Life expectancy in the U.S. is declining for middle-aged people of all groups

https://www.nytimes.com/2019/11/26/health/life-expectancy-rate-usa.html

by pseudolus • 7 years ago

141 181 7 years ago

claudeganon11• 7 years ago

“The whole country is at a health disadvantage compared to other wealthy nations,” the study’s lead author, Dr. Steven Woolf of Virginia Commonwealth University, said. “We are losing people in the most productive period of their lives. Children are losing parents. Employers have a sicker work force.”

For profit healthcare in America is devouring its people and economy, full stop. We can either have a society where half a million people go bankrupt from medical debt each year, thousands die from treatable illnesses and lack of access to medicines, while hospital CEOS and insurance execs walk away with millions. Or, we can have one that excises their parasitism like the rest of the developed world figured out was necessary decades ago.

tenebrisalietum2• 7 years ago

So let's say the worst case scenario happens, and 500,000 people do go bankrupt due to medical expenses every year for a while. Let's say this happens pretty consistently over 10 years. How will that affect the broader political landscape, economy and society?

claudeganon11• 7 years ago

I dunno, maybe you would see things like sharp curbs in life expectancy among middle class people. Or a rise of reactionary politics that cynically (but not falsely) targets affluent liberals who turn a blind eye to the suffering of the poor...

PopeDotNinja• 7 years ago

Your healthcare costs more, and the lives of 500k people suck more than they needed to.

zeveb• 7 years ago

For profit healthcare in America is devouring its people and economy, full stop. We can either have a society where half a million people go bankrupt from medical debt each year, thousands die from treatable illnesses or lack of access to medicines, while hospital CEOS and insurance execs walk away with millions, or we can have one that excises their parasitism like the rest of the developed world figured out was necessary decades ago.

The majority of the world still has, to my knowledge, for-profit health care: Britain, Germany, France, Switzerland , Sweden and Italy all have at least some form of private health care.

The United States definitely have a problem with health care prices. It doesn't appear from where I sit to be an issue with individual bad actors (although of course they do exist) but rather structural. In part, the well-intended federal and state attempts to improve things have backfired — as they tend to do — and made things even more expensive (which reminds me of federal student loans, another instance of well-meaning attempts to help the lesser-off which somehow seem to benefit the upper middle classes most of all; cf. also federally-subsidised mortgages).

ptah3• 7 years ago

at least some form of private health care.

a very tiny proportion of them yes, in the US the whole thing is private

SolaceQuantum4• 7 years ago

IIRC the issue is not that private healthcare exists in first world countries. The major issue is that private healthare is the primary healthcare insurance provider for USA citizens.

bambataa• 7 years ago

Private health care exists in the UK but the NHS is public, though there are attempts to change this [1] as apparently the US model is considered something to emulate. I definitely wouldn't use the UK as a comparison to the US' private system as the funding models are completely different.

From the outside it seems that government attempts to shape the market (by the measures you mention) seem to work out worse and more expensively than measures to make the market (e.g. NHS). We have this in the UK with the government providing subsidies to buy private houses rather than just build enough public houses. I'd be interested in some economic insight into this if anyone has any.

[1] https://www.theguardian.com/society/2019/nov/08/private-surg...

marvin• 7 years ago

The issue has never been whether private healthcare providers should be allowed to exist.

The question is whether a good publicly-funded alternative should be available, to allow everyone treatment for the vast majority of conditions and illnesses that are lethal or significantly affect quality of life.

Most countries that have the latter, also turn out to have much cheaper healthcare overall.

This system doesn't solve or treat every problem, and the US system manages to provide better quality of care in some cases, but there's a serious morality issue here that it does fix. Along with many pragmatic socioeconomic benefits (e.g. healthcare for retirees, early-stage and failing entrepeneurs)

rsynnott• 7 years ago

The majority of the world still has, to my knowledge, for-profit health care: Britain, Germany, France, Switzerland , Sweden and Italy all have at least some form of private health care.

While private health care exists in all of those countries, and in some of them it's a significant part of the system, a lot of what exists isn't actually _for-profit_.

For instance, in Ireland we have a dual public and private system (primary care is private unless you're old, very young, or low income, private hospitals exist as an option), but most of the private system is either outright non-profit (most private hospitals, the statutory VHI health insurer) or is heavily constrained by the existence of the non-profit portion and regulation (private insurers have to compete with the VHI, and are not allowed charge risk-based rates for most customers).

DiogenesKynikos2• 7 years ago

The countries you listed are all dominated by public health care systems. The NHS in the UK is entirely public (insurance and providers). The other countries have public insurance that covers everyone, and a mix of public and private hospitals. It's a bit complicated in Germany and Switzerland, where there are multiple semi-public insurers, but those insurers are so heavily regulated they're basically public entities (price, coverage and payments to providers are all fixed by government).

kasey_junk• 7 years ago

Without tackling the obesity/sedentary/nutrition problems the healthcare issue will persist.

Similarly the opioid/meth epidemics of the last 2 decades are not (just) healthcare problems.

xtian• 7 years ago

You can’t divorce poor life choices from the economic context they are made within. These are complex issues, but is it controversial to say that people are more interested in investing in their health when they have less stress and more opportunity?

Likewise, you aren’t going to get a healthcare system which can make a meaningful impact on improving the lifestyles of the kinds of people you’re talking about without changing the current economic incentives.

dragonwriter3• 7 years ago

Without tackling the obesity/sedentary/nutrition problems the healthcare issue will persist.

Without healthcare system improvements, you aren't going to succeed in tackling those.

But, yes, it's true that there are more problems with US health than the health care system (though the issues in the broader economy that are at issue are very similar to those effecting the helathcare system.)

Angostura3• 7 years ago

A good public healthcare system actually puts money into trying to address those problems, as does the government who pays for it. A private healthcare system may be a little more... ambivalent.

C1sc0cat2• 7 years ago

Ban advertising of prescription drugs to the gen pop

davidw3• 7 years ago

There's also an entrepreneurial angle:

If you don't have to worry about health care, it becomes much easier to start and run a small company.

claudeganon11• 7 years ago

Indeed. As someone who works in the arts, it’s quite apparent how much easier it is to survive for my friends and colleagues in Canada and Europe. Even discounting the public funding for the arts many of them receive, simply not having to worry about healthcare and medicine costs as a freelancer makes a huge, obvious differences the length and viability of their careers.

whatshisface• 7 years ago

It's not that simple, it would be possible to have a socialized healthcare system where entrepreneurs paid for everything and lost more than they gained as a result. It could happen, the public line for that policy would look like "let silicon valley unicorn billionaires pay their fair share" and the private line would be "come on Mr. Congressman, you aren't seriously thinking of taxing your future employer, are you? Find somebody else with money."

rb8082• 7 years ago

I kinda agree, but in reality Europeans are much less likely to start and run a company.

hectorr1• 7 years ago

Which is clearly why the U.S. is such a terrible environment for starting new businesses.

tinyhouse8• 7 years ago

The US private healthcare system has lots of problems and I'm not trying to defend it. However, the public European model is very misleading. The reason is that most people who can afford it pay for private insurance, even in Europe. Otherwise they need to wait months for a doctor appointment.

lentil_soup• 7 years ago

How healthcare works in Europe changes quite a lot per country. Which country specifically are you talking about?

claudeganon11• 7 years ago

Nope. My grandmother and extended family in the UK received great, high quality care as working class people for all of their lives. There have been more issues with access to care since right wingers started attacking and defunding the NHS, but hopefully Corbyn will soon put an end to all of that.

brazzy• 7 years ago

Germany ringing in: nope, we don't.

wlll2• 7 years ago

A couple of thoughts:

1. In the UK the number of people with private medical insurance was (a couple of years ago) around 12% (according to one source). I don't know anyone who has it personally, I don't (and I can afford it). Do you know what the figures are for other European countries?

2. Is it possible that having a (relatively) cheap and functional state provided health care system keeps insurance costs down? If you're charging some large amount of money for health insurance and the alternative is effectively free* then you'd think that people wouldn't bother with it.

* you pay for it anyway in taxes, it's not a lot of money, or it's free, depending on your income level.

standardUser• 7 years ago

Who cares if you have to wait 3 days or 3 months? What matters is outcomes. If you wait three months, are properly treated and have a good outcome, that is a healthcare success.

If you wait 3 days, go deep in to debt, and get the exact same outcome, how is that better?

Obviously, people are not dying as they wait for their appointments throughout Europe. Otherwise their health metrics would not be so consistently better than in the US. Maybe focusing on wait times is not the right way to look at the issue.

dragonwriter3• 7 years ago

However, the public European model is very misleading.

The phrase “the public European model” is misleading, because there are lots of European models which provide universal healthcare, and while almost all of them involve a vastly greater public share of all expenditures than the US system which fails at universality, in some, IIRC, a substantial share of that is through publicly subsidized private insurance. The British model is not the French model is not the German model, etc.; the two things they have in common is universality and not being as ludicrously inefficient as the US model.

dade_• 7 years ago

Private health insurance and lack of universal public health insurance that is.

All doctor offices in Canada are private corporations, for whatever reason the hospitals are not and that is where the worst of our problems lay.

willhslade• 7 years ago

Care to expound?

whiddershins• 7 years ago

The fact that our healthcare system is messed up is not synonymous with getting rid of profit.

Every time something is screwed up in the US, there’s a bunch of people who scream “See! Capitalism!”

This, to my mind is unproductive and rather transparent advocacy for an underlying ideological inclination.

Sometimes things can be fixed without resorting to “Socializing” them.

Here’s something broken under a socialized mechanism: every piece of NYC infrastructure.

igravious4• 7 years ago

"This, to my mind is unproductive and rather transparent advocacy for an underlying ideological inclination."

And you're not ideologically inclined in the opposite direction?

Look at what is already socialized: fire departments, court system, police service, the three-letter agencies, military, politicians presumably?, a lot of education (despite student loans), a chunk of the health service already, road network, probably a lot more things.

I put it to you – given that so much related to the public good is publicly funded and given that examples from the rest of the world abound that public health services are cheaper why wouldn't you socialize the bulk (> 90%) of health.

Clearly, to my mind, the reason why it hasn't yet happened in the States is down to government capture, a.k.a. lobbying, a.k.a. legal bribery.

Brain_Thief• 7 years ago

I find it interesting that your condemnation of unproductive ideological advocacy is couched within a hyperbolic rant wherein you seem to assume the privilege of having your words taken metaphorically and not literally ("every piece" of NYC infrastructure is broken, implicitly due to "Socialism"; people are "screaming" about the ills of capitalism) while simultaneously refusing to extend that same privilege to the people you decry. Whatever your intentions, your use of bad-faith argumentation practices reflects poorly on your stance and mirrors the condescending messaging employed by advocates of the obviously untenable status quo. I claim that your comment was written in bad faith because it feels both divisive and derisive and makes no attempt at offering a bridge of understanding for balanced discussion to occur.

bernierocks2• 7 years ago

The dirty secret is that for profit healthcare runs the rest of the world. The majority of new drugs are created in the US and nations that have government-run healthcare create generics by ripping off/taking the IP and creating cheap alternatives. This is the only reason drugs are cheaper in other parts of the world.

The R&D, which costs millions (and sometimes billions) still needs to be paid for by someone..and the government just isn't efficient enough to do this effectively and within a decent time frame.

The problem isn't for-profit healthcare. The problem is the insurance companies. They create an un-needed middleman that inflates the cost of everything. A better alternative would be to get rid of insurance for most things, allow doctors and hospitals to charge directly to consumers (which would bring the costs way down).

Surgeries would also come down in cost because of competition. The ones that don't come down are most likely because they are rare and have little competition. These can be covered under insurance.

Daishiman4• 7 years ago

The majority of new drugs are created in the US and nations that have government-run healthcare create generics by ripping off/taking the IP and creating cheap alternatives. This is the only reason drugs are cheaper in other parts of the world.

So all those Swiss, German and French pharmaceutical companies are a figment of my imagination then.

thisiswater• 7 years ago

I find the public vs private debate unfolding here extremely interesting, but I have no idea about it. What are your sources? Where can I learn more about the contribution of the private sector to healthcare, the returns on their investments, and how insurance companies affect that equation?

scottlocklin2• 7 years ago

It's certainly true that the health care system in the US is bonkers, and there are manifest injustices in how things work, but it also represents an enormous failure in public health efforts. 4/10 US adults are obese. Only 30% of the country manages to not be overweight!

claudeganon11• 7 years ago

The absence of good public health initiatives is also the result of the fractured, poor quality, expensive, private healthcare system in the US.

smartstakestime• 7 years ago

Healthcare has little to do with health. Its this thinking that is the reason why Americans are declining in quality of life.

Stop blaming the other, its not making you stronger or better. Better healthcare will not stop you from drinking too much , eating too much, not exercising enough. No drug is going to fix your social anxiety. Drugs fix symptoms not causes.

This "health disadvantage" what is it exactly. I bet its lung and diabetes issues. We do it to ourselves. Once you accept that you will see the fix. Its not some billionaire giving you money , it you not giving money to the drug dealing (alcohol, unhealthy food, weed/tobacco/vape) billionaires and getting active.

Religion used to be a good way to get out before, a secular nation needs to find a similar motivation that gets people out of their houses. Maybe the worst drug is the media keeping us planted in our chair. Either way I dont trust the gov. so even if we put more money into "healthcare" they would fuck it up. Prove me wrong.

etrautmann• 7 years ago

This is a diversion and a false dilemma. What you're saying is not wrong in that people should live healthy lifestyles, but it is also true that the health care system is now strongly disincentivizing preventative care, early treatment (or any treatment) in a way that can lead to increased mortality.

SolaceQuantum4• 7 years ago

"No drug is going to fix your social anxiety."

But access to afforable medicine will definitely fix a big chunk of my anxiety about not being able to afford medicine!

"I bet its lung and diabetes issues."

It's really hard to take care of diabetes in america, due to the costs of adequate insulin and related medical purchases such as bloodwork and glucose testing devices.

hindsightbias• 7 years ago

You can have the best healthcare in the world and it won’t overcome modern lifestyle choices.

I spent the last week in 4 different states and airports. The BMI variety between them was staggering. Diabetes rates aren’t soaring because some healthplan is expensive.

People blame opoids like they’re causal. Those people have always been in physical agony, there’s just a magic pill now for their disability and as more people make worse choices that population is only going to grow.

Until K-12 diets and physical activity become mandates I don’t see how we get ahead of this problem with tech or cheaper healthcare.

RickJWagner• 7 years ago

But from 2010 to 2017 (the cited years) are the years of the ACA.

Was it a failure?

frockington13• 7 years ago

Unpopular opinion but I think the ACA did more to cripple hourly workers than any other legislation in history. The mandate to provide healthcare to anyone working over 30 hours resulted in work weeks being cut to 29.5 hours for many

spiderfarmer• 7 years ago

The lack of empathy and solidarity is only growing in the U.S. so this problem won’t be solved any time soon.

nextstep• 7 years ago

I have a more optimistic view. Bernie Sanders’ campaign explicitly asks people if they are willing to fight for people they don’t know, and his campaign has the largest donor base and the biggest rallies.

WhompingWindows3• 7 years ago

I love Bernie and I voted for him in the 2016 primary... that said, I won't be voting for him in 2020. He's not indicative of some great revolution, of some kumbaya moment...Sanders is going to get less than 20% of the vote in the primary and, as a socialist, he is hated and a non-starter for 30% of the populace who rabidly support Trump.

Bernie, Biden, Trump: We do not need elderly presidents. 80 year olds are scientifically proven to be cognitively declined relative to younger individuals. They are much more likely to die in office, more likely to have memory issues, slower to comprehend new things, and are just much more out of touch with the average citizen.

So, while I laud Bernie's character, I don't think a 77 year old man being preferred by less than 20% of one half of the electorate is cause for optimism.

anovikov• 7 years ago

Maybe it's fracking?

mfer5• 7 years ago

And while suicides, drug overdoses and alcoholism were the main causes

It looks like there is increasing mental health issues that aren't being addressed. This seems to get blown past too quickly.

We tend to look at the medical side of things and the way the healthcare system works. But, somethings have changed that caused the mental heath of many to go down. Will changing the US to single payer or medicare for all change the mental health problems? Given the research I've read it's highly unlikely.

Can we please put more time into understanding and addressing the increasing mental health problems? This is important for forums like this because studies have repeatedly found we have a hand in it.

majos2• 7 years ago

Given the research I've read it's highly unlikely.

Can you expand on this? I see a pretty direct line through an unpayable medical expense, inability to afford housing, and declining mental health from all of the associated stress. Add in the unpredictable nature of health scares and that seems like a terrible mixture for mental health.

mfer5• 7 years ago

I'll start with one example. The rising suicide rate. Since 2010 there has been a large increase in teen girl suicide rate. A significant cause of this is social media and smart phones. This has to do with bullying, comparisons, and other things. [3]

Now take a place like Texas where the homeless population has decreased [2] in the same window the suicide rate has gone up [1]. This is just an example.

I know there is a lot of political talk on some of this. I would suggest taking some time to read the data which is prevalent. You can easily find it with search engines.

I see a pretty direct line through an unpayable medical expense, inability to afford housing, and declining mental health from all of the associated stress. Add in the unpredictable nature of health scares and that seems like a terrible mixture for mental health.

Can you point me to some research on this? Data researchers have observed? I've not seen this.

[1] https://www.utsystem.edu/sites/default/files/news/assets/Sui... [2] https://www.thn.org/wp-content/uploads/2017/05/2016-Infograp... [3] http://www.jeantwenge.com/research/

dota_fanatic• 7 years ago

Don't you think these things are directly related?

A friend of mine had some minor mental health issues going into their 20s. Lack of meaningful opportunity paired with obscenely expensive and inaccessible healthcare helped drive those to become major health issues, including drug addiction, due to intoxicating themselves to "help" distract from their grim reality.

Absolutely I think it would have been different had they had access to general preventative healthcare from the start so they could get routine dental, physical, etc. Would they be cured of their mental health problems? Probably not. Would the effects have been less destructive? Yeah, I would bet on it.

mfer5• 7 years ago

Don't you think these things are directly related?

From what I've read there isn't a strong relation between them. Some of it is obvious. The system has been roughly the same for many years but the change happened to mental health anyway.

As I start to read studies on it I learn there are other factors affecting mental health.

The people who study these things are predominantly saying it's related. Why should we think it is?

jordandeang2• 7 years ago

The universal health care proposals by Bernie Sanders and Pramila Jayapal include mental health and substance abuse treatment services.

https://www.congress.gov/bill/116th-congress/senate-bill/112... https://www.congress.gov/bill/116th-congress/house-bill/1384...

simonsarris2• 7 years ago

Why does everyone think this will help? Don't we already have more mental healthcare than ever before? Why is the assumption that even more would help?

What was mental healthcare like 30, 50, 100 years ago? Was there a lot more of it back then? Why do people attribute the suicide and drug use to lack of care? It seems like the most extreme dodge of actual issues to paper over it with yet-more-healthcare. For all we know, none of what we have already is really helping, and more won't help more.

Retric• 7 years ago

Stress and mental heath are strongly linked. So, the current system with it’s high costs and uncertainty is actively making things worse.

On it’s own it might not make a huge change, but in aggregate this is a significant effect.

espresso_enigma• 7 years ago

These are diseases of despair. The financial inequality in this country is literally killing us. Sure there are other mental illness issues, there always are, and always will be. But this inequality is the root of the issues causing the . declining life expectancy. If the average person can't feel somewhat secure in their life, like they aren't completely struggling and beat down just making ends meet, if we are living one paycheck away from homelessness or bankruptcy, buried in debt from student loans, medical bills, credit card debt, mortgage etc... Most people can barely stay afloat, let along save for retirement, and have time to actually feel relaxed and able to enjoy their lives. What do we expect from this situation? A healthy society?

downerending• 7 years ago

They are diseases of despair, and that is key. (have an upvote)

But casting this as primarily an issue of financial inequality seems misleading. I wouldn't feel one whit less awful if everyone in the country was poorer than me.

It's absolute want that matters. If you can't afford medical care for your kid, it doesn't matter whether or not anyone or everyone else can--you're still going to be devastated.

mensetmanusman• 7 years ago

One interesting rabbit hole is that children who live with and are raised by both parents have very low levels of mental health issues.

Currently, less than half of the children in the U.S. being born will experience this.

droithomme• 7 years ago

Everyone's got their own opinion about what is to blame for this, I'll toss mine in.

I see a lot of people with stress and despair related problems such as high blood pressure, heart disease, obesity, alcoholism, drug use. Diet can be an issue as well but diet problems on these come from stress management tactics, it's not the diet that's the root cause here.

Currently a major source of stress is the general political atmosphere of endemic bullshit, violence, fake news, lies, shout downs, cancel culture, cover ups, self dealing, and all this on both sides. And if you say both sides both sides jump down your throat trying to bullying you into agreeing with them their side whatever it is is perfect and the other side are literal demons who need to exterminated. By not agreeing only one side is at fault, then you as well are labeled a demon worthy of extirpation as well. Choose sides or be cast into hell. But choosing either side is to buy into a delusion.

Another cause of poor health has been mentioned: the health care system really is shit for most people. My insurance runs over $20,000 a year for a really crappy policy that doesn't cover anything since everyone is out of network or there's a copay that is more than the cash price, meaning I just pretend I don't have insurance to save money. Any hospital emergency I can be assured that either the plan doesn't cover the hospital at all or doesn't cover the people working there. In network coverage for anything involving more than one person doesn't exist. And although many doctors are good people and competent a lot more are money grubbing and incompetent, having practices managed or advised by MBAs with maximum profit as the sole motive. Specialists are particularly hard to get ahold of and charge absurd amounts compared to literally every other country in the world.

How to fix any of these? None of it is ever going to get fixed. The deep state is not just a government thing, it also extends to medicine, teaching, police, and other professions which have invisible networks that will thwart any attempt at reform or improvement to protect their own positions and lifestyles. Trying to fix it is a waste of time that only leads to being made a target of attacks, and introducing massive stress into your life. One might as well try to fix communism from inside Stalin's Soviet Union. You'll only be disappeared or end up dead. Best instead to figure out ways to have as little to do with the system as possible, and undermine it whenever you have the opportunity, hoping it will eventually collapse. The only way out is collapse at this point. Some cars are so far gone they can't be fixed. Likewise with houses. I've seen people try to restore an old farmhouse or victorian with a rotted foundation and floors and spend hundreds of thousands of dollars ending up with a crappy house with poor energy efficiency and little resale value. They are broke and stressed out and just spent a decade exposing themselves to black mold and sometimes things like asbestos. They could instead have demolished it and built a full size replica using modern efficient methods for a tiny fraction of what they spent "fixing" it. Why did they pursue restoration instead? Because they bought the rotted house for what they thought was a bargain and ignored its long term costs, and also they "fell in love" with it through simple familiarity and comfort of knowing it was theirs. Tearing something down or throwing it out and starting over again is the only way out of things that are far too rotted and broken to be worth fixing. Political and economic systems, houses, cars, and relationships all fall under this rule.

apta• 7 years ago

I'm not sure it's politics as much as a deeper underlying cause. A lot of today's salaries are just not sustainable to live and retire off of anymore. You read stories about how several decades ago, a man working at a gas station was able to afford a house, car, and support his wife and children. Today, you have people in their 30s who are still in debt, and whose salaries are barely able to sustain them. They end up having to work 2 or even 3 jobs if they have a family to support.

Combine this with a consumer heavy society, where people seem unable to control their impulses, and this is not a good result.

Ididntdothis• 7 years ago

" A lot of today's salaries are just not sustainable to live and retire off of anymore. You read stories about how several decades ago, a man working at a gas station was able to afford a house, car, and support his wife and children."

I just moved into a new place and had a painter do the walls. He started working at Safeway with 17, retired at 52 with a pension, has 2 houses and raised 2 kids. that sounds almost impossible these days.

jstewartmobile3• 7 years ago

I think US healthcare is poisoning people. Every office-dweller is on proton-pump inhibitors, SSRIs, or both. In most cases, the PPIs are there to treat people who have wrecked their GI tracts by popping ibuprofen once or twice a day. Every older person is also on statins. Then there's the oxycontin dominance in the red states.

People constantly going to the doctor over side-effects and dosage level adjustments. Doctors just see them as walking wallets, and prescribe a new pill to cover the old side-effects with new ones.

Your liver and your kidneys can only take so much--see the dialysis centers popping up all over the place...

volkl48• 7 years ago

No, people are poisoning themselves.

~40% of the US population is obese and in total, ~72% of the US population is overweight (including those classified as obese).

Every doctor I know would prefer you to eat and move/exercise appropriately rather than prescribing you drugs. That's the preferred treatment and would prevent many of those issues.(especially when you also include other basics of a healthy lifestyle, like sleeping enough and not abusing substances).

However, as is obvious, most people are unwilling to actually do what's required for that. So doctors are left with trying to mitigate symptoms or reduce harm without being able to tackle the cause.

----------

It will be interesting to see what happens in the coming decades elsewhere in the world, as most of the rest of the world is rapidly catching up to the unfortunate "norms" of US weight problems.

I suspect you will see the prevalence of many of those ailments rising elsewhere in tandem.

jstewartmobile3• 7 years ago

No, medicine is. If "healthcare" didn't offer alternatives to getting your shit together, people would either get their shit together, or die.

From past life expectancy stats, the former happened more than the latter.

Also, recent US life expectancy decline can be accounted for, entirely, by prescription opioid epidemic.

iatrogenics

nickthemagicman2• 7 years ago

"most people are unwilling to actually do what's required for that."

Correction...most people don't have TIME to do what's required because of capitalism requiring them to work immense hours.

WhompingWindows3• 7 years ago

Your post is not medically accurate. PPIs are not there to treat people who have "wrecked their GI tracts by popping ibuprofen once or twice a day". PPIs are very useful drugs for people with GERD, whether that's due to anatomic differences in their LES, dietary concerns, stress levels, excess coffee or alcohol consumption, or side-effects from any number of drugs/treatments (including the one you mentioned, ibuprofen, but that's a subset of a long list of reasons).

Second, "every" office dweller is not on these drugs, that's a gross overstatement.

SSRI's are not even close to universally prescribed; they are known to not be that effective, many people do not take them but treat mild or moderate depression with psychotherapy, exercise, behavior changes, etc.

Regarding statins, they are very useful and have prevented a lot of deaths. They may be over-prescribed due to their generally safe and effective characteristics, however it's a GOOD thing to improve healthcare among the elderly (which is what is stated in the article).

Dialysis centers are popping up all over the place due to the rising obesity/type 2 diabetes epidemic, the drugs very much take a second-hand effect in that causal pathway.

You shouldn't spout off incorrect medical knowledge in an off-handed way. There are many uninformed people out there who may absorb this and propagate these incorrect views. Facts matter, science matters, as a healthcare researcher I can't let these misstatements go uncorrected.

jstewartmobile3• 7 years ago

"as a healthcare researcher"

I wonder who's signing the paychecks?

edit: and I think it's fair to ask about conflict of interest when reply is an appeal to one's own authority.

readarticle• 7 years ago

“In the northeast and midwest” should be appended to the title.

California experienced negative growth. Texas, Georgia, Florida, Oregon, Washington “0-5% growth”.

Dr. Woolf said one of the findings showed that the excess deaths were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana.

—

“I’m not sure the dramatic, ‘there’s something desperately wrong with the entire country’ narrative is entirely accurate,” Dr. Harper said. “Certain groups, such as Hispanics and Asians, are doing O.K. It’s not like the entire country is being subsumed by a single social phenomenon that can explain all of this. There are a lot of moving parts.”

Balgair• 7 years ago

The CDC report gives a much better view of these findings [0]. I would really suggest reading the report. It is not jargony and takes maybe 15 minutes to zip through. They really put a lot of time into making it accessible and it shows.

In reading that report some things that I noticed are [1]:

Pg. 8: Alzheimer's Disease caused deaths for both males and females increased a fair bit! And for males, Unintentional Deaths also increased recently. Note that the Y-axis is in a LOG scale; any movement upwards is a lot.

Pg. 10: Yeah, Juul and the like really are hurting children. Grades 2 & 3 Obesity are increasing too. Both are not good.

Pg. 11: Asthma in black children has gone up a fair amount.

Pg. 14: West Coast and Virginian essential vaccination is under 2/3 babies (3 years or younger). That is WELL below herd immunity. New England, Deep South, and Plains states are above 3/4.

Pg. 21: Ages 15-44 have seen an uptick in mortality. Note: The y-axis is in LOG scale, so it's been a fair bit of an uptick.

Pg. 22: A big uptick in infant mortality due to unintentional injuries.

Pg. 23: ... Jesus ... a huge increase in child suicide rates and an increase in teen homicide and suicide rates. Note: The y-axis is in LOG scale.

Pg. 24: HIV deaths are WAY down (!), unintentional injuries and liver cirrhosis are up.

Pg. 25: Alzheimer's deaths in the elderly are up a fair amount.

pg. 26: Holy shit ... overdose rates are just ... wow ...

pg. 27: Appalachia and New England ... good Lord ... I mean, you hear things about it all, but wow.

pg. 29: Cirrhosis deaths in middle aged men are really climbing. The booze, it ain't good.

BTW here's the scihub link for the JAMA article that the NYT is talking about: https://scihub.bban.top/https://jamanetwork.com/journals/jam...

[0] https://www.cdc.gov/nchs/hus/index.htm

[1] this is mostly a summary that I posted here 38 days ago when the report first dropped. Seriously, just read the CDC report!

TurkishPoptart3• 7 years ago

When you say: >Note: The y-axis is in LOG scale What does this mean?

throwanem• 7 years ago

It runs by orders of magnitude, e.g. 1, 10, 100, 1000...

ls612• 7 years ago

pg. 29: Cirrhosis deaths in middle aged men are really climbing. The booze, it ain't good.

The vast majority of cirrhosis is not related to booze, about 80% of it is caused by hepatitis.

frockington13• 7 years ago

Pg. 14: West Coast and Virginian essential vaccination is under 2/3 babies (3 years or younger). That is WELL below herd immunity. New England, Deep South, and Plains states are above 3/4.

It's disgusting what is happening. Parents from the most educated places in the nation are knowingly putting others at risk. If those states can justify a sugary beverage tax they should be able to justify a tax on antivaxers.

izzydata• 7 years ago

The way things are going in the US are unsustainable and I'm not even talking about the impending climate problems. What is going to give out first and how long will it take?

shantly• 7 years ago

If we don't fix healthcare costs it'll be that in 5-15 years, just looking at the increases in costs year over year. It's strangling the economy.

After that we very likely have a (lack of) retirement crisis coming in, I reckon, 15-30 years. I'd guess there'll be a concurrent falling off of generational passing-on of wealth (inheritance) that'll compound the issue and ensure it lasts much of the rest of the century. This'll be way worse if all we've managed to do with health care costs is hold them at their already-too-high levels, rather than lower them.

The worst risk is that crises aren't always blamed on the right people/issues, and sometimes end up causing scary shifts in the politics of a state (watch as I carefully avoid Godwinning the thread)—I suspect the mobility of wealth and how much money is in the hands of effectively stateless corporations will make any such occurrence rather more interesting than it has been in the past in the US, e.g. the Great Depression, as incentives for various actors may not be aligned the same ways they have been. One hopes the phrase "feeding frenzy" won't apply, but it seems possible.

frockington13• 7 years ago

Wouldn't less people reduce our carbon footprint? Thinning the herd (particularly the obese) may be what the world needs to combat climate change

higeyuki• 7 years ago

How happy are you? Truly, ask yourself. Think back and think of how things have drastically changed in society.

This is telling of a world that cares more and more about the "economy" then they do people. With little to no focus on living and so much emphasis on "success," "Business," and "economy."

Work with little pay, a buy in club for access to healthcare and no work/life balance in many jobs. It does not surprise me even the smallest amount. Health insurance (at least in the states) is more like a Costco membership. It just gives you access to healthcare.

Healthcare profits have been in decline so I don't think it is about the "for profit" system as much as it is other things in our environment (work/natural.) I think this is more telling of how our culture chooses to live and has structured the work environment.

https://www.wsj.com/articles/u-s-hospital-profits-fall-as-la...

fma• 7 years ago

Anyone who has followed presidential candidate Andrew Yang knows this. This is why he wants the "American Scorecard" which consists with indicators including life expectancy, suicide rate, drug overdose rate...rather than things like GDP, unemployment.

The country is not healthy. Until we put these numbers in the forefront, we will keep trying to just increase GDP at the cost of people's lives.

TurkishPoptart3• 7 years ago

Is there something us devs with money to throw around can do to, well, not fix, but alleviate the insurance gap? Perhaps there could be a large pool we could pay into, that people could spend solely on necessary medical care.

jhloa2• 7 years ago

Are you proposing a secondary level of insurance for a failing primary insurance system? Won't that just make it worse?

Empact• 7 years ago

Key quotes for me:

Dr. Woolf said one of the findings showed that the excess deaths were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana.
“What’s not lost on us is what is going on in those states,” he said. “The history of when this health trend started happens to coincide with when these economic shifts began — the loss of manufacturing jobs and closure of steel mills and auto plants.”
The increased deaths from drug overdoses reflected increased rates of addiction to opioids. But they have also risen because of changes in the drug supply in the East and Midwest. Over the last decade, the synthetic drug known as fentanyl has been mixed into heroin — or in some places has replaced it. That has made the drug supply more deadly, since it is difficult for users to know the dose they are taking.
Life expectancy in the coastal metro areas — both east and west — has improved at roughly the same rate as in Canada.

These together point to me to local crises: people in hard times due to economic shifts turning to drugs, etc, as an outlet.

There are many ways to improve the lot of these people, but being blind to the cause does not help them. Also let’s be clear about the scale of the problem:

While the total number of excess deaths — meaning the number of deaths that would not have happened if the mortality rate had continued to improve — is small, at 33,000

For context, total overdose deaths are ~70,000/year. https://www.cdc.gov/drugoverdose/index.html

nickthemagicman2• 7 years ago

It's unregulated capitalism. Jobs are dead end unless you have advanced degrees which eliminates a huge portion of the country. Most jobs require you to be sedentary in office and work long hours. 70% of the country is living paycheck to paycheck. The healthcare industry is profiting massively at the expense of the population. Politicians have been purchased by big biz so this will not change. It's just going to get worse.

m463• 7 years ago

I don't think people realize the increased mortality of being on the upper end of the (literal) scale.

Here's a journal article:

https://journals.plos.org/plosmedicine/article?id=10.1371/jo....

but to summarize BMI vs years lost:

  BMI    40-45   45-50   50-55   55-60
  men    -6.5    -10.8   -10.6   -17.0
  women  -6.9     -9.1   -10.3   -13.1

Life expectancy in the U.S. is declining for middle-aged people of all groups

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