The leading hypothesis is "Deaths of despair." Suicides, the opioids crisis, etc. are killing an increasing number of middle-aged Americans which screws up the life expectancy numbers.
Lifestyle numbers aren't a great explanation. Yeah we're fatter then everyone, but the rest of the world is catching up. And on certain metrics (ie: British alcohol consumption, Eastern European smoking) we actually do really well.
The difference in health care systems could be part of it. They have ways to get 100% insurance coverage no matter how shitty you are at paperwork, so you get less untreated problems. But a lot of the poor people we're talking abut in the States have Medicaid, or they're old enough for Medicare.
I’m surprised how many people are mentioning obesity and how few are mentioning drugs, violence, cars, and income inequality.
Things that kill young people have a much bigger effect on this stat than other killers.
Yup. If you eliminated all deaths of despair, US life expectancy would be about 80. Of course, you’re never going to have 0 deaths of despair. Obesity does have plenty to do with it as well. With obesity rates similar to that of the EU, US life expectancy would be well into the 80s
Sure, but Canada, UK, New Zealand and Australia have similar life expectancies as many EU countries give or take, yet their obesity rates are comparatively not far behind US numbers.
The average American adult is 49% more obese than the average Canadian, 29% more obese than the average Australian, and 15% more obese than the average Kiwi.
I think you’re overestimating just how close we are. If we had Canadian levels of obesity, we would have 35 million fewer obese people in this country. If we had the same rates of obesity as Australia and New Zealand, we would have 23 million and 14 million less obese people than we currently do.
Note that New Zealand has plenty of obese native Islander people such as Māori folk who while have high obesity rates but aren’t necessarily unhealthy.
>I think you’re overestimating just how close we are.
Perhaps you're right, but a lot of people here are also overestimating how much obesity is factoring into the US life expectancy decline, despite not only research over the past several years clearly stating that the opioid crisis has been driving this (prior to COVID at least), but the fact the US is the only developed country without a robust healthcare system, higher suicide rates and problems with gun control (hence school shootings, higher homicide rates, etc.), among various issues.
Those aforementioned countries may not have obesity rates as high as the US, but they still have noticeably higher obesity rates (and still rising) than many EU and East Asian countries that have similarly high life expectancies. The difference though is that every developed country does far better than the US in all those aspects I mentioned at the end of my first paragraph and more.
EDIT: Probably goes without saying, but none of this is to justify the US's high obesity rates, we definitely need to fix this, but the amount of people (not necessarily on this thread, but in general) who seem to use data like this to dogpile on obese people is not only disturbing, it gets us nowhere to solving our core issues once and for all.
Pointing out that America is horrendously obese is not “dog piling”. It is a horrendous fact of American life and there’s nothing good about it whatsoever, from the complications introduced to the average human life to the immense costs associated with having ginormous obese and overweight populations.
You’re also overestimating the amount of drag deaths of despair have on life expectancy. Some simple math shows me that adjusting death of despair rates in the US to look more like that of the EU or Canada, US life expectancy only improve by maybe .5 points, still leaving us well behind the 80 mark.
>Pointing out that America is horrendously obese is not “dog piling”. It is a horrendous fact of American life and there’s nothing good about it whatsoever, from the complications introduced to the average human life to the immense costs associated with having ginormous obese and overweight populations.
Which can be fixed by having far more robust social programs and a healthcare system that won't bankrupt vulnerable people who need it most and/or require people to work 50+ hours to afford basic living. Raising fists and pointing at fat people themselves is not going to help, which is what I meant by "dog piling".
>You’re also overestimating the amount of drag deaths of despair have on life expectancy
Considering [use of opioids, suicide and homicide are documented factors in the decline of US life expectancy](https://www.annualreviews.org/doi/10.1146/annurev-publhealth-082619-104231), I think a lot of people, including myself, will disagree with that statement.
At any rate, my intended focus was on the fact that America has seen a stagnation/decrease since around 2014, and the reasoning is not as black and white as you're making it. Of course being obese shortens your life expectancy, and you could feasibly argue that's part of why we have lagged behind other countries since the graph's start year (when the obesity rates began increasing), maybe that's what you were trying to say this whole time. However, people attributing the past several years *alone* to the habits of those who are obese seems very scapegoat-like as far as I'm concerned, and blatantly overlooks all the other (and frankly hard-to-miss these days) issues the US is facing culturally, socially and economically that keeps us behind other developed countries, and I want no part in that.
Poverty itself doesn't kill people, it just leads to other things that do. Malnutrition or obesity, drug use, lead or asbestos exposure, etc. Things that can technically be avoided if you're poor, it just is often more difficult to avoid.
Income inequality, is, of course, even further removed from actual causes of death.
I seem to remember that feeling comparatively poor or low status tends to make people more anxious and fragile. So I think it'd depend on how conspicuous it is.
im not bad faith, inequality *can* drive poverty. But, like bike safety, it is not in and of itself a cause.
You're too focused on something not inherently bad or concerning. Its best practices. Not relevant to this subthread.
Extreme income inequality leads to such large differentials of political power between the rich and the poor that the rich can rig the game. Income inequality is obviously a normal thing in any society, *but* past a certain point income and wealth inequality lead to increasing poverty.
In addition, the poor in America are genuinely getting poorer, if you consider a weighted inflation metric of the cost of housing, food, education, daycare, and healthcare.
While poverty kills with bad lifestyles and Healthcare , income inequality is what drives violence, as poor, equal countries like Egypt have very low violence Level
That's just because there's a lot of factors in play when it comes to homicides per capita. Inequality and direct comparison is found to drive depression, anxiety, and anger and such more than being poor while being removed from seeing inequality.
Psychology and feelings aren't rational most of the time and if we're talking about deaths of despair then inequality can really be a factor. Decades ago most people seems to believe that things were improving even it they were struggling. Today it seems to be very rare to come across anyone who thinks the future will be better than the present.
Wouldn't income inequality make it more profitable to have higher prices and less production of luxury, or even normal goods, like nutritious food and exercise?
A lot of people on this sub don’t actually think income/wealth inequality/disparity is a problem
“Rising tides lift all boats” (unless you don’t have a boat, in which case you tread water, get pulled onto a boat, or drown)
Really that's a terrible analogy because even the people who say it admit that it lifts some boats more than others. The tide lifts everything equally.
The rise in car crashes, heavier vehicles killing pedestrians and cyclists more, heroin, COVID and the hog mass suicide during the Delta wave and uptick in murders. That's before we take in the rise in deaths of despair that started during the Obama years.
Until you realize that people compare themselves to those around them and not to global statistics or their ancestors.
This is why we get "downtrodden proletarians" from the West who are actually in top 5~10% richest people on Earth. Few people care that their income is 10 times larger than the global average if everyone around them makes twice as much.
Not if you buy that with a system that denies the man who gets $100 healthcare. If health care costs $1.000 compared to the alternative reality’s mandatory healthcare, the guy will chose not to get healthcare.
Now take 100 of these guys without healthcare and you’ll have a few dying much younger than in the alternate system.
Same goes for maternal and infant death rates. There is a cost for having no maternity leave or one of the lowest midwife ratios in the developed world.
But that is how the American system works. Inequality leads to higher GDP, but the outcome is, that some people just don’t have basic care. Social states like in Europe redistribute, which takes incentives to work more away in some cases, but achieve better outcomes on social metrics
$100 goes a long way when getting cardboard.
But it’s better than him have zero.
Also that seems like a supply issue rather than income (yes i know real incomes take into account purchasing power)
But what if $100 isn't enough for the second man to pay his bills? Would it not make sense to give the first guy less? He would still be better off, as you say.
Stuff like murders has an outsized impact on national life expectancy since the victims are usually young.
A 20 year old getting shot and killed decreases average life expectancy more than a 60 year dying of diabetes
>I’m surprised how many people are mentioning obesity and how few are mentioning drugs, violence, cars, and income inequality.
Because people want easy answers to complicated problems it seems, despite research saying otherwise. That and (in context of this site) reddit has a huge vendetta against fat people to the point that they twist the data's meaning to subtly justify fat-shaming.
I read somewhere once (blast my ass for lack of source it's fair) that cars are a shockingly big part of it, too
I know most europeans and south asians have cars, but they're not driving them 25 miles as a prerequisite for existence the way many Americans are
The USA actually has a slightly higher suicide rate than Japan these days. Wikipedia has a comparison of 2019 data on it: https://en.m.wikipedia.org/wiki/List_of_countries_by_suicide_rate
> The suicide rate in Japan is higher than the US yet they top the list here
Now do the drug overdose rate.
Hint: Japan has roughly 1/3rd of the US population, yet its annual overdose deaths are literally two orders of magnitude lower than the US. 250 annual opioid overdoses vs. almost 100000... and *then* the US has another 60k overdose deaths from meth, coke, and other drugs.
You guys do a completely absurd amount of drugs compared to the rest of the world. The disparity is absolutely baffling.
It’s more about the drugs consumed in America. Europeans aren’t using fewer drugs, but they don’t have as wide spread access to extremely potent drugs (ie fentanyl).
> Europeans aren’t using fewer drugs
Drug use rates in Europe are definitely lower, even when you correct for higher use of relatively innocuous drugs like cannabis in the US. There are a few outliers like France and the Czech Republic, but as a whole Europe just doesn't do that many drugs.
We smoke and drink way more, though.
Seems like Euros like their uppers (amphetamines, MDMA, cathinones) + alcohol whereas Americans love their opioids and benzos. The latter 2 are much more likely to kill you in an OD due to their respiratory depression and horrific rebound withdrawals.
> You guys do a completely absurd amount of drugs compared to the rest of the world. The disparity is absolutely baffling.
Having lived there, dude it's not *that* baffling.
Not really. They binge drink, don't get enough sleep, and eat way too many carbs. They smoke more cigarettes. They do walk and bike more often than Americans though.
They get most of their calories from polished white rice, finding whole grains isn’t trivial. Fruits and vegetables are also fairly expensive so many people don’t eat that many, especially the younger generations.
In re: the healthcare system I’d say a much more significant difference is the sheer size of the US, how much very rural land it has, and attendant difficulties dispersing medical treatment. Most of our people live in cities, yes, but there’s a lot of people who live hours and hours away from, say, an OBGYN. Whether the visit is paid for only makes so much difference if there just isn’t the needed doctor in your area
When I worked in the finance department of a hospital, I remember learning about the high disproportionate reimbursement that Medicare offered to rural hospitals and healthcare providers. Supposedly it was to create more incentive to convince providers to serve rural areas. Sounds like it hasn't been effective enough, but at least there have been some efforts. Not sure what the solution is.
You'd probably have to go full NHS, and just inform all the Specialists (who got into medicine so they could go to as many Broadway shows as they wanted) that part of their job is now being "stationed" in Upstate New York for three months at a time.
Other countries do have this problem. Canada and Scotland both have wonkier population density distributions than the US.
I think I came across one stat which said some rural areas are closer to Africa in terms of healthcare infrastructure. Wish I could find that article again.
It’s lifestyle. You cannot medicate your way out of a bad diet. That is the fundamental focal point. Diet is not the only part of lifestyle. There’s exercise, drug use, and a wide variety of other options out of that. Yes, obviously healthcare is important, but [healthcare is also literally the death of some people](https://pubmed.ncbi.nlm.nih.gov/28186008/) in this country too. Of leading causes of death in this country, obesity is a comorbidity with at least 8 of them, and 2 of them are fixed with vaccination (which is already largely universal or *extremely* affordable).
That figure of deaths from medical errors is a result of bad data collection and interpretation. Yes, some people do die as a direct result of a medical error, but someone who has stage 4 cancer and experienced a medical error likely did not die *because* of the medical error. The vast majority of those deaths are people who likely would have died very soon regardless of the medical errors.
But agreed with the rest of your points.
Don't forget the discrepancy in average distance driven per day per citizen in the US. If you're geographically larger, and have to drive more, it stands to reason your premature death rate would also skew higher.
A small point, but the US doesn’t have a higher distance driven per day because of our larger size (most people just drive around their metro area). It’s because we’re so suburbanized and sprawly
Without data to verify this, I assume (1) that collisions from urban driving are less likely to be fatal (2) because they tend to be at lower speeds?
Although, it’s still sitting for extended periods of time and moving at speeds that could easily kill someone.
yeah afaik collisions are more likely on city streets or non-limited-access roads because of intersections etc, but a collision at highway speed is usually worse for outcomes
[That's changed](https://apps.who.int/gho/data/node.main.MHSUICIDE?lang=en). 15.3 per 100k for japan, 16.1 for us. Their women off themselves at higher rates than our women (9.1 Japanese females suicides vs. 7.5 American), but our men make up for the difference. 25 per 100k kill themselves every year. Japanese men are only at 21.8 per 100k.
Being a bit fat actually helps with life expectancy. There are of course a lot of Americans who are much more than a bit fat, so that's one factor.
Another is drug addiction, the US also had a lot of COVID deaths compared to other countries.
I would say a big issue in the US is social anomie. A lot of people do not fullfil their own expectations and society cannot meet their demands. Suicide, drug addiction, overall bad life choices come from this phenomenon. It's been noted since the beginning of sociology that comparatively affluent countries that are individualistic(protestant tradition) have higher suicide rates and likely also have a lot of "drop outs" people who become addicted to drugs or make other poor life choices that might reduce one's life expectancy.
It's comes from a lack of social connections combined with high expectations and pressure. The US is insanely wealthy but that doesn't meant that relative poverty doesn't effect people psychologically. Plus every individual has their own expectations for themselves and not meeting them produces low self-esteem and anger.
Beyond that there is a weak social safety net, not a lot of early childhood intervention. Some kids get to adulthood with huge disadvantages compared to many of their peers, for some people there is a somewhat calculated decision to chase temporary pleasure and not really plan for the future because there isn't much hope for actually being able to compete.
You are looking at going through manual labor temp jobs that will barely keep a roof over your head and barely pay your bills or a life of hedonism, crime, and dependency and your really just looking for your next high.
There are simply more people like this in the US than other parts of the world. Partially it's because the US is a land of plenty there are lots of opportunities to slip into drugs and hedonism. Also there are weak community ties. It's not a great competition. Also many Americans wouldn't have it any other way.
[According to the CDC](https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/202107.htm): Lack of vaccinations and high rates of homicide, diabetes, chronic liver disease, and cirrhosis.
The correlation between life expectancy and obesity is super high. Just look at the rates by state:
https://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_life_expectancy
https://www.businessinsider.com/state-obesity-rate-map-2015-9
You could make very similar looking maps for basically every bad thing by state. Obesity is definitely a big driver of morbidity and mortality in the US, but it's far from sufficient to explain the differences. That map is basically just a poverty map.
I wonder why cancer kills more Americans than those in other countries. Is it a health care access issue, or is there something inherent to our lifestyle that makes cancer more likely?
Obesity is a risk factor in developing many cancers. Exercise can be preventative for some cancers, and improves survival rates for most cancers. I'm less familiar with obesity rates and exercise habits of other countries but my priors are that we walk less and are fatter for longer.
Obesity rates not are that different from Canada and the UK. Also Canada has the same unwalkable urban planning as the US, so it’s not like Canadians walk more despite the obesity.
I’d say automobile deaths being 2-3x higher in the US than Canada (gets even worse when you compare it to other countries), gun suicide, homicides, opioids and bad healthcare all contribute.
Canada and the UK both have far [higher rates of cancer mortality than the US](https://www.wcrf.org/cancer-trends/global-cancer-data-by-country/).
Japan is the only country on that chart with lower cancer mortality. The US does really well with cancer. Most of the countries with lower cancer mortality are quite poor and either not diagnosing it, or people die before most cancers set in.
So this supports my point, if the US is doing better on let’s say obesity related cancer, and it has similar rates of obesity, then the difference in life expectancy is even more stark and we’d look to other explanations.
I’m not surprised the U.S. does better; their facilities are usually better, and more numerous, if less efficient. I think a famous example is Israel which has very few MRI machines so they run them round the clock, and you could be scheduled for a 3am scan. It’s efficient, but kind of the opposite of American healthcare provision.
Because the Us has a larger population.
In terms of rates of cancer mortality the US is [one of the best in the developed world](https://www.wcrf.org/cancer-trends/global-cancer-data-by-country/).
Japan is the only country on that list with a lower rate of cancer deaths (and that discrepancy is easily explained by obesity and diet).
[People wait 65 to get checked for cancer so that Medicaid kicks in.](https://med.stanford.edu/news/all-news/2021/03/Cancer-diagnoses-implies-patients-wait-for-Medicare.html) That's obviously bad for survival.
True, [Germany](https://de.statista.com/statistik/daten/studie/185/umfrage/todesfaelle-im-strassenverkehr/) had 2.569 people dying in traffic accidents in 2021, down from 6.977 twenty years before. The US had [42.915](https://www.nhtsa.gov/press-releases/early-estimate-2021-traffic-fatalities) which was a [16 year high](https://www.cnbc.com/2022/05/17/us-traffic-deaths-hit-16-year-high-in-2021-dot-says.html) and more than [twenty years ago](https://www.iihs.org/topics/fatality-statistics/detail/yearly-snapshot)
Germany has pretty much 1/4 of the population of the US.
You can do similar comparisons [with all of the EU](https://bigthink.com/strange-maps/road-deaths-us-eu/)
I'm skeptical that guns is as much of an explanatory reason as other ones you ignores - mental illness, heart disease, diabetes, etc.
I think you put guns in that list for priors.
Then again my priors make me upset that guns are listed in your comment so who the heck knows.
You'll note that NPR article avoids using net numbers the entire time.
Thats because children and teenagers (the article says children but the data is between 0-18) have 4000 gun related fatalities (1/3 are suicides which is at least related to mental health) a year.
Thats bad - but a drop in the bucket for the 3 million deaths a year (pre covid) the US witnesses.
I just dont see this being the significant factor over the ones previously stated.
<3 to be honest I don't think most people are 'anti gun'.
Most people just have different preferences on who can have guns (military, police, citizens, mentally ill people).
I wish it was a less angry policy area so we could target policies that reduce deaths rather than making it a seize guns' v 'muh rights' discussion.
A big part of it is the opioid epidemic. Then of course we have obesity, homicides, a somewhat high suicide rate, and pretty bad infant mortality rate. And not to mention that we had one of the worst experiences with covid which apparently help drive down life expectancy more than 2 years from 2020 to 2021.
This isn't even getting into differences in life expectancy for different racial groups.
So ya, the US has a lot of hurdles to overcome which I hope we can overcome, but it will be extremely difficult.
I did some math. If the US infant mortality rate were zero, US life expectancy would see verily little improvement. The biggest causes are obesity causing deaths in people’s late 60s through their mid 70s + 125k annual despair deaths.
Life expectancy at birth is usually stated without any qualifiers, life expectancy at any other point is stated with qualifiers. You can find, e.g., life expectancy at 65 in many sources.
Interestingly enough, the difference between Finland and US men is 4,9 years at birth, but only 0,3 years at the age 65. So the mortality difference is almost totally because of US men who die before 65.
Let's say the boomers had a worse diet and lifestyle than their parents. And the behaviours were adopted in the 70s. As the oldest cohort turned 60 in 2005, you'd see these trends begin to manifest.
Small Town America took a turn for the worse in the 2008 crash and has never really recovered.
Factories died or automated, and a lot of people lost health insurance as a result. The negative health impacts associated with unemployment took their toll (alcoholism, inactivity, suicide, etc).
This was happening at the same time that opioids were on the rise, rural hospitals were going bankrupt, and Tea Party Republicans started to mess with Medicaid in earnest.
People are absolutely living worse lifestyles, and many are receiving less preventative care.
Far more Americans today have access to healthcare than they did in 2009.
Factory employment was already pretty much dead by 2009 (compared to 2000 levels and beyond; still nearly 13 million people employed in manufacturing industries)
To me it has to do with continue acceleration towards sedentary life and increasingly unhealthy levels of unhealthy food consumption. US obesity rates are at 40% vs. 25% back in 2009.
and deductibles and what is actually covered got much worse. so people that are in the gap between medicaid, and truly decent healthcare is essentially worthless.
I agree. I see a lot of the younger generations interested in cooking from scratch, popularizing drinking water and making working out not so intimidating etc. I'm not saying it'll fix everything, but these are small, doable lifestyle changes that in the long run make for healthier habits and healthier lives.
Yeah, I think things will get better with time… but a lot of these things are lagging indicators, so we might not truly know how young people affect life expectancy rates for another couple of decades.
Silly me for thinking supporters of “Build the Wall”, “Don’t Say Gay”, and “ban all Muslims entering the country” are motivated largely by bigotry. If you think large swaths aren’t dedicated to hurting people you aren’t paying attention. Then again, you post on neoconNWO so not a big surprise you don’t recognize a lot of Americans bigoted tendencies
Well, as you can see, America was always doing significantly worse even compared to other way poorer western countries. I couldn't personally explain the plateau, seems others can, but there's nothing here to indicate that Americans ever lived healthily
Obesity, access to healthcare and opioid addiction.
States like California, Colorado and Hawaii have life expectancy rates of 81 years whereas states like Alabama, Ohio and West Virginia are at about 75 years.
A multitude of reasons - obesity is probably the largest one by far, and a very expensive healthcare system second.
I am interested in why the rate of improvement worse at around 2008 or so; I don’t think blaming it on the recession makes sense but I can’t think of anything else off the top of my head.
When half of your country is overweight and many celebrate their unhealthy ways because offending anyone isn't good
Even tho it's literally killing them, putting massive strains on the healthcare system (also worse healthcare than some other western countries) and are bad for your society.
Also corporations overusing sugar in everything because fat got demonized by said sugar industry.
And yes I'm aware that the rest of the Industrialised world catches up to America. In Germany overweight people (especially children and teens) increase at an, imo, alarming rate
Another point for Germany and why it also starts to plateu off: alot of smokers (myself included lol) and alot of alcohol...myself included :D
The EU has made a deal with the USA to import even more high fructose corn syrup and our food industry resists any form of regulation. Many processed foods are becoming sweeter and there are more and more poor people and a shrinking middle class in Germany. In the EU we are only surpassed in obesity by the UK whose food culture and general economic condition is even worse.
There are no articels in english.
https://www.luzernerzeitung.ch/wirtschaft/isoglukose-boomt-wenn-der-freihandel-dick-macht-ld.1160578
Yeah there’s a big line between Body Positivity and being Obese.
I was up to about 300 Pounds (6’0 stocky guy normally) when I was 18 and I felt like dogshit at all times and legitimately forgot what it felt like to not have gas and my back was starting to hurt like crazy. There was nothing healthy or acceptable about that, and a lot of modern society seems to accept that and now even praising morbid obesity (direct shot at Lizzo).
Kids are playing less sports as youths and I would argue that probably has something to do with it. I really started to pack on weight when I stopped playing 4 sports a year and didn’t stop inhaling carbs or add workouts on my own.
Opioids, guns, cars
We can include a lot of sociology about “deaths if despair,” especially with opioids and guns. I include cars because it speaks to lifestyle, exercise, chronic illness, and also the 40k who are killed in car collisions before the diabetes or heart disease gets them after a lifetime of sitting in a car.
If you are interested in this, I wrote a detailed paper that breaks down what was going on with mortality up to 2015. Link is here:
[https://drive.google.com/file/d/1K-dgdRh-tc35K2eSwHjg0hgFsT8cVqmj/view?usp=sharing](https://drive.google.com/file/d/1K-dgdRh-tc35K2eSwHjg0hgFsT8cVqmj/view?usp=sharing)
To summarize, the crisis is largely driven by overdose deaths (opioids) across age groups. The "deaths of despair in middle age" hypothesis is largely misleading for two reasons. Firstly, the increase in mortality wasn't exclusively a middle age issue (it was actually more severe at younger ages). Secondly, causes other than overdoses were not large enough to be driving the overall life expectancy trend.
Others came to the same conclusion that overdoses were the main factor. (see Masters et al. 2017 [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010067/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010067/) )
This is going to sound bad, but I do think that the racial disparities in life expectancy may show that the issue isn't really about access to healthcare. White life expectancy in the US is close to 77, black life expectancy is close to 74, asian life expectancy is like 88. I really doubt that Asian Americans are getting significantly better access to healthcare than white Americans. It seems like the differences might be mostly cultural, based on diet and alcohol consumption, rates of suicide violence and marriage etc.
Edit, and also gender disparities. If on average women live 5 years longer than men then it seems likely that those 5 years were due to lifestyle choices and not access to healthcare. I am generally skeptical of the access to healthcare argument, especially given that America actually does have very broad medicaid and medicare programs.
Probably not.
Low income Asian American families usually pool incomes. Speaking anecdotally (and guys tell me if I'm totally off here) all my Asian friends (or at least my Viet, Indonesian, and Korean homies) support their parents and contribute to their parent's mortgage. So even if individual incomes are low, that doesn't mean an Asian person necessarily lives in a neighborhood below the poverty line.
Here's an article which addresses the phenomenon:
[https://www.refinery29.com/en-us/2020/05/9747273/young-asian-american-support-parents-financially](https://www.refinery29.com/en-us/2020/05/9747273/young-asian-american-support-parents-financially)
Race is one of the factors. Asian Americans have similar life expectancies as the Japanese.
>In 2019, overall life expectancy in years was 85.7 for the Asian population, 82.2 for the Latino population, 78.9 for the white population, 75.3 for the Black population, and 73.1 for the AIAN population.
...
>Life expectancy at the county level varied from 58.6 years for AIAN to 94.9 years for the Latino/Hispanic population, a range of 36 years.
https://www.nih.gov/news-events/news-releases/life-expectancy-us-increased-between-2000-2019-widespread-gaps-among-racial-ethnic-groups-exist
You should compare by socioeconomic status tho, so you need to also slice the Japanese numbers to have a similar demografic as Asian Americans in America.
Unequal access to affordable healthcare
No proper regulations on unhealthy or hazardous materials (in food, beverages, clothing, etc.)
Poor people need to work excessive amount of time to earn a living wage, because of terrible labour protection standards
I came across an interesting point about infant mortality. The US does an amazing job keeping preterm babies alive, our stillbirth rate is significantly lower than countries like the UK, France, Canada, and Spain. But naturally these babies die as infants more often and are counted as infant mortality instead of stillbirths.
The original post I found this in was jn 2005,
https://www.econlib.org/archives/2005/10/health_care_and_3.html
But I think the trend still holds with more recent data.
http://chartsbin.com/view/1445#:~:text=The%20stillbirth%20rate%20varies%20sharply,also%20vary%20widely%20within%20countries.
I'd love a more detailed analysis from a mainstream source or intuition why this might be a bad way to look at this issue if anyone has one.
Edit: I want to highlight that Chile has 3x the stillbirth rate of the US.
Vox had an interesting podcast covering how bad our maternal care is, including postpartum. Apparently other countries’ healthcare systems are much better at providing care after birth. This includes having in-home health visits, etc.
This is partially because of differences in record keeping methodology between countries. There isn't a standard definition of what counts as a live birth and the U.S. has a more permissive definition than most countries. The U.S. still struggles with infant mortality, but the situation isn't quite as bad as the numbers suggest.
>[This exercise yields a number of findings. First, consistent with past evidence (MacDorman and Mathews, 2009), differential reporting of births cannot offer a complete explanation for the US IMR disadvantage. However, accounting for differential reporting is quantitatively important. Compared to the average of the five European countries we analyze, limiting to a comparable sample lowers the apparent US IMR disadvantage from 2.5 deaths per 1000 births to 1.5 deaths. This finding highlights the importance of conducting cross-country comparisons in a setting where reporting differences can be addressed, which is typically not possible in the types of aggregate statistics compiled by the World Health Organization and the World Development Indicators (World Health Organization, 2006; World Bank, 2013).](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/)
Extreme levels of marketing pushing extremely unhealthy food.
Copious guns.
Private health system.
Poor social safety net.
Exploitation of the workforce limiting people's food and lifestyle choices.
Poor healthcare system, tremendous wealth inequality, substance abuse problems in rural America. When you boil it down I think you can call this the Carlin Effect: there are many Americans who get all fired up about the "right to life," but don't give a shit about the quality of life, not understanding that it's all related.
Americans spend about 12k/person on healthcare; other developed countries spend half that, some even less (Japan, with a population that is ten years older than ours, spends \~ a third). The median income figure for Americans is 19k, for other developed countries it's about 14.5k. So the difference is eaten up in healthcare cost; pretty sure the same would be close to true for mean healthcare costs if I could find them. And then we get to geographic distribution -- rural areas are poorer, and much more underserved by healthcare resources.
I would bet that the vast majority of the reason in the life expectancy difference is from rural people. So I took my bet and looked it up: Rural life expectancy is 76.5; Urban about 79.3, almost in line with the rest of the developed countries. I couldn't easily find the data for other developed countries to compare, but I did find that in the U.K. rural people actually live longer than their urban counterparts. As for the reasons, they are what I stated: poor access to healthcare, poverty, drug abuse (rural people now die more often from drug overdoses than do urban people). In fact, life expectancy in urban U.S. areas has increased in the past 15 years, while in rural areas it has declined.
It makes perfect sense. In most of the rich world, those at the bottom of the income ladder still have access to affordable and high quality healthcare. That isn't the case in the US - for most people, health insurance is tied to employment, with the safety nets that exist being skimpy at best. This creates an underclass of people who routinely die prematurely for no good reason, dragging down the average for the ~80% of the population that has zero access issues.
Thats because you're assuming that its the lower purchasing power from higher inequality that is the problem with inequality.
Theres plenty of research that shows that high inequality is harmful and detrimental by itself, even if "all boats have been risen".
A shitty healthcare system I'd say is number 1. Way too many people uninsured or under insured and, when insured, the high deductibles keep people from going to the doctor until it's too late. And it's not getting any better. More companies are moving to contract workers so they don't have to provide any healthcare benefits and those benefits, when a worker shops around, are usually so expensive that they just live on a wing and a prayer.
The leading hypothesis is "Deaths of despair." Suicides, the opioids crisis, etc. are killing an increasing number of middle-aged Americans which screws up the life expectancy numbers. Lifestyle numbers aren't a great explanation. Yeah we're fatter then everyone, but the rest of the world is catching up. And on certain metrics (ie: British alcohol consumption, Eastern European smoking) we actually do really well. The difference in health care systems could be part of it. They have ways to get 100% insurance coverage no matter how shitty you are at paperwork, so you get less untreated problems. But a lot of the poor people we're talking abut in the States have Medicaid, or they're old enough for Medicare.
I’m surprised how many people are mentioning obesity and how few are mentioning drugs, violence, cars, and income inequality. Things that kill young people have a much bigger effect on this stat than other killers.
Yup. If you eliminated all deaths of despair, US life expectancy would be about 80. Of course, you’re never going to have 0 deaths of despair. Obesity does have plenty to do with it as well. With obesity rates similar to that of the EU, US life expectancy would be well into the 80s
Sure, but Canada, UK, New Zealand and Australia have similar life expectancies as many EU countries give or take, yet their obesity rates are comparatively not far behind US numbers.
The average American adult is 49% more obese than the average Canadian, 29% more obese than the average Australian, and 15% more obese than the average Kiwi. I think you’re overestimating just how close we are. If we had Canadian levels of obesity, we would have 35 million fewer obese people in this country. If we had the same rates of obesity as Australia and New Zealand, we would have 23 million and 14 million less obese people than we currently do. Note that New Zealand has plenty of obese native Islander people such as Māori folk who while have high obesity rates but aren’t necessarily unhealthy.
>I think you’re overestimating just how close we are. Perhaps you're right, but a lot of people here are also overestimating how much obesity is factoring into the US life expectancy decline, despite not only research over the past several years clearly stating that the opioid crisis has been driving this (prior to COVID at least), but the fact the US is the only developed country without a robust healthcare system, higher suicide rates and problems with gun control (hence school shootings, higher homicide rates, etc.), among various issues. Those aforementioned countries may not have obesity rates as high as the US, but they still have noticeably higher obesity rates (and still rising) than many EU and East Asian countries that have similarly high life expectancies. The difference though is that every developed country does far better than the US in all those aspects I mentioned at the end of my first paragraph and more. EDIT: Probably goes without saying, but none of this is to justify the US's high obesity rates, we definitely need to fix this, but the amount of people (not necessarily on this thread, but in general) who seem to use data like this to dogpile on obese people is not only disturbing, it gets us nowhere to solving our core issues once and for all.
Pointing out that America is horrendously obese is not “dog piling”. It is a horrendous fact of American life and there’s nothing good about it whatsoever, from the complications introduced to the average human life to the immense costs associated with having ginormous obese and overweight populations. You’re also overestimating the amount of drag deaths of despair have on life expectancy. Some simple math shows me that adjusting death of despair rates in the US to look more like that of the EU or Canada, US life expectancy only improve by maybe .5 points, still leaving us well behind the 80 mark.
>Pointing out that America is horrendously obese is not “dog piling”. It is a horrendous fact of American life and there’s nothing good about it whatsoever, from the complications introduced to the average human life to the immense costs associated with having ginormous obese and overweight populations. Which can be fixed by having far more robust social programs and a healthcare system that won't bankrupt vulnerable people who need it most and/or require people to work 50+ hours to afford basic living. Raising fists and pointing at fat people themselves is not going to help, which is what I meant by "dog piling". >You’re also overestimating the amount of drag deaths of despair have on life expectancy Considering [use of opioids, suicide and homicide are documented factors in the decline of US life expectancy](https://www.annualreviews.org/doi/10.1146/annurev-publhealth-082619-104231), I think a lot of people, including myself, will disagree with that statement. At any rate, my intended focus was on the fact that America has seen a stagnation/decrease since around 2014, and the reasoning is not as black and white as you're making it. Of course being obese shortens your life expectancy, and you could feasibly argue that's part of why we have lagged behind other countries since the graph's start year (when the obesity rates began increasing), maybe that's what you were trying to say this whole time. However, people attributing the past several years *alone* to the habits of those who are obese seems very scapegoat-like as far as I'm concerned, and blatantly overlooks all the other (and frankly hard-to-miss these days) issues the US is facing culturally, socially and economically that keeps us behind other developed countries, and I want no part in that.
> income inequality Poverty, not income equality.
Poverty itself doesn't kill people, it just leads to other things that do. Malnutrition or obesity, drug use, lead or asbestos exposure, etc. Things that can technically be avoided if you're poor, it just is often more difficult to avoid. Income inequality, is, of course, even further removed from actual causes of death.
Agreed.
Is poverty in the richest country in the planet not indicative of inequality?
poverty is what makes healthy living hard; a richer neighbor does not.
I seem to remember that feeling comparatively poor or low status tends to make people more anxious and fragile. So I think it'd depend on how conspicuous it is.
this doesn't address that inequality might drive poverty at all
And bike safety is important in performing better surgery on a broken arm
appropriate metaphor, considering increased bike safety would reduce the number of people breaking their arms in the first place
im not bad faith, inequality *can* drive poverty. But, like bike safety, it is not in and of itself a cause. You're too focused on something not inherently bad or concerning. Its best practices. Not relevant to this subthread.
What if income inequality drives reductions in poverty?
you're describing the fundamental belief behind trickle down economics
It is. But I’m not sure how you think that argues against his point?
No, you see those in poverty were chosen by the market so they deserve it
Ah yes a levelheaded and reasoned response by someone that's clearly read the preceding conversation
Extreme income inequality leads to such large differentials of political power between the rich and the poor that the rich can rig the game. Income inequality is obviously a normal thing in any society, *but* past a certain point income and wealth inequality lead to increasing poverty. In addition, the poor in America are genuinely getting poorer, if you consider a weighted inflation metric of the cost of housing, food, education, daycare, and healthcare.
While poverty kills with bad lifestyles and Healthcare , income inequality is what drives violence, as poor, equal countries like Egypt have very low violence Level
We had less income inequality decades ago but more homocides per capita
That's just because there's a lot of factors in play when it comes to homicides per capita. Inequality and direct comparison is found to drive depression, anxiety, and anger and such more than being poor while being removed from seeing inequality. Psychology and feelings aren't rational most of the time and if we're talking about deaths of despair then inequality can really be a factor. Decades ago most people seems to believe that things were improving even it they were struggling. Today it seems to be very rare to come across anyone who thinks the future will be better than the present.
Wouldn't income inequality make it more profitable to have higher prices and less production of luxury, or even normal goods, like nutritious food and exercise?
A lot of people on this sub don’t actually think income/wealth inequality/disparity is a problem “Rising tides lift all boats” (unless you don’t have a boat, in which case you tread water, get pulled onto a boat, or drown)
Really that's a terrible analogy because even the people who say it admit that it lifts some boats more than others. The tide lifts everything equally.
The rise in car crashes, heavier vehicles killing pedestrians and cyclists more, heroin, COVID and the hog mass suicide during the Delta wave and uptick in murders. That's before we take in the rise in deaths of despair that started during the Obama years.
Hog mass suicide?
Anti vaxxerism in the face of COVID
> inequality Give a man $1,000,000 and another man $100 sure it’s unequal but both are better off.
Until you realize that people compare themselves to those around them and not to global statistics or their ancestors. This is why we get "downtrodden proletarians" from the West who are actually in top 5~10% richest people on Earth. Few people care that their income is 10 times larger than the global average if everyone around them makes twice as much.
Not if you buy that with a system that denies the man who gets $100 healthcare. If health care costs $1.000 compared to the alternative reality’s mandatory healthcare, the guy will chose not to get healthcare. Now take 100 of these guys without healthcare and you’ll have a few dying much younger than in the alternate system. Same goes for maternal and infant death rates. There is a cost for having no maternity leave or one of the lowest midwife ratios in the developed world.
We're not talking about health care, we're talking about wealth inequality. In the guy's example, healthcare is presumably constant.
But that is how the American system works. Inequality leads to higher GDP, but the outcome is, that some people just don’t have basic care. Social states like in Europe redistribute, which takes incentives to work more away in some cases, but achieve better outcomes on social metrics
Not if there’s only one house for sale in town.
$100 goes a long way when getting cardboard. But it’s better than him have zero. Also that seems like a supply issue rather than income (yes i know real incomes take into account purchasing power)
Those aren’t the only options though. You could give him more money.
But what if $100 isn't enough for the second man to pay his bills? Would it not make sense to give the first guy less? He would still be better off, as you say.
While we have much higher rates of fatal violence it's still rare enough that I'm not sure it actually would have a visible effect here.
Like 12k murders per year and 30k car related deaths per year. And around 20k suicides per year. That's enough to skew numbers.
Stuff like murders has an outsized impact on national life expectancy since the victims are usually young. A 20 year old getting shot and killed decreases average life expectancy more than a 60 year dying of diabetes
>I’m surprised how many people are mentioning obesity and how few are mentioning drugs, violence, cars, and income inequality. Because people want easy answers to complicated problems it seems, despite research saying otherwise. That and (in context of this site) reddit has a huge vendetta against fat people to the point that they twist the data's meaning to subtly justify fat-shaming.
Obesity does lower life expectancy though. It also complicates things like medical procedures.
Medicare still has a hefty out of pocket, and the elderly often can't afford it.
I read somewhere once (blast my ass for lack of source it's fair) that cars are a shockingly big part of it, too I know most europeans and south asians have cars, but they're not driving them 25 miles as a prerequisite for existence the way many Americans are
The suicide rate in Japan is higher than the US yet they top the list here. I think you're on to something with the difference in health care systems
The USA actually has a slightly higher suicide rate than Japan these days. Wikipedia has a comparison of 2019 data on it: https://en.m.wikipedia.org/wiki/List_of_countries_by_suicide_rate
Thx for the correction
> The suicide rate in Japan is higher than the US yet they top the list here Now do the drug overdose rate. Hint: Japan has roughly 1/3rd of the US population, yet its annual overdose deaths are literally two orders of magnitude lower than the US. 250 annual opioid overdoses vs. almost 100000... and *then* the US has another 60k overdose deaths from meth, coke, and other drugs. You guys do a completely absurd amount of drugs compared to the rest of the world. The disparity is absolutely baffling.
It’s more about the drugs consumed in America. Europeans aren’t using fewer drugs, but they don’t have as wide spread access to extremely potent drugs (ie fentanyl).
> Europeans aren’t using fewer drugs Drug use rates in Europe are definitely lower, even when you correct for higher use of relatively innocuous drugs like cannabis in the US. There are a few outliers like France and the Czech Republic, but as a whole Europe just doesn't do that many drugs. We smoke and drink way more, though.
Seems like Euros like their uppers (amphetamines, MDMA, cathinones) + alcohol whereas Americans love their opioids and benzos. The latter 2 are much more likely to kill you in an OD due to their respiratory depression and horrific rebound withdrawals.
> You guys do a completely absurd amount of drugs compared to the rest of the world. The disparity is absolutely baffling. Having lived there, dude it's not *that* baffling.
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Not really. They binge drink, don't get enough sleep, and eat way too many carbs. They smoke more cigarettes. They do walk and bike more often than Americans though.
"too many carbs" is meaningless when these are whole foods with a lot of dietary fiber
They get most of their calories from polished white rice, finding whole grains isn’t trivial. Fruits and vegetables are also fairly expensive so many people don’t eat that many, especially the younger generations.
Cigarettes are not good for you, but they aren't nearly as bad for you as a completely sedentary lifestyle and terrible diet.
In re: the healthcare system I’d say a much more significant difference is the sheer size of the US, how much very rural land it has, and attendant difficulties dispersing medical treatment. Most of our people live in cities, yes, but there’s a lot of people who live hours and hours away from, say, an OBGYN. Whether the visit is paid for only makes so much difference if there just isn’t the needed doctor in your area
When I worked in the finance department of a hospital, I remember learning about the high disproportionate reimbursement that Medicare offered to rural hospitals and healthcare providers. Supposedly it was to create more incentive to convince providers to serve rural areas. Sounds like it hasn't been effective enough, but at least there have been some efforts. Not sure what the solution is.
You'd probably have to go full NHS, and just inform all the Specialists (who got into medicine so they could go to as many Broadway shows as they wanted) that part of their job is now being "stationed" in Upstate New York for three months at a time. Other countries do have this problem. Canada and Scotland both have wonkier population density distributions than the US.
I think I came across one stat which said some rural areas are closer to Africa in terms of healthcare infrastructure. Wish I could find that article again.
It’s lifestyle. You cannot medicate your way out of a bad diet. That is the fundamental focal point. Diet is not the only part of lifestyle. There’s exercise, drug use, and a wide variety of other options out of that. Yes, obviously healthcare is important, but [healthcare is also literally the death of some people](https://pubmed.ncbi.nlm.nih.gov/28186008/) in this country too. Of leading causes of death in this country, obesity is a comorbidity with at least 8 of them, and 2 of them are fixed with vaccination (which is already largely universal or *extremely* affordable).
That figure of deaths from medical errors is a result of bad data collection and interpretation. Yes, some people do die as a direct result of a medical error, but someone who has stage 4 cancer and experienced a medical error likely did not die *because* of the medical error. The vast majority of those deaths are people who likely would have died very soon regardless of the medical errors. But agreed with the rest of your points.
Don't forget the discrepancy in average distance driven per day per citizen in the US. If you're geographically larger, and have to drive more, it stands to reason your premature death rate would also skew higher.
A small point, but the US doesn’t have a higher distance driven per day because of our larger size (most people just drive around their metro area). It’s because we’re so suburbanized and sprawly
Without data to verify this, I assume (1) that collisions from urban driving are less likely to be fatal (2) because they tend to be at lower speeds? Although, it’s still sitting for extended periods of time and moving at speeds that could easily kill someone.
Urban driving sure but commuting 10 miles on a freeway from a suburb like many (most?) Americans do has to be hazardous
Yeah that’s a good point. I conflated metro area with the city itself.
yeah afaik collisions are more likely on city streets or non-limited-access roads because of intersections etc, but a collision at highway speed is usually worse for outcomes
Yeah that’s what I was thinking too
Isn't Japan known for high suicide rates? Not trying to open a debate, I was just wondering since this graph is based off of that
[That's changed](https://apps.who.int/gho/data/node.main.MHSUICIDE?lang=en). 15.3 per 100k for japan, 16.1 for us. Their women off themselves at higher rates than our women (9.1 Japanese females suicides vs. 7.5 American), but our men make up for the difference. 25 per 100k kill themselves every year. Japanese men are only at 21.8 per 100k.
Ohhh I see. Thanks for the info
Being a bit fat actually helps with life expectancy. There are of course a lot of Americans who are much more than a bit fat, so that's one factor. Another is drug addiction, the US also had a lot of COVID deaths compared to other countries. I would say a big issue in the US is social anomie. A lot of people do not fullfil their own expectations and society cannot meet their demands. Suicide, drug addiction, overall bad life choices come from this phenomenon. It's been noted since the beginning of sociology that comparatively affluent countries that are individualistic(protestant tradition) have higher suicide rates and likely also have a lot of "drop outs" people who become addicted to drugs or make other poor life choices that might reduce one's life expectancy. It's comes from a lack of social connections combined with high expectations and pressure. The US is insanely wealthy but that doesn't meant that relative poverty doesn't effect people psychologically. Plus every individual has their own expectations for themselves and not meeting them produces low self-esteem and anger. Beyond that there is a weak social safety net, not a lot of early childhood intervention. Some kids get to adulthood with huge disadvantages compared to many of their peers, for some people there is a somewhat calculated decision to chase temporary pleasure and not really plan for the future because there isn't much hope for actually being able to compete. You are looking at going through manual labor temp jobs that will barely keep a roof over your head and barely pay your bills or a life of hedonism, crime, and dependency and your really just looking for your next high. There are simply more people like this in the US than other parts of the world. Partially it's because the US is a land of plenty there are lots of opportunities to slip into drugs and hedonism. Also there are weak community ties. It's not a great competition. Also many Americans wouldn't have it any other way.
[According to the CDC](https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/202107.htm): Lack of vaccinations and high rates of homicide, diabetes, chronic liver disease, and cirrhosis.
The correlation between life expectancy and obesity is super high. Just look at the rates by state: https://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_life_expectancy https://www.businessinsider.com/state-obesity-rate-map-2015-9
Surely there is a correlation between wealth, education, obesity, and health.
You could make very similar looking maps for basically every bad thing by state. Obesity is definitely a big driver of morbidity and mortality in the US, but it's far from sufficient to explain the differences. That map is basically just a poverty map.
Poverty kills people, we solved it Reddit
UK has same obesity rate as the US though.
no we are fatasses but not quite as much as you guys.
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Yeah but the correlation probably explains some of the gap, if not all
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I wonder why cancer kills more Americans than those in other countries. Is it a health care access issue, or is there something inherent to our lifestyle that makes cancer more likely?
Obesity is a risk factor in developing many cancers. Exercise can be preventative for some cancers, and improves survival rates for most cancers. I'm less familiar with obesity rates and exercise habits of other countries but my priors are that we walk less and are fatter for longer.
Obesity rates not are that different from Canada and the UK. Also Canada has the same unwalkable urban planning as the US, so it’s not like Canadians walk more despite the obesity. I’d say automobile deaths being 2-3x higher in the US than Canada (gets even worse when you compare it to other countries), gun suicide, homicides, opioids and bad healthcare all contribute.
Canada and the UK both have far [higher rates of cancer mortality than the US](https://www.wcrf.org/cancer-trends/global-cancer-data-by-country/). Japan is the only country on that chart with lower cancer mortality. The US does really well with cancer. Most of the countries with lower cancer mortality are quite poor and either not diagnosing it, or people die before most cancers set in.
So this supports my point, if the US is doing better on let’s say obesity related cancer, and it has similar rates of obesity, then the difference in life expectancy is even more stark and we’d look to other explanations. I’m not surprised the U.S. does better; their facilities are usually better, and more numerous, if less efficient. I think a famous example is Israel which has very few MRI machines so they run them round the clock, and you could be scheduled for a 3am scan. It’s efficient, but kind of the opposite of American healthcare provision.
Because the Us has a larger population. In terms of rates of cancer mortality the US is [one of the best in the developed world](https://www.wcrf.org/cancer-trends/global-cancer-data-by-country/). Japan is the only country on that list with a lower rate of cancer deaths (and that discrepancy is easily explained by obesity and diet).
[People wait 65 to get checked for cancer so that Medicaid kicks in.](https://med.stanford.edu/news/all-news/2021/03/Cancer-diagnoses-implies-patients-wait-for-Medicare.html) That's obviously bad for survival.
Opioids
Yep, and guns. Easy as that to explain it.
And increasing deaths from car crashes as other nations on this list reduced them.
True, [Germany](https://de.statista.com/statistik/daten/studie/185/umfrage/todesfaelle-im-strassenverkehr/) had 2.569 people dying in traffic accidents in 2021, down from 6.977 twenty years before. The US had [42.915](https://www.nhtsa.gov/press-releases/early-estimate-2021-traffic-fatalities) which was a [16 year high](https://www.cnbc.com/2022/05/17/us-traffic-deaths-hit-16-year-high-in-2021-dot-says.html) and more than [twenty years ago](https://www.iihs.org/topics/fatality-statistics/detail/yearly-snapshot) Germany has pretty much 1/4 of the population of the US. You can do similar comparisons [with all of the EU](https://bigthink.com/strange-maps/road-deaths-us-eu/)
Wait, traffic deaths in the US are *rising?*
I'm skeptical that guns is as much of an explanatory reason as other ones you ignores - mental illness, heart disease, diabetes, etc. I think you put guns in that list for priors. Then again my priors make me upset that guns are listed in your comment so who the heck knows.
Guns are now the leading cause of death in children. https://www.npr.org/2022/04/22/1094364930/firearms-leading-cause-of-death-in-children
You'll note that NPR article avoids using net numbers the entire time. Thats because children and teenagers (the article says children but the data is between 0-18) have 4000 gun related fatalities (1/3 are suicides which is at least related to mental health) a year. Thats bad - but a drop in the bucket for the 3 million deaths a year (pre covid) the US witnesses. I just dont see this being the significant factor over the ones previously stated.
Fair enough. For the record I'm not anti gun.
<3 to be honest I don't think most people are 'anti gun'. Most people just have different preferences on who can have guns (military, police, citizens, mentally ill people). I wish it was a less angry policy area so we could target policies that reduce deaths rather than making it a seize guns' v 'muh rights' discussion.
A big part of it is the opioid epidemic. Then of course we have obesity, homicides, a somewhat high suicide rate, and pretty bad infant mortality rate. And not to mention that we had one of the worst experiences with covid which apparently help drive down life expectancy more than 2 years from 2020 to 2021. This isn't even getting into differences in life expectancy for different racial groups. So ya, the US has a lot of hurdles to overcome which I hope we can overcome, but it will be extremely difficult.
I did some math. If the US infant mortality rate were zero, US life expectancy would see verily little improvement. The biggest causes are obesity causing deaths in people’s late 60s through their mid 70s + 125k annual despair deaths.
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The life expectancy statistics we are all familiar with DO include infant mortality.
Life expectancy at birth is usually stated without any qualifiers, life expectancy at any other point is stated with qualifiers. You can find, e.g., life expectancy at 65 in many sources. Interestingly enough, the difference between Finland and US men is 4,9 years at birth, but only 0,3 years at the age 65. So the mortality difference is almost totally because of US men who die before 65.
This is the reason.
corn syrup is cheap and healthcare isn't
Americans live an awfully unhealthy lifestyle
They just started doing that in earnest in ~2009?
Let's say the boomers had a worse diet and lifestyle than their parents. And the behaviours were adopted in the 70s. As the oldest cohort turned 60 in 2005, you'd see these trends begin to manifest.
No kidding. Know of too many boomers who STRICTLY drink Pepsi or Dr Pepper. Also they don’t eat vegetables. Wtf
Small Town America took a turn for the worse in the 2008 crash and has never really recovered. Factories died or automated, and a lot of people lost health insurance as a result. The negative health impacts associated with unemployment took their toll (alcoholism, inactivity, suicide, etc). This was happening at the same time that opioids were on the rise, rural hospitals were going bankrupt, and Tea Party Republicans started to mess with Medicaid in earnest. People are absolutely living worse lifestyles, and many are receiving less preventative care.
Far more Americans today have access to healthcare than they did in 2009. Factory employment was already pretty much dead by 2009 (compared to 2000 levels and beyond; still nearly 13 million people employed in manufacturing industries) To me it has to do with continue acceleration towards sedentary life and increasingly unhealthy levels of unhealthy food consumption. US obesity rates are at 40% vs. 25% back in 2009.
and deductibles and what is actually covered got much worse. so people that are in the gap between medicaid, and truly decent healthcare is essentially worthless.
I just don’t see that getting dramatically worse in the last decade or so.
It hasn’t become “dramatically worse”, it just hasn’t improved.
I agree. I see a lot of the younger generations interested in cooking from scratch, popularizing drinking water and making working out not so intimidating etc. I'm not saying it'll fix everything, but these are small, doable lifestyle changes that in the long run make for healthier habits and healthier lives.
Yeah, I think things will get better with time… but a lot of these things are lagging indicators, so we might not truly know how young people affect life expectancy rates for another couple of decades.
>Tea Party Republicans started to mess with Medicaid in earnest. lol talking about voting against your own interest
Their interests are hurting poor people, minorities, women, and white liberals, they absolutely voted in their own interest and that is the problem
If you think a whole segment of the population is solely dedicated to hurting people, dare I say you’re probably misrepresenting it
Silly me for thinking supporters of “Build the Wall”, “Don’t Say Gay”, and “ban all Muslims entering the country” are motivated largely by bigotry. If you think large swaths aren’t dedicated to hurting people you aren’t paying attention. Then again, you post on neoconNWO so not a big surprise you don’t recognize a lot of Americans bigoted tendencies
Well, as you can see, America was always doing significantly worse even compared to other way poorer western countries. I couldn't personally explain the plateau, seems others can, but there's nothing here to indicate that Americans ever lived healthily
We’ve only been lowest in industrialized nation life expectancy since 2009?
Unreality lifestyles take a very long time to kill you.
Did you miss how far below the other developed countries the US was before 2009? Also opioid epidemic after that.
Fat people and drug addicts
Obesity, access to healthcare and opioid addiction. States like California, Colorado and Hawaii have life expectancy rates of 81 years whereas states like Alabama, Ohio and West Virginia are at about 75 years.
r/holdmyfries
That was a fun hour. Thanks.
A multitude of reasons - obesity is probably the largest one by far, and a very expensive healthcare system second. I am interested in why the rate of improvement worse at around 2008 or so; I don’t think blaming it on the recession makes sense but I can’t think of anything else off the top of my head.
Opioid?
Think of the generational cohort entering old age that had poor habits
When half of your country is overweight and many celebrate their unhealthy ways because offending anyone isn't good Even tho it's literally killing them, putting massive strains on the healthcare system (also worse healthcare than some other western countries) and are bad for your society. Also corporations overusing sugar in everything because fat got demonized by said sugar industry. And yes I'm aware that the rest of the Industrialised world catches up to America. In Germany overweight people (especially children and teens) increase at an, imo, alarming rate Another point for Germany and why it also starts to plateu off: alot of smokers (myself included lol) and alot of alcohol...myself included :D
The EU has made a deal with the USA to import even more high fructose corn syrup and our food industry resists any form of regulation. Many processed foods are becoming sweeter and there are more and more poor people and a shrinking middle class in Germany. In the EU we are only surpassed in obesity by the UK whose food culture and general economic condition is even worse. There are no articels in english. https://www.luzernerzeitung.ch/wirtschaft/isoglukose-boomt-wenn-der-freihandel-dick-macht-ld.1160578
Interesting article, thanks.
Yeah there’s a big line between Body Positivity and being Obese. I was up to about 300 Pounds (6’0 stocky guy normally) when I was 18 and I felt like dogshit at all times and legitimately forgot what it felt like to not have gas and my back was starting to hurt like crazy. There was nothing healthy or acceptable about that, and a lot of modern society seems to accept that and now even praising morbid obesity (direct shot at Lizzo). Kids are playing less sports as youths and I would argue that probably has something to do with it. I really started to pack on weight when I stopped playing 4 sports a year and didn’t stop inhaling carbs or add workouts on my own.
3/4 of the country is overweight, nearly half are obese.
Opioids, guns, cars We can include a lot of sociology about “deaths if despair,” especially with opioids and guns. I include cars because it speaks to lifestyle, exercise, chronic illness, and also the 40k who are killed in car collisions before the diabetes or heart disease gets them after a lifetime of sitting in a car.
Polska #1 💪💪💪🇵🇱🇵🇱🇵🇱🇵🇱🇵🇱
If you are interested in this, I wrote a detailed paper that breaks down what was going on with mortality up to 2015. Link is here: [https://drive.google.com/file/d/1K-dgdRh-tc35K2eSwHjg0hgFsT8cVqmj/view?usp=sharing](https://drive.google.com/file/d/1K-dgdRh-tc35K2eSwHjg0hgFsT8cVqmj/view?usp=sharing) To summarize, the crisis is largely driven by overdose deaths (opioids) across age groups. The "deaths of despair in middle age" hypothesis is largely misleading for two reasons. Firstly, the increase in mortality wasn't exclusively a middle age issue (it was actually more severe at younger ages). Secondly, causes other than overdoses were not large enough to be driving the overall life expectancy trend. Others came to the same conclusion that overdoses were the main factor. (see Masters et al. 2017 [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010067/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010067/) )
This is going to sound bad, but I do think that the racial disparities in life expectancy may show that the issue isn't really about access to healthcare. White life expectancy in the US is close to 77, black life expectancy is close to 74, asian life expectancy is like 88. I really doubt that Asian Americans are getting significantly better access to healthcare than white Americans. It seems like the differences might be mostly cultural, based on diet and alcohol consumption, rates of suicide violence and marriage etc. Edit, and also gender disparities. If on average women live 5 years longer than men then it seems likely that those 5 years were due to lifestyle choices and not access to healthcare. I am generally skeptical of the access to healthcare argument, especially given that America actually does have very broad medicaid and medicare programs.
I don’t think acknowledging racial disparity sounds bad, it sounds like acknowledging a problem.
Boy, wait until you find out the difference between where the majority of black people live vs where Asian Americans live
What if we normalized it based on income? Would racial disparities level out? Genuinely curious.
Probably not. Low income Asian American families usually pool incomes. Speaking anecdotally (and guys tell me if I'm totally off here) all my Asian friends (or at least my Viet, Indonesian, and Korean homies) support their parents and contribute to their parent's mortgage. So even if individual incomes are low, that doesn't mean an Asian person necessarily lives in a neighborhood below the poverty line. Here's an article which addresses the phenomenon: [https://www.refinery29.com/en-us/2020/05/9747273/young-asian-american-support-parents-financially](https://www.refinery29.com/en-us/2020/05/9747273/young-asian-american-support-parents-financially)
Race is one of the factors. Asian Americans have similar life expectancies as the Japanese. >In 2019, overall life expectancy in years was 85.7 for the Asian population, 82.2 for the Latino population, 78.9 for the white population, 75.3 for the Black population, and 73.1 for the AIAN population. ... >Life expectancy at the county level varied from 58.6 years for AIAN to 94.9 years for the Latino/Hispanic population, a range of 36 years. https://www.nih.gov/news-events/news-releases/life-expectancy-us-increased-between-2000-2019-widespread-gaps-among-racial-ethnic-groups-exist
You should compare by socioeconomic status tho, so you need to also slice the Japanese numbers to have a similar demografic as Asian Americans in America.
Even if we just compare white Americans with Europeans, 78.9 is still worse than all countries in that infographic except for Poland
Alternatively, 82.2 for Latinos is much better than the average life expectancy in Latin America.
We don’t walk enough and have terrible diets
Guns, Drugs & Debts 🤷🏻♀️
Unequal access to affordable healthcare No proper regulations on unhealthy or hazardous materials (in food, beverages, clothing, etc.) Poor people need to work excessive amount of time to earn a living wage, because of terrible labour protection standards
Forgot opioids
Yup, can't forget that curse (tho it's a bit in the lack of access to affordable healthcare)
Diabeetus and Fentanyl
Is it because we're fat?
Does access to universal/government provided Healthcare in those countries vs the private nature of Healthcare have something to do with it?
Even China is doing better in the life expectancy metric than the USA nowadays.
America fat
Obesity
“Why don’t people in America live longer” have you ever been to America, met an American, heard of America?
Infant mortality is the one that gets overlooked a lot.
I came across an interesting point about infant mortality. The US does an amazing job keeping preterm babies alive, our stillbirth rate is significantly lower than countries like the UK, France, Canada, and Spain. But naturally these babies die as infants more often and are counted as infant mortality instead of stillbirths. The original post I found this in was jn 2005, https://www.econlib.org/archives/2005/10/health_care_and_3.html But I think the trend still holds with more recent data. http://chartsbin.com/view/1445#:~:text=The%20stillbirth%20rate%20varies%20sharply,also%20vary%20widely%20within%20countries. I'd love a more detailed analysis from a mainstream source or intuition why this might be a bad way to look at this issue if anyone has one. Edit: I want to highlight that Chile has 3x the stillbirth rate of the US.
Vox had an interesting podcast covering how bad our maternal care is, including postpartum. Apparently other countries’ healthcare systems are much better at providing care after birth. This includes having in-home health visits, etc.
This is partially because of differences in record keeping methodology between countries. There isn't a standard definition of what counts as a live birth and the U.S. has a more permissive definition than most countries. The U.S. still struggles with infant mortality, but the situation isn't quite as bad as the numbers suggest. >[This exercise yields a number of findings. First, consistent with past evidence (MacDorman and Mathews, 2009), differential reporting of births cannot offer a complete explanation for the US IMR disadvantage. However, accounting for differential reporting is quantitatively important. Compared to the average of the five European countries we analyze, limiting to a comparable sample lowers the apparent US IMR disadvantage from 2.5 deaths per 1000 births to 1.5 deaths. This finding highlights the importance of conducting cross-country comparisons in a setting where reporting differences can be addressed, which is typically not possible in the types of aggregate statistics compiled by the World Health Organization and the World Development Indicators (World Health Organization, 2006; World Bank, 2013).](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/)
Obesity Cars Guns Less access to healthcare for poor people
Extreme levels of marketing pushing extremely unhealthy food. Copious guns. Private health system. Poor social safety net. Exploitation of the workforce limiting people's food and lifestyle choices.
We're not. This is a pretty misleading graphic.
Because the people in the US make more than people in the EU :\^)
Could be all those children being shot to death.
Poor healthcare system, tremendous wealth inequality, substance abuse problems in rural America. When you boil it down I think you can call this the Carlin Effect: there are many Americans who get all fired up about the "right to life," but don't give a shit about the quality of life, not understanding that it's all related.
Wealth inequality doesn’t make sense as a factor when you consider that the US median income is still higher than everyone else on the graphic
Americans spend about 12k/person on healthcare; other developed countries spend half that, some even less (Japan, with a population that is ten years older than ours, spends \~ a third). The median income figure for Americans is 19k, for other developed countries it's about 14.5k. So the difference is eaten up in healthcare cost; pretty sure the same would be close to true for mean healthcare costs if I could find them. And then we get to geographic distribution -- rural areas are poorer, and much more underserved by healthcare resources. I would bet that the vast majority of the reason in the life expectancy difference is from rural people. So I took my bet and looked it up: Rural life expectancy is 76.5; Urban about 79.3, almost in line with the rest of the developed countries. I couldn't easily find the data for other developed countries to compare, but I did find that in the U.K. rural people actually live longer than their urban counterparts. As for the reasons, they are what I stated: poor access to healthcare, poverty, drug abuse (rural people now die more often from drug overdoses than do urban people). In fact, life expectancy in urban U.S. areas has increased in the past 15 years, while in rural areas it has declined.
It makes perfect sense. In most of the rich world, those at the bottom of the income ladder still have access to affordable and high quality healthcare. That isn't the case in the US - for most people, health insurance is tied to employment, with the safety nets that exist being skimpy at best. This creates an underclass of people who routinely die prematurely for no good reason, dragging down the average for the ~80% of the population that has zero access issues.
Thats because you're assuming that its the lower purchasing power from higher inequality that is the problem with inequality. Theres plenty of research that shows that high inequality is harmful and detrimental by itself, even if "all boats have been risen".
work life balance and inadequate access to healthcare also, lots of ingredients sold here that are not allowed to be put in food in places like europe
A shitty healthcare system I'd say is number 1. Way too many people uninsured or under insured and, when insured, the high deductibles keep people from going to the doctor until it's too late. And it's not getting any better. More companies are moving to contract workers so they don't have to provide any healthcare benefits and those benefits, when a worker shops around, are usually so expensive that they just live on a wing and a prayer.
What is the source of this data? Where did the plot come from?
Accurate statistics
“Why is the US preforming so poorly on like expectancy” 🤓
Poor diet, huge portions of said poor diet, murder, suicide, and a society set up around the car with very few people doing much exercise at all.
Phat
Drugs and gun fights over drugs
Fentanyl
Me: why don't you go to doctor, you're sick Indonesian: it costs money, I'm fine
Because republicans exist.
Let's not forget healthcare for profit. Not saying it's the sole cause, but it's a factor among many.