11 ms·
What happened to US life expectancy?
- saosebastiao 13y agoI know it is hard to control for culture, but seeing as how mormon men are still American but have a 10 year gap in life expectancy over other American men [1], any analysis on the effects of health care across nations should at least try to control for cultural differences. That singular cultural difference is twice the magnitude of the difference between the OECD and the US. And when you realize that culture could be a far stronger predictor than health care quality/availability, you start wondering how much of that gap is due to us being fatasses. [1] http://www.washingtonpost.com/blogs/she-the-people/post/mormonism-good-for-the-body-as-well-as-the-soul/2012/06/20/gJQARk3IqV_blog.html http://www.washingtonpost.com/blogs/she-the-people/post/morm...
- seiji 13y agoThe typical american lifestyle seems designed to kill you: drink a lot, work all the time, take drugs (legal or otherwise) to medicate or recreate yourself into submission, refuse to use your 10 days a year off so you continue to look like a "team player." The mormon lifestyle is: no drinking, everything is based around family/community, and travel the world to convert others. Plus, something about a musical. Fun fact: A few tech companies refuse to recruit at BYU because mormons can't work all weekend.
- angersock 13y agoTrue, but the Mormon uptime is hard to beat, right? Don't they have disaster recovery and failover built-in?
- codex 13y agoMormons typically fast one day a week, no? What other concrete examples of culture do Mormons manifest? CORRECTION: It's actually one day a month.
- fr0sty 13y agoNo alcohol, tobacco, coffee or tea are the big ones that I can think of.
- Loughla 13y agoNo smoking, no drinking alcohol, coffee or tea (I think it may be caffeine). They also tend to have a stronger focus on homemade food (rather than pre-cooked/boxed/canned) and habits/hobbies that aren't dangerous. In other words, all of the fun, yummy, or convenient, but terrible for you things that tend to be in our lives, they're not allowed to do.
- _delirium 13y agoA few others that come to mind not related to food/drinks: * Absolutely no work on Sundays (not even checking work email) * A strong social safety net. Mormons are expected to tithe (pay 10% of their income to the church), and this is used in part to provide for members in need. Extensive volunteering is also expected, and used for some of the same purposes (e.g. caring for elderly or disabled).
- saraid216 13y ago> no drinking alcohol, coffee or tea (I think it may be caffeine) I can't speak for Mormonism, but this was the most informative summary I've seen on the subject: http://www.dummies.com/how-to/content/whats-not-on-the-mormon-menu.html http://www.dummies.com/how-to/content/whats-not-on-the-mormo...
- nowarninglabel 13y agoMormons are expected to have lower or no consumption of alcohol, tobacco, and illegal drugs (and it's fairly more difficult to obtain at least the former two in Utah). Though, I can't find any actual study data showing they do in fact have lower consumption of those, it would be interesting to see if anyone has some data showing they are in fact lower.
- jewel 13y agoIt's once a month, and is a two-meal fast of both food and drink. Another concrete cultural practice that could make a difference is that Mormons abstain from alcohol, coffee, tea, and tobacco.
- dragonwriter 13y ago> I know it is hard to control for culture, but seeing as how mormon men are still American but have a 10 year gap in life expectancy over other American men The study [1] did not find that Mormon men have a 10 year advantage of other American men, it found that the "optimum" subgroup of white Mormon men ("optimum" defined as never smoked, married, 12+ years education, and at least weekly church attendance) had a 9.8 year life expectancy advantage over white males in general in the US -- and that similar figures were seen for the same "optimum" characteristics among all religions. [1] Original source: http://www.belnapfamily.org/brentjbelnap/institute/Preventive_Medicine_2008_Lifestyle_and_Mormon_Mortality_Enstrom.pdf http://www.belnapfamily.org/brentjbelnap/institute/Preventiv...
- alexeisadeski3 13y agoAsk and ye shall receive! Answer: Americans engage in more risky behavior than other OECD members (driving, we also drive worse than some OECD members, etc): http://www.forbes.com/sites/theapothecary/2011/11/23/the-myth-of-americans-poor-life-expectancy/ http://www.forbes.com/sites/theapothecary/2011/11/23/the-myt... http://b-i.forbesimg.com/theapothecary/files/2013/11/National-Life-Expectancy12.png http://b-i.forbesimg.com/theapothecary/files/2013/11/Nationa...
- a8da6b0c91d 13y agoIt's funny how oblivious Americans are to the dangers of driving. This despite generally knowing people who have been badly injured or killed in vehicular accidents. Car exhaust is also a big deal. Air pollution kills. Instead of talking about the very concretely understood dangers of car culture, people want to spout total nonsense about sugar or freak out about a little second hand smoke.
- logjam 13y agoUh, "a little second hand [tobacco] smoke" is a "very concretely understood danger" - a huge factor in both morbidity and mortality: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/ http://www.cdc.gov/tobacco/data_statistics/fact_sheets/healt...
- alexeisadeski3 13y agoHell is other people.
- dewiz 13y agofood, pollution, poverty, war.. many aspects where US does "more" than others
- melling 13y agoAll nice guesses but I don't suppose you have any data to support them? Yes, war for examples, sounds logical, but how many Americans have died in wars in the past 30 years? 10,000? Does that really move the needle?
- aetherson 13y agoWord. And remember, the OECD isn't "The US, France, Germany, and the UK." This link is (on table 2) the PPP adjusted incomes for each decile of the OECD countries: http://www.oecd.org/site/piaac/Additional%20tables.xlsx http://www.oecd.org/site/piaac/Additional%20tables.xlsx The US median 1st decile hourly earnings are $7.40. Austria, the Czech Republic, Estonia, Germany, Italy, Japan, Korea, the Netherlands, Poland, the Slovak republic, and Spain are all below there. Australia, Canada, Denmark, Finland, France, Ireland, Norway, Sweden, and the UK are above there. So I don't think that poverty is causing the US to underperform compared to the OECD mean or median.
- Someone 13y agoI think a honest comparison should use something like the Big Mac index (http://en.wikipedia.org/wiki/Big_Mac_Index http://en.wikipedia.org/wiki/Big_Mac_Index), but for healthcare. If one does that I bet that first decile American scores way lower on the number of hours he can afford to spend in a hospital per year, or on the number of days he has to work for a visit to the dentist. On the other hand, I think he will be able to buy more over the counter medicines.
- aetherson 13y agoWell, it's possible that I'm misinterpreting the parent commenter, but I don't think it's a very strong or interesting statement to say, "I think that lower healthcare outcomes are due to worse healthcare." I assumed that when dewiz listed "poverty" in a group of confounding variables like "war" or "pollution" (which, by the way, is another thing that the US is probably not particularly bad about) in explaining lower life expectancies, he wasn't trying to use "poverty" as a proxy for "low access to healthcare," so much as something that independently worsens healthcare outcomes even controlling for healthcare access. (And, by the way, while I don't think that it explains the difference in life expectancies raised by the parent article, I do agree with dewiz that poverty almost certainly has a negative effect on healthcare outcomes, even if you perfectly control for access to healthcare.)
- 300bps 13y agoThe U.S. is #1 in common cancer 5-year survival rates: http://b-i.forbesimg.com/theapothecary/files/2013/11/CONCORD-table12.jpg http://b-i.forbesimg.com/theapothecary/files/2013/11/CONCORD... Further, remove fatal injuries from life expectancy data and U.S. is #1 in life expectancy. Source: http://b-i.forbesimg.com/theapothecary/files/2013/11/National-Life-Expectancy12.png http://b-i.forbesimg.com/theapothecary/files/2013/11/Nationa...
- Steko 13y agoSpoilers: that chart ends in 1999.
- jakobsen 13y agoThis. Plus why would anyone want to remove fatal injuries from life expectancy? It certainly looks like a legit concern to me.
- mberning 13y agoIsn't it amazing how data can be bent to tell almost any desired story?
- bryanlarsen 13y ago5-year survival rate is a poor statistic for comparing cancers across regions. It's highly correlated with how early the cancer was detected -- treatment effectiveness is just noise in comparison.
- Fang 13y agoThis is untrue. Ohsfeldt and Schneider did not 'remove fatal injuries from life expectancy data', they used a regression analysis to adjust life expectancy values to equalise the number of fatal injuries. They have not actually dug deep to actually investigate whether fatal injuries does explain low life expectancies, only observed that there is a correlation. This methodology is questionable, to say the least, and can potentially produce perverse results, and to my knowledge, they have not shown their working to show that they have not fallen into the many many pitfalls this method can generate.
- drzaiusapelord 13y agoWhile I'm sure the lack of medical access and quality of are major contributors, I think this OECD document on obesity and overweight rates are telling as well: http://www.oecd.org/health/49716427.pdf http://www.oecd.org/health/49716427.pdf
- ams6110 13y agoThe sugar- and grain-rich diet that has been aggressively promoted by the USDA for decades is responsible for a large part of this. The "low fat" mantra resulted in a lot of "fat free" but sugar-laden and/or grain based foods being the primary component of many diets, resulting in epidemic obesity and diabetes.
- smoyer 13y agoExactly ... we're fat (I'll own it - I'm fat)
- cowsandmilk 13y agoThe USDA marketed equally to everyone, yet we see a wide gap in growth in life expectancy shows wide disparities between the poor and wealthy[1]. The growth of life expectancy of those with money has kept up with the OECD growth, while the life expectancy of the poor has largely stagnated. [1] http://www.washingtonpost.com/business/economy/economic-inequality-contributing-to-gap-in-life-expectancy/2013/03/10/54b5d21c-89df-11e2-98d9-3012c1cd8d1e_graphic.html http://www.washingtonpost.com/business/economy/economic-ineq...
- wutbrodo 13y agoIt's easy to imagine that the damage from following a poor diet is harder on those with lower levels of income and education.
- mhurron 13y ago>The "low fat" mantra resulted in a lot of "fat free" but sugar-laden and/or grain based foods being the primary component of many diets, resulting in epidemic obesity and diabetes. This is because people can't read more than one thing, it's not a conspiracy on the part of the government. Messages from the US government are correct, Americans in general consume too much fatty foods. That people can't look at what they're eating, see it contains 900% of their daily sugar intake and instead stop thinking at that bright 'LOW FAT' sticker on the front is not the governments fault. And god damn, grains are a portion of the diet, they're not pushing a high grain diet. The food pyramid is 'all things in moderation' in an infographic form. And grains aren't going to kill you.
- rayiner 13y agoThe U.S. has greater income and healthcare inequality, and has a larger population of poor people living without access to reasonable medical care. The major impact of this on life-expectancy shows up in infant mortality rates, which is 6.14 per 1,000 versus 4 per 1,000 OECD average: http://www.nbcnews.com/health/us-infant-mortality-rate-drops-only-little-2D11763970 http://www.nbcnews.com/health/us-infant-mortality-rate-drops.... The graphs in the article showslife expectancy at birth, which is a number dominated by infant mortality rate. For life expectancy at age 65, the US is slightly above the OECD average. Comparable to Germany or Norway. See Page 19 of this PDF: http://www.oecd-ilibrary.org/docserver/download/8109111ec004.pdf?expires=1389124518&id=id&accname=guest&checksum=D26C4DD088EA8D0A1A891658B6A8AAAD http://www.oecd-ilibrary.org/docserver/download/8109111ec004.... The other OECD countries started pulling away on infant mortality starting in the 1970's: http://www.conferenceboard.ca/Files/hcp/health/health2012_infMort_tbl.png http://www.conferenceboard.ca/Files/hcp/health/health2012_in....
- refurb 13y agoThe US has a higher rate of infant mortality because it has more premature births. http://www.newsweek.com/us-leads-industrialized-world-premature-births-2917 http://www.newsweek.com/us-leads-industrialized-world-premat...
- rayiner 13y agoThere's lot's of elements to the problem. For example, the infant morality rate for black Americans is double the rate for white Americans, and triple the OECD average: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a6.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a6.htm.
- yummyfajitas 13y ago...and has a larger population of poor people living without access to reasonable medical care. This is unlikely to affect the stats. Giving poor people access to health care does not improve physical health in any measurable way. It does make them feel better, however. http://www.nber.org/oregon/ http://www.nber.org/oregon/
- astalwick 13y agoI would love to see a comparison graph from Canada. The US and Canada are not the same country, but they're similar in a lot of ways. If Canada's graph shows the same drop, it'd be an indication that maybe the problem isn't with the US healthcare system, maybe it's something about culture/diet/environment/etc.
- dghughes 13y agoFrom my perspective as a child of the 70s in a province not on the US Canada has been flooded with US culture. At worst in my childhood were maybe a McDonalds and a Dairy Queen. No cable TV and few other cultural influences. Now we're fat, WalMart shopping, gun toting, rap music/urban culture, even dialects are more US sounding.
- buckbova 13y agoMy childhood exposure of Canada was through the movie strange brew. Still a favorite of mine. http://www.imdb.com/title/tt0086373/ http://www.imdb.com/title/tt0086373/ I figured all Canadians were hosers who scarfed donuts and drank beer. Then I watched Kids In the Hall and I figured they were mostly funny gay fellows. Then I watched South Park . . .
- akgerber 13y agoAnother big difference in the American way of life is that, in most cities, we've managed to engineer a wholly car-dependent transportation system, such that the average American walks half as much people in other countries: http://well.blogs.nytimes.com/2010/10/19/the-pedometer-test-americans-take-fewer-steps/?_r=0 http://well.blogs.nytimes.com/2010/10/19/the-pedometer-test-... All that driving also puts the average American at huge risk for dying young in a car crash.
- DanBC 13y agoAs well as lack of exercise and increased risk of accident is the problem of air pollution, which kills a significant number of people.
- saraid216 13y agoNot even a car crash. http://www.kidsandcars.org/back-overs.html#Studies http://www.kidsandcars.org/back-overs.html#Studies One of my more memorable events back when I lived in a suburban cul-de-sac as a teenager was walking home from school and finding a neighbor's 4-year-old stumbling into the street, blind with tears. Her mom hadn't noticed that she wasn't in the car when she drove out.
- robin_reala 13y agoEspecially as US driving tests are anecdotally much easier than tests in other developed countries. [1] [1] http://www.theguardian.com/world/shortcuts/2013/oct/11/britain-make-its-driving-test-harder-18-curfew http://www.theguardian.com/world/shortcuts/2013/oct/11/brita...
- Zigurd 13y agoThe proverbial two-edged sword there.
- curtis 13y agoI wonder if the non-US OECD life expectancy might -- for some decades prior to 1990 or so -- have been excessively depressed by a couple of years. There are two major reasons I can think of for this. The first is that for at least the first half of the 20th century the U.S. population on average was probably substantially wealthier than European counterparts (European countries make up a substantial part of the OECD). The second is that the civilian population of much of Europe suffered much more during World War II. This might have resulted in lingering effects on life expectancy that gradually disappeared over the ensuing decades.
- vasilipupkin 13y agothat would explain convergence between U.S. and OECD, but it wouldn't explain a continuously widening gap going forward in favor of OECD vs US
- jessaustin 13y agoIt would explain the emergence of a gap caused by other factors that harm USA but previously canceled out by the factors noted that harmed e.g. Europe.
- curtis 13y agoI think that it might explain part of the divergence. There are a couple of obvious reasons that the U.S. might trail the OECD -- the greater number of deaths due to higher car accident rates and a higher murder rate, as well as a well known disparity in the life expectancies of Americans of primarily European descent and those of people of primarily African descent. I'm still trying to figure out how to say this. I'm wondering if the "natural" life expectancy in the U.S. has always trailed the "natural" life expectancy of the rest of the OECD (judged collectively, anyway) but because of some systemic effects in Europe this natural disparity was offset for some decades. The effect might have been something that gradually faded, exposing the natural life expectancy differential. I don't want to overstate things here -- there are some clear candidates for things that might have gone wrong with health in the United States in the last couple of decades that we want to look at. But I suspect this is not the only thing we're seeing in this data.
- Ologn 13y ago"perhaps doing and eating what we want (to the extent we’re making choices) is more valuable than lower mortality and morbidity" It seems more systemic to me. I go to my supermarket and decide to eschew snacks like candy or potato chips for dried fruit or the like. But even the dried fruit has extra sugar added to it. I look at the vitamins and such on some yogurts and there is very little healthy about them. Normal dinner type foods are loaded with sodium, cholesterol, saturated fat etc. Even when one wants to be eat healthy, it can be a trial, because so much food is loaded with junk, even "healthy" type foods.
- beachstartup 13y agoi don't agree with this, at least for people who can afford it or live in non-food desert areas (you didn't make the distinction in your assertion) if you walk into a any grocery store, there's fresh/unprocessed meat, poultry, eggs, fish, vegetables, fruit everywhere. you don't need to buy anything that comes in a box or wrapped in plastic or has added sugar or salt or anything. you don't need to eat anything beyond that selection to be healthy. whether or not you want to go through the trouble of preparing it is another matter.
- DanBC 13y agoWhat you say is true, but don't forget that most people have rudimentary at best cooking skills and haven't learnt how to use a shopping list. Combine that with misleading labels and massive advertising budgets of ready meals and it's easy to understand how people fall into the trap.
- adventured 13y agoMost people haven't learned how to use a shopping list? What people are you talking about exactly (emphasis, as I'd like to know who you're describing here)? I grew up in poor Appalachia. Every single person I knew, understood perfectly well how to use a shopping list, and how to cook. I simply can't imagine who these people are that don't know such things, given my comparison group is in theory low on the education chart.
- RankingMember 13y agoThe Amish present another interesting divergence from the general populace's life expectancy: "[T]he Amish have had a 72-year life expectancy not only for the past few decades, as have most Americans, but for the last 300 years—since they settled in the United States in the 1700s, when most people living in America were dying in their 40s." http://gerontology.umaryland.edu/documents/Advances_in_Aging_fall031.pdf http://gerontology.umaryland.edu/documents/Advances_in_Aging...
- chc 13y agoWas there really a time when most Americans were dying in their 40s (as opposed to 40 being the life expectancy from birth, which is a wildly different thing)?
- 0A0D66 13y agoYeah, something weird is going on there. 72 years at birth for the Amish sounds absolutely crazy too. Maybe the Amish one is life expectancy at 5 or 20 and the other at birth.
- maxerickson 13y agoIt's possible that they simply have much lower rates of infant mortality. The linked discussion is from pay-walled researchers, so hard to see where they discuss their methodology. Low incidence of alcohol use, strong communities with a tradition of midwifery, narrow genetic pool (which would tend to exaggerate any gene pool effects) are all things that could contribute to lower rates of infant mortality.
- RankingMember 13y agoI had no idea the two were different, so thanks for making that distinction. For anyone else's sake, I'll share what I learned: Life expectancy from birth weights times of poor medicine and prenatal care towards the low end of the life expectancy scale because of much higher infant mortality rates, whereas in modern times life expectancy from birth would be weighted the opposite. So basically, if you filter out infant mortality and other "first years of life" deaths, you get a more accurate picture of how long someone could actually expect to live if they make it past the initial thresholds to human existence. At least that's what I've grasped thus far.
- javert 13y agoUndoubtedly has something to do with the fact that patients and doctors are not free to make the best decisions for personal care. You can actually do better in that regard in a German-style nationalized healthcare system than an American-style quasi-national corruptocracy. But there is only one way to guarantee it completely and in principle: separation of state and medicine, just as we have separate of state and church and should have separation of state and economics.
- dragonwriter 13y ago> just as we have separate of state and church and should have separation of state and economics. That's a nice series of words that doesn't really have coherent meaning: "politics" and "economics" are different names for essentially the same thing, the manner in which a society distributes power. You can't separate them -- state action is inherently economic.
- javert 13y agoThat's simply not true. Under laissez-faire capitalism, the state is separated from economics except in that it must tax and spend to maintain a night-watchman state (military, courts, and police). The only thing that state action inherently is, is coercive. (Though I'm not advocating anarchy; coersion can be moral.)
- vasilipupkin 13y agoI would be curious to see not just the median but the mean. The median isn't super informative in the sense that U.S. is much more heterogeneous / unequal than OECD
- jessaustin 13y agoIn the absence of high infant mortality, it isn't clear to me why median and mean for lifespan would diverge in any meaningful way. In the presence of high infant mortality, the mean would just be lower than the median: how would that be particularly informative?
- vasilipupkin 13y agoMedian and mean could and most likely do diverge because poor people live significantly shorter lives than rich/middle class people. Europe in general is more equal than the U.S.
- ronaldx 13y agoThe mean would give the same quantity of information but biased (in this case) by the infant mortality rate, which probably should be examined seperately. The median is the preferred statistical standard. What you are looking for is a distribution of life expectancies per country.
- vasilipupkin 13y ago"the median is the preferred statistical standard" - that depends, not sure what this blanket statement means. But yes, you are right, I am looking for the distribution or a sense of it anyway.
- dragonwriter 13y agoYou'd really want to see something like a lifespan version of the Gini coefficient to assess inequality. Having the mean as well as the median wouldn't really tell you a lot.
- 13y ago
- sgustard 13y agoUS needs to step up its effort to export lower life expectancy: http://en.wikipedia.org/wiki/List_of_countries_by_cigarette_consumption_per_capita http://en.wikipedia.org/wiki/List_of_countries_by_cigarette_...
- azernik 13y agoThis bit struck home for me: Some have also suggested that unfavorable US performance is explained by higher risk of iatrogenic disease, drug toxicity, hospital-acquired infection, and a cultural preference to “do more,” with a bias toward new technology, for which risks are understated and benefits are unknown. I know some people who use both the US and the Israeli health systems to some degree, and one contrast I've heard is that Americans (patients as well as doctors) tend to prefer newer, less well-tested (because newer), and more expensive (because still patent-protected and brand-name) drugs even when the new drugs have the same or worse performance than decades-old alternatives. I'm not sure if the health drawbacks of this approach are significant, but the economic ones are stupendous; the newer brand-name drugs can be ten times more expensive than the old ones.
- hackbinary 13y agoUniversally available public health care, or lack there of. Americans spend a disproportionate amount of their GDP on inflated (private) health care costs, and are therefore more reluctant to seek treatment before conditions become acute.
- FrankenPC 13y agoIf you tweaked the chart to show relative lifespan based on income, I wonder what you'd see?
- vasilipupkin 13y agoI also wonder if population density makes a difference. An ambulance should take less time to get to you in Manhattan than 80 miles outside of Houston.
- shaunrussell 13y agoCorn subsidies and good marketing.
- AnimalMuppet 13y agoOne might guess that around 1995, something happened to the US food supply. Maybe the big surge of GMOs (which didn't happen in Europe because they're banned)?
- jakobsen 13y agoGMOs are not banned in Europe as a whole, but it looks like only Spain have a significant GMO output [1]. Coincidentally Spain has a nice life expectancy, so there doesn't seem to be an obvious correlation (one might argue that Spain might produce but not consume most of it GM crops, which I don't know). [1] http://www.ipsnews.net/2013/03/spain-leads-the-eu-in-gm-crops-but-no-one-knows-where-they-are/ http://www.ipsnews.net/2013/03/spain-leads-the-eu-in-gm-crop...
- diogenescynic 13y agoWe lack basic access to affordable health care, we drive too much which causes more fatal accidents/injuries, we don't walk enough so we don't get enough exercise, and we eat highly processed foods. Pretty simple.
- JakeJackson 13y agoOne question: Are the OECD averages weighted by population, or does each country get equal weight?
- OregonJon 13y agoIt strikes me that "Life Expectancy at Birth" is the wrong measure. I suspect (and would like to see the stats) that the USA has a higher mortality rate below age 40 than other western countries but that it levels out after that. But is life expectancy the end all and be all. At age 98 my aunt, who was of sound mind and body, was informed she'd probably live to be a 100. Her response? "Oh, God, I hope not." She lived to 102, aware and cognizant to the end.
- jakobsen 13y ago>I suspect (and would like to see the stats) that the USA has a higher mortality rate below age 40 than other western countries but that it levels out after that The USA has a lower than average life expectancy at age 65, and the life expectancy has also grown less than average for that group, according to the OECD[1] EDIT: >But is life expectancy the end all and be all I agree there. The same document includes a "healthy life years at age 65" (only for European countries though), but it is arguably a much less objective measurement and hence less useful. [1] http://www.oecd-ilibrary.org/docserver/download/8111101ec066.pdf?expires=1389206996&id=id&accname=guest&checksum=8971B0DE70B924813D5691E2D119601C http://www.oecd-ilibrary.org/docserver/download/8111101ec066...
- Communonymous 13y agoThe scary thing is that if you break it down by income top earners are improving. Similar findings if you look at infant mortality rates. "The life of a single person is worth more than all the money of the richest man on earth." - Che Guevara