collectivism (as no one is an island). Us, not I. I like taxes, with them I buy civilization, help those in need, and build lasting institutions of value and relevance.
m12k 2y ago
"While less access to health care and weaker social structures can explain the gap between the wealthy and poor in the US, it doesn't explain the differences between the wealthy in the US and the wealthy in Europe, the researchers note. There may be other systemic factors at play that make Americans uniquely short-lived, such as diet, environment, behaviors, and cultural and social differences." Off the top of my head, obesity seems like the obvious culprit to investigate. If so, I wonder if semaglutide will close this gap again?
- Swoerd 2y ago
  [dead]
- isoprophlex 2y ago
  obesity is a symptom, not a cause. to me, the rabid response to anything remotely resembling socialism, and the inability to see life as anything but a zero-sum game is the obvious culprit. this precludes caring for eachother, and creates a life that's essentially a never-ending rat race for everyone, rich and poor alike. you cant inject your way out of a society that is, at its core, defined by class/racial segregation, systemic inequality and distrust of governments.
- 542354234235 2y ago
  American prepared food has on average, almost twice as much sugar as in Europe, largely due to differences in regulation. Americans walk less than in Europe, making less than half as many foot trips as Europeans, largely due to differences in infrastructure. Americans visit the doctor less often than in Europe, largely due to the lack of universal healthcare all other high-income countries have. I think obesity might be the symptom, not the actual culprit.
comrade1234 2y ago
I’m an American that moved to Europe over ten years ago. It’s interesting to see what I’ve anecdotally observed backed up by real stats - old people just seem healthier and more active here. I’ll be hiking in the alps and being passed by old people on the trail. I’ve gone ski touring and saw people in their 70s climbing mountains with me. I had a 90-year-old neighbor that was more active than me in the neighborhood until she finally died outside walking. Another observation - wealthy Americans live like poor Europeans. Living somewhere where you have to drive everywhere is something that poor people have to do here. Eating manufactured unhealthy food - poor.
- MrSkelter 2y ago
  I am a dual national with roots in Europe. A far greater contributor is the lack of avoidable chronic disease in Europe. I know many middle class and above Americans who have ongoing battles with their insurance companies to treat and manage relatively mundane issues. If they apply enough time and money they can usually resolve things though often this requires pausing treatment or changing doctors recommendations. This does not exist in Europe. What your doctors recommend happens regardless of your income. There is an image I see when in the US. A homeless person who is crippled and pushing themselves with a stick or one leg in a wheelchair. Lame thanks to lack of treatment. You never see that in Europe. Homeless people exist but they aren’t chronically ill. This has positive effects for everyone. There is less disease in the environment and it’s easier for people to literally get back on their feet. It’s a bit of wishful thinking to presume Americans poor health is all lifestyle choices and advertising. It’s the system and a pervasive lack of easy to access treatment at all levels of society.
  - Vegenoid 2y ago
    I have what I believe is "decent" employer-sponsored health insurance, but using the healthcare system is still an enormous pain in the ass, as is getting insurance to pay for the things that they are supposed to. I'm pretty healthy and young. I keep wondering "are there really that many people whose experience getting healthcare system doesn't suck ass and feel like getting robbed"? My partner insists that our health insurance must actually not be that good, I believe that our health insurance is above average and Americans have been conned into ignoring their own direct experience, but neither of us have much of a reference.
TimTheTinker 2y ago
To me, this is an excellent argument that merely making healthcare more affordable in the US isn't the answer. I'd like to posit that the culprit(s) of bad US health could likely be narrowed down by carefully analyzing the differences between (a) 1970 and now; and (b) Americans and Europeans in an exhaustive list of the human body's environmental touchpoints, narrowing the list to things that apply to >90% of each population. A few examples: - food supply differences. For example, European regulation prohibits GMO and a lot of pesticides that are allowed in the US. Meat also differs significantly in their food supply (corn vs grass for beef) and other factors. - vaccines. How much of the European vaccine schedule's components are not sourced from American suppliers? - atmosphere. Off-gassing of synthetic materials in homes and offices is a newer thing. - containers. In 1970, none of the food supply was distributed in plastic containers, for example. And glass containers are a lot more popular in Europe than the US. I do wonder whether the answers could be staring us in the face, but have been suppressed because of corporate interests in the US. (Much the same as how cigarette smoking was publicly labeled "healthy" prior to the 1970s, even by scientists and doctors, because of studies funded by Philip Morris and other tobacco companies.) At least theoretically, health-related companies do stand to benefit financially from keeping us alive but less healthy. Widespread chronic semi-disease does make a lot of money, especially for vertically integrated insurers who can delay/deny claims, and for suppliers who have achieved regulatory capture of some sort.
- pixl97 2y ago
  To couple with food supply differences add in calorie intake differences. With pollution add in car culture which decreases the amount walked
  - TimTheTinker 2y ago
    In 1970, obesity in the US was not anywhere as much of a problem. But car culture (and gasoline pollution) was very much a thing. > calorie intake differences Yeah, that's a big one. Also, processing foods heats them multiple times prior to sale, which increases caloric bioavailability.
- kvdveer 2y ago
cpursley 2y ago
It's the build-environment (how cities are designed). Everything is America is segregated, especially by income, age and race to an extent. Culture (fitness and food) also play a role. There's a reason more walkable places like Denver and NYC have healthier people.
- cafard 2y ago
  Denver is walkable? I'd have called it "sprawling".
  - kjkjadksj 2y ago
    At first glance it looks sprawly but then visiting there you realize most of those tract housing developments open up in the back to some walk and bike trail network, which remain sunny dry and mild much of winter (the real snow is in the mountains denver is frequently bone dry), and a good portion of the population is getting 50 days out of their epic or ikon pass plus engaging in some summer outdoor hobby.
    - cafard 2y ago
      Fifty years ago, one heard that Colfax Avenue was the longest street in the US, or maybe the world. I got a lot of exercise in my Denver days, some of it running or hiking, but I also spent a lot of time in cars.
- TimTheTinker 2y ago
  I read something recently that said the rise of American suburbia can be traced to increased rates of crime in the cities due to immigrant populations (this was over the last 50 years or so). Now that Europe has seen such a huge increase in immigrant populations (and the corresponding crime increases), perhaps suburban-type environments will become more desirable there in the near future.
  - 4887d30omd8 2y ago
    What you are referring to is called "white flight" and the causes were more complex than crime or immigration. The casual link between immigration and crime is generally agreed to be false. So whatever you read that claimed immigration caused crime to go up seems incorrect.
kurofune 2y ago
Could be the "beautiful beef" we are not eating here in Europe.
lucidguppy 2y ago
1) You have to walk in Europe. 2) People eat better.
- OJFord 2y ago
  I think it would be more accurate to say you can (and people choose to).
  - tialaramex 2y ago
    You more or less have to. If you're very wealthy I guess you could travel everywhere on a sedan chair or something, but the US thing where you drive to everything can't work in many parts of Europe. In very high density areas they don't want private motor vehicles so they're just banned, there's maybe public transit but you'd really have to be unhurried to take public transit over a distance that's say a 10 minute walk. In very low density areas nobody bothered adding a road. Why not just walk? I mean you could use a serious off road vehicle (no the fact your "truck" says it has AWD does not mean it will work) but even in places where that's legal why not just fucking walk?
  - rsynnott 2y ago
    There's an aspect of "have to", as well, in many larger cities. I mean, I suppose if you were morally opposed to walking maybe you could spend a couple of hours a day in traffic and rent parking somewhere... Many offices, even offices in which very affluent people work, would not necessarily have parking, and if they did it would not be enough for everyone. I work for a big multinational in Dublin, in an office that has about 500 people and I think about 30 or 40 parking spaces. This is the first office I've worked in that had parking at all (mostly a consequence of it being from the 1970s), and Ireland is one of the _more_ car-oriented European countries. And Dublin isn't exactly a huge city. If you take the likes of London or Paris, most affluent people are going to be commuting by public transport; driving just isn't really practical. I'd be curious whether NYC, which has some aspects of this, has longer life expectancies than elsewhere in the US.
    - OJFord 2y ago
mattmaroon 2y ago
[flagged]
dvsfish 2y ago
Funny and sad anecdote - I was travelling through Paris and met some Americans on the train.. and they commented on the fact Paris doesn't seem to have many medical facilities compared to the USA. It was presented as a negative, which seemed shockingly shallowly thought through to us as non American tourists.
paulryanrogers 2y ago
In the Midwest US I also see evangelical Christianity pushing faith healing so hard that to be some kinds of sick are moral failures. Combined with the puritan view of poverty as a symptom of moral failure, and there is a lot of turning up ones nose at the poor and sick as undeserving of public assistance. Only when they bend the knee to God will they be worthy of help, and only with strings attached.
- claar 2y ago
  What you describe is more accurately called the "prosperity Gospel", not evangelical Christianity. Mainstream evangelical Christianity doesn't believe anything like what you describe.
  - deleted 2y ago
    [deleted]
  - paulryanrogers 2y ago
    What I describe is what I've seen in many evangelical churches over decades and in three different countries, first hand. Evangelicals like to think their flavor is immune from all that ailes other branches of Christianity. Yet they too look down on the sick and the poor, sometimes more than older and more traditional strains of the religion.
  - wtfwhateven 2y ago
    >Mainstream evangelical Christianity doesn't believe anything like what you describe. This is not true.
  - therealdrag0 2y ago
    Non-prosperity gospel churches don’t say it out loud, but the implications are easy to draw. Massive ideological and cultural structures aren’t logical proofs, there are many contradictions.
- robocat 2y ago
  I suspect you think that healthcare is helpful, and that if we could only buy poor people more healthcare then their lives would be improved. Healthcare regularly doesn't help that much. Even the richest often die young because healthcare regularly cannot FIX things (think chemotherapy then die). There's some mental fallacy we buy into that health can be fixed - when the only healthy choice is preventative mitigation. The answer is to live a healthy life: especially regular exercise. But also sensible food choices and removing stress (remove stressors or maybe learn techniques to ignore stress), and avoiding drugs/alcohol/smoking. Rich Americans are unhealthy too and for the majority how much they spend on medical interventions usually doesn't fix their quality-of-life or length-of-life. The poor mostly have as much access to a healthy life as the wealthy: so why are both the poor and the rich unhealthy? The hard question to answer is why we live unhealthy lifestyles ;; is it capitalist advertising ;; should we blame cultural mores ;; are we victims of our own poor choices... Anecdotes (New Zealand specific): 1: a poorer friend with hip problems that needed replacements in 40s but was forced to live in excruciating conditions for years due to how New Zealand's socialised health budgetary constraints are implemented (via waiting lists). No money was saved by the government because the surgery was eventually paid for (background: surgery cost for both hips was approx equal one pretax year of minimum wages in NZ). 2: two friends with a poor backgrounds that got middle aged diabetes - my guess is caused by booze & maybe smoking. Both THEN started exercise and also changed their habits and lifestyle. One is well off and money didn't really help them. Both could have previously lived healthier lifestyles but only changed their habits after being faced with severe frightening outcomes. Drugs like metformin help (that drug is cheap, however ongoing regular monitoring by doctor is not cheap). Expensive surgical interventions caused by diabetes will never fix the problems caused by poor living. How much we should blame people's "choices" for poor health outcomes is difficult to answer. If someone chooses to drink booze, how much should society pay for their choice? We have high sin taxes in New Zealand so people have often paid for their medical help however the taxes do not cover the overall societal cost. A better example is acquaintances that have destroyed their health through recreational drug usage (which definitely isn't sanctioned by larger society, and definitely is sanctioned by peer society). I'm a huge believer in personal choice - but I'm no fan of having to pay for the bad choices made by others. That's the issue with New Zealand's socialism. I can carefully live a prudent life : however it galls to be taxed to pay for people that ignore the cost of their choices. Aside: it really neeps my bibbles that doctors are seen as saving lives. Engineering, economics and science save most lives. Doctors don't help much. (Ofc "saving" lives is a nonsense term anyway)
simion314 2y ago
Could be the food regulations, the ones Trump hates so much because it prevents USA exporting USA foods to EU.
dismalaf 2y ago
As someone who lives part-time in Europe (and they can be mostly lumped together because of shared culture and the EU, but I spend significant time in 3 EU countries in addition to living 6 months of the year in a single one) but raised in Canada... - Europeans have access to better quality food. Good vegetables are the rule as opposed to the exception, commodity meat is better quality and high quality dairy is cheap. - Europeans walk, a lot. As most towns existed before cars, they're all built for walking. Mixed use neighbourhoods are the rule rather than the exception. Europeans are also far more social and that often means doing physical activities with your friends (I play football and futsal with a group of guys from the village, ages 25-60). - Europeans do drink a lot, but it's in moderation, if that makes sense. Less binge drinking all at once, more drinks during meals and spread throughout the week. We all know the liver processes alcohol at a specific rate so this is less damaging to health. - Universal healthcare. Even the EU countries with mixed public/private systems make it universally available. Insurance rates far more reasonable, less strings attached. Unlike in Canada, we have a paediatrician in Europe. We can see a doctor same day without resorting to the ER. Appointments can be made typically next-day, although I've heard of waits that are several days in the city. Versus Canada where we can't even get a family doctor at all and need to go to the ER for anything. - Stress. 5 weeks vacation. Employee-friendly laws. Active, social lifestyle. Everyday necessities are far more affordable. Rent isn't 60% of the average take-home income (unlike Canada).
- throaway2501 2y ago
  what EU country has the best food? (i’m from canada but every time i’ve been in the EU i’ve noticed the EU food is much better)
  - dismalaf 2y ago
    IMO, Italy, France, Spain. In that order. We have a home in Czech Republic (my partner's country of origin) and I'm also partial to the food there (I'm also east European but a generation back), but it's probably not quite as objectively good as the first 3, still better than Canada though.
- rsynnott 2y ago
deleted 2y ago
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taeric 2y ago
Would be interesting to see what the causes of death were? I'm also still surprised that "current smoking status" is a thing. Quickly checking, seems a lot of western Europe is higher in that than the US? Curious how regional that is in the US, even. I don't see nearly as many smokers around home as I do when I visit the likes of Atlanta.
lr1970 2y ago
The title of the article is terrible. The death rate everywhere in the world is the same and is equal to 100%. Everyone dies someday. The article's title should have used something like "life expectancy" instead of "death rate".
readthenotes1 2y ago
"The findings are a stark reminder that even the wealthiest Americans are not shielded from the systemic issues in the US contributing to lower life expectancy, such as economic inequality ...," lead study author Irene Papanicolas, a professor of health services, policy and practice at Brown, said in a news release. That's a pretty funny take, that economic inequality is a systemic risk for rich people. I wonder if Dr P thinks that the stress of noblesse oblige is too much for the frail US elites (as opposed to the horrible diet endemic in the US)
sershe 2y ago
The thing missed in all these arguments is a large variety in life expectancy between states, and demographic controls. The states all have more or less the same problems and non problems with their healthcare system, so it cannot really explain that. And I'm pretty sure levels of car dependence won't explain a large part of it either since most states are largely car dependent. Iirc (phone post) japanese Americans have higher life expectancy than Japanese, or at least in the ballpark. Maybe some cultures/lifestyles, like whatever they are doing in the South, just suck. OTOH, maybe we should allow people to make choices. I'm pretty sure I'd live longer if I did interval sprints instead of reading HN, but that's a tradeoff I am willing to make.

120 points by zdw 2y ago

mdtrooper 2y ago

https://en.wikipedia.org/wiki/Public_health https://en.wikipedia.org/wiki/Public_health

deleted 2y ago

[deleted]

Nicholas_C 2y ago

Not surprising given our diet and car-dependent culture. From the article: >While less access to health care and weaker social structures can explain the gap between the wealthy and poor in the US, it doesn't explain the differences between the wealthy in the US and the wealthy in Europe, the researchers note. There may be other systemic factors at play that make Americans uniquely short-lived, such as diet, environment, behaviors, and cultural and social differences.

jklinger410 2y ago

[flagged]

deleted 2y ago
[deleted]

pixelpoet 2y ago

Those tariffs on Denmark and Switzerland in particular (major medicine producers) aren't going to help...

Luc 2y ago
Pharmaceuticals are exempted at the moment.
sureglymop 2y ago
Well, Switzerland cowardly decided not to react or retaliate, even though those tariffs make no sense. I don't know why we expect a reasonable response here, if you ask me this is a huge red flag and warning that the US is not a trustworthy trade partner.
- lesuorac 2y ago
  > Well, Switzerland cowardly decided not to react or retaliate, even though those tariffs make no sense. I'm not sure that reactionary tarifs are the correct action. Flagging products as American or pulling them from the selves seems much more affective. If you counter-tariff you just tax your own citizens. If you decrease supply then it actually hurts US.
  - ashoeafoot 2y ago
    The usual swiss reaction to news of this magnitude is to dig bunkers several kilometres down .
sleepyguy 2y ago
At least 50% of generics come from India, and they import 80% of the Active Pharmaceutical Ingredients from China. If China or India stop pharmaceutical shipments to the USA, there would be extreme shortages, and the die off would be biblical in proportions.

renewiltord 2y ago

Realistically I’ll take my 82.6 years in San Francisco over 78.1 in Berlin, 85.39 in Madrid, or 80.4 in London. The tradeoffs are better for me and I don’t want to make America into Spain to get those last 3 years to Madrid. It’s all right. 82 is a good life.

toomuchtodo 2y ago
To each their own. I’m headed to Spain to live, not to grind unnecessarily. You only get one life, and most of how we spend our days outside of family and loved ones doesn’t matter. I’ll have a glass of Sangria for you (a lie, I’ll take the whole pitcher and drink while reading HN). America gets what it deserves: self defeating turmoil and churn disguised as effort and progress, while objectively being a worse place to exist (happiness, health outcomes, etc). Line goes up, but life is suffering. To win is to know what Enough is.
- ty6853 2y ago
  On a per capita adjusted basis UAE/Dubai blows about every other place out the water for number of incoming rich migration (even on absolute basis they are near top). Much easier to get an investor visa, far lower taxes on business income, you can easily import servants and trade duties are miniscule. Everything is available if you are rich because all you must do is fill out some relatively simple paperwork and whoever you want appears. It looks like in this age for the rich the optimum is something closer to dictator capitalism, as democracies start to embrace more regulation and social redistribution schemes. Singapore and Dubai have been winning choices so long as the people in power don't change their mind and start splitting skulls.
  - toomuchtodo 2y ago
    The Middle East human rights situation is in conflict with my belief and value system. Agency and autonomy are important, as well as shared responsibility and collectivism (as no one is an island). Us, not I. I like taxes, with them I buy civilization, help those in need, and build lasting institutions of value and relevance.

m12k 2y ago

"While less access to health care and weaker social structures can explain the gap between the wealthy and poor in the US, it doesn't explain the differences between the wealthy in the US and the wealthy in Europe, the researchers note. There may be other systemic factors at play that make Americans uniquely short-lived, such as diet, environment, behaviors, and cultural and social differences." Off the top of my head, obesity seems like the obvious culprit to investigate. If so, I wonder if semaglutide will close this gap again?

Swoerd 2y ago
[dead]
isoprophlex 2y ago
obesity is a symptom, not a cause. to me, the rabid response to anything remotely resembling socialism, and the inability to see life as anything but a zero-sum game is the obvious culprit. this precludes caring for eachother, and creates a life that's essentially a never-ending rat race for everyone, rich and poor alike. you cant inject your way out of a society that is, at its core, defined by class/racial segregation, systemic inequality and distrust of governments.
542354234235 2y ago
American prepared food has on average, almost twice as much sugar as in Europe, largely due to differences in regulation. Americans walk less than in Europe, making less than half as many foot trips as Europeans, largely due to differences in infrastructure. Americans visit the doctor less often than in Europe, largely due to the lack of universal healthcare all other high-income countries have. I think obesity might be the symptom, not the actual culprit.

comrade1234 2y ago

I’m an American that moved to Europe over ten years ago. It’s interesting to see what I’ve anecdotally observed backed up by real stats - old people just seem healthier and more active here. I’ll be hiking in the alps and being passed by old people on the trail. I’ve gone ski touring and saw people in their 70s climbing mountains with me. I had a 90-year-old neighbor that was more active than me in the neighborhood until she finally died outside walking. Another observation - wealthy Americans live like poor Europeans. Living somewhere where you have to drive everywhere is something that poor people have to do here. Eating manufactured unhealthy food - poor.

MrSkelter 2y ago
I am a dual national with roots in Europe. A far greater contributor is the lack of avoidable chronic disease in Europe. I know many middle class and above Americans who have ongoing battles with their insurance companies to treat and manage relatively mundane issues. If they apply enough time and money they can usually resolve things though often this requires pausing treatment or changing doctors recommendations. This does not exist in Europe. What your doctors recommend happens regardless of your income. There is an image I see when in the US. A homeless person who is crippled and pushing themselves with a stick or one leg in a wheelchair. Lame thanks to lack of treatment. You never see that in Europe. Homeless people exist but they aren’t chronically ill. This has positive effects for everyone. There is less disease in the environment and it’s easier for people to literally get back on their feet. It’s a bit of wishful thinking to presume Americans poor health is all lifestyle choices and advertising. It’s the system and a pervasive lack of easy to access treatment at all levels of society.
- Vegenoid 2y ago
  I have what I believe is "decent" employer-sponsored health insurance, but using the healthcare system is still an enormous pain in the ass, as is getting insurance to pay for the things that they are supposed to. I'm pretty healthy and young. I keep wondering "are there really that many people whose experience getting healthcare system doesn't suck ass and feel like getting robbed"? My partner insists that our health insurance must actually not be that good, I believe that our health insurance is above average and Americans have been conned into ignoring their own direct experience, but neither of us have much of a reference.

TimTheTinker 2y ago

To me, this is an excellent argument that merely making healthcare more affordable in the US isn't the answer. I'd like to posit that the culprit(s) of bad US health could likely be narrowed down by carefully analyzing the differences between (a) 1970 and now; and (b) Americans and Europeans in an exhaustive list of the human body's environmental touchpoints, narrowing the list to things that apply to >90% of each population. A few examples: - food supply differences. For example, European regulation prohibits GMO and a lot of pesticides that are allowed in the US. Meat also differs significantly in their food supply (corn vs grass for beef) and other factors. - vaccines. How much of the European vaccine schedule's components are not sourced from American suppliers? - atmosphere. Off-gassing of synthetic materials in homes and offices is a newer thing. - containers. In 1970, none of the food supply was distributed in plastic containers, for example. And glass containers are a lot more popular in Europe than the US. I do wonder whether the answers could be staring us in the face, but have been suppressed because of corporate interests in the US. (Much the same as how cigarette smoking was publicly labeled "healthy" prior to the 1970s, even by scientists and doctors, because of studies funded by Philip Morris and other tobacco companies.) At least theoretically, health-related companies do stand to benefit financially from keeping us alive but less healthy. Widespread chronic semi-disease does make a lot of money, especially for vertically integrated insurers who can delay/deny claims, and for suppliers who have achieved regulatory capture of some sort.

pixl97 2y ago
To couple with food supply differences add in calorie intake differences. With pollution add in car culture which decreases the amount walked
- TimTheTinker 2y ago
  In 1970, obesity in the US was not anywhere as much of a problem. But car culture (and gasoline pollution) was very much a thing. > calorie intake differences Yeah, that's a big one. Also, processing foods heats them multiple times prior to sale, which increases caloric bioavailability.
kvdveer 2y ago

cpursley 2y ago

It's the build-environment (how cities are designed). Everything is America is segregated, especially by income, age and race to an extent. Culture (fitness and food) also play a role. There's a reason more walkable places like Denver and NYC have healthier people.

cafard 2y ago
Denver is walkable? I'd have called it "sprawling".
- kjkjadksj 2y ago
  At first glance it looks sprawly but then visiting there you realize most of those tract housing developments open up in the back to some walk and bike trail network, which remain sunny dry and mild much of winter (the real snow is in the mountains denver is frequently bone dry), and a good portion of the population is getting 50 days out of their epic or ikon pass plus engaging in some summer outdoor hobby.
  - cafard 2y ago
    Fifty years ago, one heard that Colfax Avenue was the longest street in the US, or maybe the world. I got a lot of exercise in my Denver days, some of it running or hiking, but I also spent a lot of time in cars.
TimTheTinker 2y ago
I read something recently that said the rise of American suburbia can be traced to increased rates of crime in the cities due to immigrant populations (this was over the last 50 years or so). Now that Europe has seen such a huge increase in immigrant populations (and the corresponding crime increases), perhaps suburban-type environments will become more desirable there in the near future.
- 4887d30omd8 2y ago
  What you are referring to is called "white flight" and the causes were more complex than crime or immigration. The casual link between immigration and crime is generally agreed to be false. So whatever you read that claimed immigration caused crime to go up seems incorrect.

kurofune 2y ago

Could be the "beautiful beef" we are not eating here in Europe.

lucidguppy 2y ago

1) You have to walk in Europe. 2) People eat better.

OJFord 2y ago
I think it would be more accurate to say you can (and people choose to).
- tialaramex 2y ago
  You more or less have to. If you're very wealthy I guess you could travel everywhere on a sedan chair or something, but the US thing where you drive to everything can't work in many parts of Europe. In very high density areas they don't want private motor vehicles so they're just banned, there's maybe public transit but you'd really have to be unhurried to take public transit over a distance that's say a 10 minute walk. In very low density areas nobody bothered adding a road. Why not just walk? I mean you could use a serious off road vehicle (no the fact your "truck" says it has AWD does not mean it will work) but even in places where that's legal why not just fucking walk?
- rsynnott 2y ago
  There's an aspect of "have to", as well, in many larger cities. I mean, I suppose if you were morally opposed to walking maybe you could spend a couple of hours a day in traffic and rent parking somewhere... Many offices, even offices in which very affluent people work, would not necessarily have parking, and if they did it would not be enough for everyone. I work for a big multinational in Dublin, in an office that has about 500 people and I think about 30 or 40 parking spaces. This is the first office I've worked in that had parking at all (mostly a consequence of it being from the 1970s), and Ireland is one of the _more_ car-oriented European countries. And Dublin isn't exactly a huge city. If you take the likes of London or Paris, most affluent people are going to be commuting by public transport; driving just isn't really practical. I'd be curious whether NYC, which has some aspects of this, has longer life expectancies than elsewhere in the US.
  - OJFord 2y ago

mattmaroon 2y ago

[flagged]

dvsfish 2y ago

Funny and sad anecdote - I was travelling through Paris and met some Americans on the train.. and they commented on the fact Paris doesn't seem to have many medical facilities compared to the USA. It was presented as a negative, which seemed shockingly shallowly thought through to us as non American tourists.

paulryanrogers 2y ago

In the Midwest US I also see evangelical Christianity pushing faith healing so hard that to be some kinds of sick are moral failures. Combined with the puritan view of poverty as a symptom of moral failure, and there is a lot of turning up ones nose at the poor and sick as undeserving of public assistance. Only when they bend the knee to God will they be worthy of help, and only with strings attached.

claar 2y ago
What you describe is more accurately called the "prosperity Gospel", not evangelical Christianity. Mainstream evangelical Christianity doesn't believe anything like what you describe.
- deleted 2y ago
  [deleted]
- paulryanrogers 2y ago
  What I describe is what I've seen in many evangelical churches over decades and in three different countries, first hand. Evangelicals like to think their flavor is immune from all that ailes other branches of Christianity. Yet they too look down on the sick and the poor, sometimes more than older and more traditional strains of the religion.
- wtfwhateven 2y ago
  >Mainstream evangelical Christianity doesn't believe anything like what you describe. This is not true.
- therealdrag0 2y ago
  Non-prosperity gospel churches don’t say it out loud, but the implications are easy to draw. Massive ideological and cultural structures aren’t logical proofs, there are many contradictions.
robocat 2y ago
I suspect you think that healthcare is helpful, and that if we could only buy poor people more healthcare then their lives would be improved. Healthcare regularly doesn't help that much. Even the richest often die young because healthcare regularly cannot FIX things (think chemotherapy then die). There's some mental fallacy we buy into that health can be fixed - when the only healthy choice is preventative mitigation. The answer is to live a healthy life: especially regular exercise. But also sensible food choices and removing stress (remove stressors or maybe learn techniques to ignore stress), and avoiding drugs/alcohol/smoking. Rich Americans are unhealthy too and for the majority how much they spend on medical interventions usually doesn't fix their quality-of-life or length-of-life. The poor mostly have as much access to a healthy life as the wealthy: so why are both the poor and the rich unhealthy? The hard question to answer is why we live unhealthy lifestyles ;; is it capitalist advertising ;; should we blame cultural mores ;; are we victims of our own poor choices... Anecdotes (New Zealand specific): 1: a poorer friend with hip problems that needed replacements in 40s but was forced to live in excruciating conditions for years due to how New Zealand's socialised health budgetary constraints are implemented (via waiting lists). No money was saved by the government because the surgery was eventually paid for (background: surgery cost for both hips was approx equal one pretax year of minimum wages in NZ). 2: two friends with a poor backgrounds that got middle aged diabetes - my guess is caused by booze & maybe smoking. Both THEN started exercise and also changed their habits and lifestyle. One is well off and money didn't really help them. Both could have previously lived healthier lifestyles but only changed their habits after being faced with severe frightening outcomes. Drugs like metformin help (that drug is cheap, however ongoing regular monitoring by doctor is not cheap). Expensive surgical interventions caused by diabetes will never fix the problems caused by poor living. How much we should blame people's "choices" for poor health outcomes is difficult to answer. If someone chooses to drink booze, how much should society pay for their choice? We have high sin taxes in New Zealand so people have often paid for their medical help however the taxes do not cover the overall societal cost. A better example is acquaintances that have destroyed their health through recreational drug usage (which definitely isn't sanctioned by larger society, and definitely is sanctioned by peer society). I'm a huge believer in personal choice - but I'm no fan of having to pay for the bad choices made by others. That's the issue with New Zealand's socialism. I can carefully live a prudent life : however it galls to be taxed to pay for people that ignore the cost of their choices. Aside: it really neeps my bibbles that doctors are seen as saving lives. Engineering, economics and science save most lives. Doctors don't help much. (Ofc "saving" lives is a nonsense term anyway)

simion314 2y ago

Could be the food regulations, the ones Trump hates so much because it prevents USA exporting USA foods to EU.

dismalaf 2y ago

As someone who lives part-time in Europe (and they can be mostly lumped together because of shared culture and the EU, but I spend significant time in 3 EU countries in addition to living 6 months of the year in a single one) but raised in Canada... - Europeans have access to better quality food. Good vegetables are the rule as opposed to the exception, commodity meat is better quality and high quality dairy is cheap. - Europeans walk, a lot. As most towns existed before cars, they're all built for walking. Mixed use neighbourhoods are the rule rather than the exception. Europeans are also far more social and that often means doing physical activities with your friends (I play football and futsal with a group of guys from the village, ages 25-60). - Europeans do drink a lot, but it's in moderation, if that makes sense. Less binge drinking all at once, more drinks during meals and spread throughout the week. We all know the liver processes alcohol at a specific rate so this is less damaging to health. - Universal healthcare. Even the EU countries with mixed public/private systems make it universally available. Insurance rates far more reasonable, less strings attached. Unlike in Canada, we have a paediatrician in Europe. We can see a doctor same day without resorting to the ER. Appointments can be made typically next-day, although I've heard of waits that are several days in the city. Versus Canada where we can't even get a family doctor at all and need to go to the ER for anything. - Stress. 5 weeks vacation. Employee-friendly laws. Active, social lifestyle. Everyday necessities are far more affordable. Rent isn't 60% of the average take-home income (unlike Canada).

throaway2501 2y ago
what EU country has the best food? (i’m from canada but every time i’ve been in the EU i’ve noticed the EU food is much better)
- dismalaf 2y ago
  IMO, Italy, France, Spain. In that order. We have a home in Czech Republic (my partner's country of origin) and I'm also partial to the food there (I'm also east European but a generation back), but it's probably not quite as objectively good as the first 3, still better than Canada though.
rsynnott 2y ago

deleted 2y ago

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taeric 2y ago

Would be interesting to see what the causes of death were? I'm also still surprised that "current smoking status" is a thing. Quickly checking, seems a lot of western Europe is higher in that than the US? Curious how regional that is in the US, even. I don't see nearly as many smokers around home as I do when I visit the likes of Atlanta.

lr1970 2y ago

The title of the article is terrible. The death rate everywhere in the world is the same and is equal to 100%. Everyone dies someday. The article's title should have used something like "life expectancy" instead of "death rate".

readthenotes1 2y ago

"The findings are a stark reminder that even the wealthiest Americans are not shielded from the systemic issues in the US contributing to lower life expectancy, such as economic inequality ...," lead study author Irene Papanicolas, a professor of health services, policy and practice at Brown, said in a news release. That's a pretty funny take, that economic inequality is a systemic risk for rich people. I wonder if Dr P thinks that the stress of noblesse oblige is too much for the frail US elites (as opposed to the horrible diet endemic in the US)

sershe 2y ago

The thing missed in all these arguments is a large variety in life expectancy between states, and demographic controls. The states all have more or less the same problems and non problems with their healthcare system, so it cannot really explain that. And I'm pretty sure levels of car dependence won't explain a large part of it either since most states are largely car dependent. Iirc (phone post) japanese Americans have higher life expectancy than Japanese, or at least in the ballpark. Maybe some cultures/lifestyles, like whatever they are doing in the South, just suck. OTOH, maybe we should allow people to make choices. I'm pretty sure I'd live longer if I did interval sprints instead of reading HN, but that's a tradeoff I am willing to make.