The decline in U.S. life expectancy is unlike anything seen in a century (2018)(popsci.com)
popsci.com
The decline in U.S. life expectancy is unlike anything seen in a century (2018)
https://www.popsci.com/life-expectancy-declining
345 comments
Same thing is happening in the US just in slow motion.
Exactly. Chalmers Johnson and Chris Hedges concur.
America: the Farewall Tour - https://www.worldcat.org/title/america-the-farewell-tour/ocl...
DECLINE of EMPIRES: The Signs of Decay - https://youtu.be/Q2CCs-x9q9U
Today, in Paradise, the power was out for most of the day... like Mogadishu or Baghdad. America, like a slowly-boiled frog, has become a third-world country:
- no universal healthcare
- grotesque inequality: lower average pay, unlivable wages, more billionaires, millions of homeless.
- wealth transfer from the poor to the rich through tariffs, fines, fees and other taxes
- crumbling infrastructure - tens of thousands of structurally-deficient bridges and crossings
- apathetic, uncaring police letting crime go unpunished and misery flourish
Americans don't know how bad they have it... it's great for the very rich, but it's horrible for most people including the aspirational rich who will never be so and yet vote/work against their own interests and be cowardly traitors against We The People.
America: the Farewall Tour - https://www.worldcat.org/title/america-the-farewell-tour/ocl...
DECLINE of EMPIRES: The Signs of Decay - https://youtu.be/Q2CCs-x9q9U
Today, in Paradise, the power was out for most of the day... like Mogadishu or Baghdad. America, like a slowly-boiled frog, has become a third-world country:
- no universal healthcare
- grotesque inequality: lower average pay, unlivable wages, more billionaires, millions of homeless.
- wealth transfer from the poor to the rich through tariffs, fines, fees and other taxes
- crumbling infrastructure - tens of thousands of structurally-deficient bridges and crossings
- apathetic, uncaring police letting crime go unpunished and misery flourish
Americans don't know how bad they have it... it's great for the very rich, but it's horrible for most people including the aspirational rich who will never be so and yet vote/work against their own interests and be cowardly traitors against We The People.
There is a line my dad's scruffy friends say when discussing the decline of the US.
"Two ways... Gradually and then suddenly"
"Two ways... Gradually and then suddenly"
I encourage readers to see the original CDC report [1]. It full of facts, but quite easy to read. Skim over the data, it’s presented in graphs and tables.
Unfortunately, this is one of those subjects that numerous commenters see through their own political or philosophical perspectives of the headlines without consulting the underlying data. Check out things for yourself.
There are some disturbing trends I noticed while looking over the data on my phone. Homicides, suicides, and accidents of young men have continued to increase and appear to me to be pulling down overall life expectancies (which have changed a small amount in the last few years).
[1] https://www.cdc.gov/nchs/data/hus/hus17.pdf
Unfortunately, this is one of those subjects that numerous commenters see through their own political or philosophical perspectives of the headlines without consulting the underlying data. Check out things for yourself.
There are some disturbing trends I noticed while looking over the data on my phone. Homicides, suicides, and accidents of young men have continued to increase and appear to me to be pulling down overall life expectancies (which have changed a small amount in the last few years).
[1] https://www.cdc.gov/nchs/data/hus/hus17.pdf
A few points I saw:
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.
Aside: On the increases in 'unintentional death'. I get a whiff of the issues that Colorado Springs had with their teen suicide cell a few years back. The coroner, in deference to the religious families of the deceased, would label the deaths not as a suicide, but as something different. The problem became that since these deaths were not recorded properly, CDC officials were not alerted and the suicide cell was allowed to fester. There were a lot of kids that died as a result of that. The increase in 'unintentional deaths' may be something similar, where the coroners are recording the deaths in deference to the wishes of the family. I've not a shred of proof on this, but I get a strong smell of it from causally looking at the data.
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.
Aside: On the increases in 'unintentional death'. I get a whiff of the issues that Colorado Springs had with their teen suicide cell a few years back. The coroner, in deference to the religious families of the deceased, would label the deaths not as a suicide, but as something different. The problem became that since these deaths were not recorded properly, CDC officials were not alerted and the suicide cell was allowed to fester. There were a lot of kids that died as a result of that. The increase in 'unintentional deaths' may be something similar, where the coroners are recording the deaths in deference to the wishes of the family. I've not a shred of proof on this, but I get a strong smell of it from causally looking at the data.
I would add that Cirrhosis isn't just alcohol. Another major contributor is sugar and complex carbs. There are about 87 million Americans that meet the criteria for Metabolic Syndrome and that is directly related and getting worse with time.
It's also caused by hepatitis (B and C)[1] which effects millions of people in the US[2].
1: https://en.wikipedia.org/wiki/Cirrhosis#Causes
2: https://www.cdc.gov/hepatitis/hcv/cfaq.htm#statistics
1: https://en.wikipedia.org/wiki/Cirrhosis#Causes
2: https://www.cdc.gov/hepatitis/hcv/cfaq.htm#statistics
and https://www.nhlbi.nih.gov/health-topics/hemochromatosis
which affects an estimated 30% of americans
Hepatitis B adult vaccination rates seem to be woefully low in the US (25-33%), and while there is treatment for Hep C, it is very expensive ($84k for a three month course).
https://www.cdc.gov/vaccines/imz-managers/coverage/adultvaxv....
https://www.cdc.gov/vaccines/imz-managers/coverage/adultvaxv....
Simple carbs?
[Edited] I am awake now. Simple carbs have more of a glycemic load and thus more impact on the liver. When your body responds to glucose, it releases insulin. Over time you build up a resistance to insulin. Your liver has to compensate for this by using up stored glutathione. I am very much over simplifying for the purpose of HN, but long story short, sugar, processed foods, grains, put a heavy load on the liver and pancreas
For example, green leafy vegetables are complex carbohydrates. They have very little glycemic load and will not harm your liver.
Pretty much all carbs are bad news. Always subtract fiber content from carbs and what is left over, your liver and pancreas will be dealing with. Vegetables have a lot of fiber for example.
For example, green leafy vegetables are complex carbohydrates. They have very little glycemic load and will not harm your liver.
Pretty much all carbs are bad news. Always subtract fiber content from carbs and what is left over, your liver and pancreas will be dealing with. Vegetables have a lot of fiber for example.
You have the two backwards.
sorry yes, multi-tasking :-) thankyou. I shall get back to work.
"Pg. 10: Yeah, Juul and the like really are hurting children. Grades 2 & 3 Obesity are increasing too. Both are not good."
I read the charts a little differently - overall tobacco product usage has gone down quite significantly, with cigarettes and cigars driving the majority of that. I think it's a safe assumption to make that at least some of that drop is due to the switch to e-cigarettes like Juul. Obviously "how much" of that drop is due to the increase in e-cigarettes vs. the natural decline of smoking is in question, but I would not draw a conclusion that e-cigarettes are hurting children.
I read the charts a little differently - overall tobacco product usage has gone down quite significantly, with cigarettes and cigars driving the majority of that. I think it's a safe assumption to make that at least some of that drop is due to the switch to e-cigarettes like Juul. Obviously "how much" of that drop is due to the increase in e-cigarettes vs. the natural decline of smoking is in question, but I would not draw a conclusion that e-cigarettes are hurting children.
Why does the report not put spotlight put on car crash deaths? Footnote links to data that says over 1/4 of unintentional injuries are from motor vehicle deaths, more than even overdoses. Add on that sitting on your butt in traffic or keeping your kids "safe" indoors is going to increase obesity and heart disease.
Do you have a source on the Colorado Springs suicide cell/coroner cover up? The number of high-school age related suicides I heard about seemed high but it wasn't like I could compare it to someplace else.
https://www.newsweek.com/2016/10/28/teen-suicide-contagious-...
It wasn't a cover up, per se, just a compassionate coroner that unintentionally threw a wrench into the apparatus.
Compare it to the Palo Alto one from a bit ago:
https://abcnews.go.com/Health/disturbing-suicide-cluster-pro...
It wasn't a cover up, per se, just a compassionate coroner that unintentionally threw a wrench into the apparatus.
Compare it to the Palo Alto one from a bit ago:
https://abcnews.go.com/Health/disturbing-suicide-cluster-pro...
Considering the recent piece I heard on NPR about the link between sugar and Alzheimer's Disease and the anti-fat/pro-sugar campaign, that makes sense that those numbers are up significantly.
Thank you for taking the time to provide a synopsis!
It is actually super readable! Takes, maybe 10 min to skim through, a good afternoon coffee break.
I'm surprised to see that homicide is actually increasing. I thought we were at all-time lows, but maybe not.
Interestingly, unintentional injuries are climbing even more than homicide (and because this is a log-scale graph, they're increasing by much more in absolute numbers). I assume this category includes drug overdoses, which is probably a good part of it, but it would also include deaths due to car crashes, which have been increasing. Cars are especially getting more dangerous to those outside of them in crashes, as cars are only safety-rated to protect those inside of them, not unfortunate pedestrians and cyclists who might get mashed up against the increasingly flat and high grilles of SUVs and trucks out there.
Interestingly, unintentional injuries are climbing even more than homicide (and because this is a log-scale graph, they're increasing by much more in absolute numbers). I assume this category includes drug overdoses, which is probably a good part of it, but it would also include deaths due to car crashes, which have been increasing. Cars are especially getting more dangerous to those outside of them in crashes, as cars are only safety-rated to protect those inside of them, not unfortunate pedestrians and cyclists who might get mashed up against the increasingly flat and high grilles of SUVs and trucks out there.
Liver disease is likely linked to the continuously rising obesity levels:
> "adult obesity rates now exceed 35% in nine states, 30% in 31 states and 25% in 48 states."
https://stateofchildhoodobesity.org/adult-obesity/
More people are now dying earlier from liver disease, instead of dying later of for example diabetes or heart disease. In more cases, the liver is failing first due to lifetime obesity problems.
> "adult obesity rates now exceed 35% in nine states, 30% in 31 states and 25% in 48 states."
https://stateofchildhoodobesity.org/adult-obesity/
More people are now dying earlier from liver disease, instead of dying later of for example diabetes or heart disease. In more cases, the liver is failing first due to lifetime obesity problems.
> "adult obesity rates now exceed 35% in nine states, 30% in 31 states and 25% in 48 states."
The source for the above data is a telephone survey for the CDC. The NCHS regularly conducts a survey on the same subject for the same CDC, but with added physical examinations. Their data is much worse, over 39.5 % of USA adults were obese in 2016. The rate was almost constantly increasing over the past years.
Source: https://www.cdc.gov/nchs/data/databriefs/db288.pdf p.5
The source for the above data is a telephone survey for the CDC. The NCHS regularly conducts a survey on the same subject for the same CDC, but with added physical examinations. Their data is much worse, over 39.5 % of USA adults were obese in 2016. The rate was almost constantly increasing over the past years.
Source: https://www.cdc.gov/nchs/data/databriefs/db288.pdf p.5
Yes, obesity is an epidemic, and we are also seeing drug overdose and suicide as two major causes of death for white men in America. Those disproportionately affect rural, middle aged folks with less economic and social prospects.
Could it also be alcohol consumption? Seems consistent with drug use.
Don't make speculation. Compare US drinking across other countries, and compare it against prior years and look at correlation. That isn't it. Read https://www.cdc.gov/nchs/data/hus/hus17.pdf which is the source for the article. You can look at page 29 of that report or https://www.niddk.nih.gov/health-information/liver-disease/c... for more information and trend data. It is NAFLD and obesity.
The top decile of American drinkers average 74 drinks a week. A lot of people. A lot of drinks.
https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...
https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...
That is mind boggling! Let's say it was 10 bud lights, LIGHTS mind you... at 145 calories each, that'd be 1,450 calories, or 73% of someone's daily 2000 calories EVERY DAY.
Calories from ethanol don't really work like other calories. The body is incredibly inefficient at using or storing calories from Ethanol. This is why most heavy drinkers aren't incredibly obese.
This is what I don't get with regards to calorie labels.
As far as I can tell they either burn stuff to see how much energy gets released or count up macro nutrients and multiply by x calories.
But if you pay attention it should be obvious that you don't digest all foods equally well and I would say the variance can be on the order of 20-30%. Do they account for this when labeling food ?
As far as I can tell they either burn stuff to see how much energy gets released or count up macro nutrients and multiply by x calories.
But if you pay attention it should be obvious that you don't digest all foods equally well and I would say the variance can be on the order of 20-30%. Do they account for this when labeling food ?
Just for clarity you're not talking about top decile of the general population; just drinkers? I've heard numbers more like 5% - 1/20. Either way it's a ton of people
No, it’s the top decile of all people (presumably adults). The bottom three deciles don’t drink at all.
Interesting, the numbers that I looked at a few months ago weren't quite so pesimistic. 1 out of 20 and the average amount was also lower (like 40). Perhaps I remember incorrectly, or am thinking of another country.
40 is about a six pack a day seven days a week.
Not according to CDC. Increased mortality is caused by nonalcoholic fatty liver disease.
The rise of NAFLD is pretty crazy. Took doctors by surprise about a decade ago. “What do you mean you don’t drink? Look at your liver!”
That disease is also not related to obesity. Funny thing that NAFLD.
Well, I know of at least one case that isn't. So the better way to put would be not always related to obesity.
It is. It has been also linked with bacteria that produce alcohol endogenously.
As long as we are speculating, I wonder if sleep deprivation is another. I have no data, but my hunch is that the rise of smartphones, never ending feeds of infotainment on the internet, on-demand streaming services, and the decline of the "9-5" work culture in favor of the gig-economy and startup "hustle porn" mean people aren't getting nearly as much sleep as they used to, which leads to all kinds of disastrous health outcomes.
Ever do shift work?
Later: Seriously. Shift work is terrible for sleep and has been a fact of industrialized life for a lot longer than the gig economy.
Later: Seriously. Shift work is terrible for sleep and has been a fact of industrialized life for a lot longer than the gig economy.
It's probably both, obesity has been continuously rising but has alcohol consumption too? Alcoholics drinks also contribute to obesity as they pack quite a bit of calories, and are addictive in nature.
Drug use has been declining for decades though, so don't think it'd be that
I am almost certain that this is 100% alcohol-related. The book headstrong opened my eyes to the problems of alcohol even in moderation.
I agree about alcohol use being more problematic than people realize. That said, has there been a rise in drinking over that timespan? According to other comments, the answer is no.
The book by the Bulletproof Coffee guy? Do tell.
Having spent the last year living is Switzerland, the major increase of drug overdoses in the US seems so preventable.
The Swiss have both decriminalized drug use (kills the black market, prevents people from getting an unknown dose of something) and highly restricted prescribing them.
I dislocated a shoulder and was never offered anything for pain, just physical therapy. This may sound harsh, but isn't setting someone up with an addiction that could lead to death pretty bad?
The Swiss have both decriminalized drug use (kills the black market, prevents people from getting an unknown dose of something) and highly restricted prescribing them.
I dislocated a shoulder and was never offered anything for pain, just physical therapy. This may sound harsh, but isn't setting someone up with an addiction that could lead to death pretty bad?
> I dislocated a shoulder and was never offered anything for pain, just physical therapy. This may sound harsh, but isn't setting someone up with an addiction that could lead to death pretty bad?
Amazing what can happen when private profits aren't tied up in the healthcare system.
Amazing what can happen when private profits aren't tied up in the healthcare system.
Neat theory but Canada is battling an opioid epidemic as well.
Yes, because apparently ibuprofen is BAD for you. To me, it sounds better to take care of the stomach rather than get hooked on opioids. When one then considers drug prices in the US and the need for prescriptions, it is not surprising people start going on heroin. From there, it’s a slippery slope. The dealer is already on the speed dial.
I find it odd that the US system (and presumably Canadian too) is so resistant to NSAIDs in paste form. Given they are more regularly killing their patients than Europeans, their arguments against patients handling imprecise dosing are as comic as morbid.
Yeah and doctors here regularly receive incentives from drug companies to push drugs on patients. My girlfriend gets free drug Rep lunch at least once every two weeks and has for years at the doctor's office she works at.
Is it normal to get pain killers for a dislocation? Never heard of that happening in the US. My friend dislocated his shoulder cliff diving last month. The doctor popped it back in and that was that.
From what I have experienced in the US doctors seem to believe that no amount of pain is acceptable. So they prescribe painkillers a lot. Definitely way more than I have experienced in Germany.
This used to be true, that US doctors were taught to treat pain itself but now medical education is more aware of the dangers of addiction and abuse and hopefully new doctors don’t prescribe at the same rates or have the same falsehoods about painkillers being safe.
It certainly isn’t my experience or anyone in my family. The only time I ever was prescribed pain killers was after surgery for severely impacted wisdom teeth. They gave me 2. I’ve had broken bones where I was put to sleep, nasty dog bite where I still have a dent in my calf, multiple stitches from random accidents, and a somewhat major car accident.
Pain killers were not even an option and the doctors said deal with it. Here’s some Ibuprofen.
It could be anecdotal, the doctors in my area are good and they are very aware of opioid issues. I know of people driving to Florida to find favorable doctors.
Pain killers were not even an option and the doctors said deal with it. Here’s some Ibuprofen.
It could be anecdotal, the doctors in my area are good and they are very aware of opioid issues. I know of people driving to Florida to find favorable doctors.
> Pain killers were not even an option...Here’s some Ibuprofen.
Hmm...isn't Ibuprofen a pain killer?
https://www.nhs.uk/medicines/ibuprofen-for-adults/
"Ibuprofen is an everyday painkiller for a range of aches and pains, ..."
When I had a broken elbow, Ibu 600 was what I got a prescription for (Germany). In the hospital after the operation I got something stronger.
Hmm...isn't Ibuprofen a pain killer?
https://www.nhs.uk/medicines/ibuprofen-for-adults/
"Ibuprofen is an everyday painkiller for a range of aches and pains, ..."
When I had a broken elbow, Ibu 600 was what I got a prescription for (Germany). In the hospital after the operation I got something stronger.
Yeah, but "painkiller" is often/mostly used to refer to opioid painkillers in the US these days.
Interesting. I have received and thrown away tons of Vicodin and muscle relaxers even for relatively minor injuries.
It could be my area. It is middle “upper” class and the opioid issues started much earlier. Doctors and pharmacies were aware of it in the early 2000s.
That's crazy.
I've been a pretty high level athlete, and have had some pretty bad injuries, and never once was I prescribed a pain killer?
Why is everything so non-uniform in this country? Because anyone with the resources to go to a doctor, you would think probably has insurance? So what is driving those differences? Just the doctors themselves?
I've been a pretty high level athlete, and have had some pretty bad injuries, and never once was I prescribed a pain killer?
Why is everything so non-uniform in this country? Because anyone with the resources to go to a doctor, you would think probably has insurance? So what is driving those differences? Just the doctors themselves?
Medicine is still more an art than science. We don't have clear evidence based practice guidelines for many conditions so doctors have to prescribe based on habit and intuition. Plus as with any profession, some are just incompetent.
You know how in your field, there is a wide variation in skill? Same in every other field.
This is anecdotal, but not all dislocations are the same. I dislocated my thumb skiing (Colorado) some years back (10?), and the bone shredded the ligaments in my palm. I was pretty grateful for the hydrocodone the doctor gave me because I don't think I would have been able to sleep for the week after the incident without it.
Idk about now, but for a long time in the not too distant past, you could get hydrocodone for virtually anything.
I grew up in Mississippi but left for good about 5 years ago. Whenever I go back it seems so desolate with no sense of hope. I can’t speak to Jackson (largest city and capital) but in the rural area I’m from, the state seems like it is completely in the winter of its current cycle. After high school or college people either leave or end up poor or on drugs. Not surprised by it having the lowest life expectancy.
Surprisingly, according to the CDC, the rate drug overdose deaths in MS didn't grow between 2006 and 2016. While terrible, the base rate isn't even that high compared to other states, so imagine what it's like elsewhere in the U.S. right now too.
For example, in states like Vermont and Delaware the drug overdose rate tripled in ten years.
https://www.cdc.gov/nchs/data/hus/hus17.pdf
For example, in states like Vermont and Delaware the drug overdose rate tripled in ten years.
https://www.cdc.gov/nchs/data/hus/hus17.pdf
Man, you're not kidding. Granted, I live in what I imagine is the wealthiest city in the state, so there's constant new construction, roads, and just a general sense of vitality, but one doesn't have to venture far at all to see exactly what you're describing.
Health and life expectancy varies geographically. Worldwide variation is enormous, but even within the United States you can expect to live 6.6 years longer if you live in Hawaii, the top-ranked state, than in Mississippi, which comes in last. With its 81.3 year life expectancy, Hawaii looks more like the Netherlands than the United States. Mississippi's 74.7 year projection looks more like Kuwait.
One problem of life expectancy is that old people retiring skew it, basically moving from Kansas to Florida at 70 increases the life expectancy of Florida, because the people who died at 20 in Kansas can't move to Florida too.
That's why Israel or Spain have such a high life expectancy with such a modest economic life, people retire there, they come while having already survived.
That's why Israel or Spain have such a high life expectancy with such a modest economic life, people retire there, they come while having already survived.
I think you're wrong...
Life expectancy is computed by counting deaths per cohort and year. That is, the statisticians will count the number of people your age who die in your location this year, and the number of people one year older, etc. At the end of the year, they do the totals and compute that, say, 0.1% of people your age died at your location, and 0.1% of people one year older, etc.
Then they compute your life expectancy by multiplying those chances together.
People moving shouldn't affect that significantly, because this computation doesn't use the past at all. All the data comes from one year.
The big assumption there is that your chance of dying in ten years is assumed to be the same as people ten years older than you dying this year. The small assumption is that the population is assumed to be stable and countable within the present year (I suppose it's possible to work around that with more sophisticated statistics, though).
Life expectancy is computed by counting deaths per cohort and year. That is, the statisticians will count the number of people your age who die in your location this year, and the number of people one year older, etc. At the end of the year, they do the totals and compute that, say, 0.1% of people your age died at your location, and 0.1% of people one year older, etc.
Then they compute your life expectancy by multiplying those chances together.
People moving shouldn't affect that significantly, because this computation doesn't use the past at all. All the data comes from one year.
The big assumption there is that your chance of dying in ten years is assumed to be the same as people ten years older than you dying this year. The small assumption is that the population is assumed to be stable and countable within the present year (I suppose it's possible to work around that with more sophisticated statistics, though).
What you said about how life expectancy is calculated is correct but...
The elderly on death's door in a nursing home are not moving to some retirement community in Florida where they can DUI a golf cart all day.
The young who are depressed or have substance abuse problems are not the people who have the spare willpower to relocate so they can run the rat race in a major metro.
So your calculations for any given year are going to favor places like NYC and Florida because their cohort includes all those "less likely to die this year" people who moved there last year. So a state or region could be doing everything wrong yet still have good life expectancy because it's where people with good life expectancy wind up.
The elderly on death's door in a nursing home are not moving to some retirement community in Florida where they can DUI a golf cart all day.
The young who are depressed or have substance abuse problems are not the people who have the spare willpower to relocate so they can run the rat race in a major metro.
So your calculations for any given year are going to favor places like NYC and Florida because their cohort includes all those "less likely to die this year" people who moved there last year. So a state or region could be doing everything wrong yet still have good life expectancy because it's where people with good life expectancy wind up.
So I did a few back-of-the-envelope calculations. What magnitude do you have in mind? Because what I got was single-digit numbers of weeks, and why bother to discuss differences as small as that?
I started by assuming that since most health care cost is concentrated in the last four years of life, that's for how long retirees can affect the statistics by moving or not moving. 4 is a small number, and the number of people who move also cannot be large compared to the general population in the area they move from, so no matter how I tweaked it, I arrived at near-zero results.
I started by assuming that since most health care cost is concentrated in the last four years of life, that's for how long retirees can affect the statistics by moving or not moving. 4 is a small number, and the number of people who move also cannot be large compared to the general population in the area they move from, so no matter how I tweaked it, I arrived at near-zero results.
it's when they recompute the life expectancy at birth from the life expectancy at the current time that the skew arises.
Maybe you're right, but if so, don't you think you'd be more persuasive with a couple of paragraphs of argument than with a single-sentence assertion?
Well its way more expensive to live in Hawaii than in Mississippi. It doesn't surprise me at all that people with more money live longer.
Chronic liver disease mortality continues to rise in the US because there is increase in nonalcoholic fatty liver disease. Increasing obesity and type 2 diabetes are believed to be the reason. People die from eating too much.
Not just eating too much, but also eating the wrong things. Sugar and complex carbs need to be put in the same control category as alcohol. Glyphosates are also a factor in this for damage to the liver and liver cancer.
I wanted to help health in the US but here's a perfect example of why we're in the situation we're in: obesity is rising in the US. Most of obesity occurs because of preventable life decisions (I assume free will here) in the sense that by changing some decisions you can become not-obese. If you're obese, you're at risk of a number of diseases that can be prevented by becoming not obese.
Gilead, a successful biotech/pharma, among others, noticed that with rising obesity,there were a number of dieases increasing in prevalence (NASH is an example). They chose to try to develop a drug for NASH, spent billions to come up with promising leads, then they failed in stage 2 or 3 (last steps before approval).
When companies spent billions on drugs, and they fail, that cost is eaten, the company doesn't make much less profit, it just factors those costs into other drugs, mainly in countries where they expect people can afford higher drug prices.
I don't blame biotech/pharma (who are driven by profit motive) for chasing expensive drugs that don't address the underlying problem, but if the equivalent amount of money had been instead spent on simple methods to reduce obesity. Who is going to spend that kind of money on general health improvements without a profit motive (other than, say, our government)?
All the above is a great simplification, but it's an example of how we got into the situation we are in. We tend to go for high-tech patches of problems rather than root causing, and it seems tied to the profit motives of companies. Ultimately I think only the government is capable of addressing structural issues like this, either by funding the research and orgs who deal with root causes, or by making laws that incentive good behavior in biotech/pharma.
Gilead, a successful biotech/pharma, among others, noticed that with rising obesity,there were a number of dieases increasing in prevalence (NASH is an example). They chose to try to develop a drug for NASH, spent billions to come up with promising leads, then they failed in stage 2 or 3 (last steps before approval).
When companies spent billions on drugs, and they fail, that cost is eaten, the company doesn't make much less profit, it just factors those costs into other drugs, mainly in countries where they expect people can afford higher drug prices.
I don't blame biotech/pharma (who are driven by profit motive) for chasing expensive drugs that don't address the underlying problem, but if the equivalent amount of money had been instead spent on simple methods to reduce obesity. Who is going to spend that kind of money on general health improvements without a profit motive (other than, say, our government)?
All the above is a great simplification, but it's an example of how we got into the situation we are in. We tend to go for high-tech patches of problems rather than root causing, and it seems tied to the profit motives of companies. Ultimately I think only the government is capable of addressing structural issues like this, either by funding the research and orgs who deal with root causes, or by making laws that incentive good behavior in biotech/pharma.
Insurance companies, individuals and employers also stand to profit from effective preventive treatment. We just need an effective subscription based obesity prevention service...
In my view this is a misunderstanding of how a for-profit insurance operates. In general, insurance companies want to make the pie larger. They have no incentive to reduce drug prices. They have no incentive to create a healthy society. Because that reduces premiums. And less premiums is less business.
Insurance companies only profit from prevention when they can prevent something they'd been paid to insure against beforehand. They may be forced to employ prevention to offer competitive insurance deals, but that makes them interested only in individual prevention for their customers. From a revenue perspective they depend on the prevalence of sickness.
I'm not saying that everybody in an insurance outfit has their priorities consciously aligned like that. But we shouldn't expect advice from an insurance to be good for our health. Sometimes they might prefer if we die fast. Or stay in therapy and opt for the extra-care package.
Insurance companies only profit from prevention when they can prevent something they'd been paid to insure against beforehand. They may be forced to employ prevention to offer competitive insurance deals, but that makes them interested only in individual prevention for their customers. From a revenue perspective they depend on the prevalence of sickness.
I'm not saying that everybody in an insurance outfit has their priorities consciously aligned like that. But we shouldn't expect advice from an insurance to be good for our health. Sometimes they might prefer if we die fast. Or stay in therapy and opt for the extra-care package.
If you downvote, can you at least provide signal why? It's unclear if you're angry at the facts I'm presenting, or disagreeing with my facts (or opinions).
The Hacker News Officially Permitted Opinion on the matter of obesity is that it's not the fault of the obese. Responsibility lies with society, or the media, or GMO crops, or Trump, or something, ANYTHING other than personal choice.
Additionally, suggesting solutions that don't have any revenue attached to them is doubleplusungood for the HN denizens for whom the only yardstick of progress is Tres Commas Tequila.
Additionally, suggesting solutions that don't have any revenue attached to them is doubleplusungood for the HN denizens for whom the only yardstick of progress is Tres Commas Tequila.
Drugs and obesity. It sure seems like we have too much abundance.
But the top comment is about inequality.
I do think we have everything we need, but we don't like seeing people have more than us. I find this strange, maybe this is genetic and used to find the best mates.
But the top comment is about inequality.
I do think we have everything we need, but we don't like seeing people have more than us. I find this strange, maybe this is genetic and used to find the best mates.
Obesity isn't caused by abundance. On the contrary, poverty is strongly correlated with obesity in the US[1]--which indeed points to an inequality link.
The correlation between poverty and drug use is strongly politicized, so much so that the top search results on Google for "substance abuse and poverty" are all political faux-informational sites. Data is hard to find.
But this is also because the data is less clear. Alcohol/marijuana are used the most in a) high income areas, and b) areas with large income inequality[2] (again an inequality link, but in slightly unexpected ways). I've found numerous sources claiming that two studies exists: The first study supposedly shows that heroin use is rising across all income brackets, while other illicit substances (besides heroin and marijuana) are more prevalent in low-income brackets. The second study supposedly shows that prescription drugs are more prevalent in lower income brackets. However, I have not been able to locate these studies (I'm guessing this is because they are behind paywalls).
Assuming all these sources aren't lying about the studies existing, I think the data does indicate a link between inequality and substance abuse (although it is not nearly as clear as the link between inequality and obesity).
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198075/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974881/
The correlation between poverty and drug use is strongly politicized, so much so that the top search results on Google for "substance abuse and poverty" are all political faux-informational sites. Data is hard to find.
But this is also because the data is less clear. Alcohol/marijuana are used the most in a) high income areas, and b) areas with large income inequality[2] (again an inequality link, but in slightly unexpected ways). I've found numerous sources claiming that two studies exists: The first study supposedly shows that heroin use is rising across all income brackets, while other illicit substances (besides heroin and marijuana) are more prevalent in low-income brackets. The second study supposedly shows that prescription drugs are more prevalent in lower income brackets. However, I have not been able to locate these studies (I'm guessing this is because they are behind paywalls).
Assuming all these sources aren't lying about the studies existing, I think the data does indicate a link between inequality and substance abuse (although it is not nearly as clear as the link between inequality and obesity).
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198075/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974881/
> Obesity isn't caused by abundance. On the contrary, poverty is strongly correlated with obesity in the US[1]--which indeed points to an inequality link.
Yep. You can see this in my state (Texas) simply by driving from a metroplex a couple of hours out into the country. Obesity visibly skyrockets.
Part of it is cultural, but part of it is economic. Healthy food is simply more expensive, especially if you want it to taste good.
Yep. You can see this in my state (Texas) simply by driving from a metroplex a couple of hours out into the country. Obesity visibly skyrockets.
Part of it is cultural, but part of it is economic. Healthy food is simply more expensive, especially if you want it to taste good.
> Healthy food is simply more expensive
Not. True. It just isn't.
It's true that _many_ healthy foods - particularly when purchased pre-prepared - are expensive. Many unhealthy foods are also expensive.
However, consider beans.
They're one of the healthiest foods, are extremely cheap, and so convenient that you can eat them right out of the can. $2 gets you two cans - 700 calories - full of fiber, protein, and vitamins.
Or, for the same price, you can get a 500 calorie Bacon McDouble.
The problem is not that "all healthy food is expensive" - it's not - it's that there are a lot of very tasty, very cheap, extremely _calorie dense_ foods, and a lot of people who lack the knowledge or willpower - yes, qualities that are often the product of poverty - to stop eating those foods all the time.
But the healthy food itself isn't expensive.
Not. True. It just isn't.
It's true that _many_ healthy foods - particularly when purchased pre-prepared - are expensive. Many unhealthy foods are also expensive.
However, consider beans.
They're one of the healthiest foods, are extremely cheap, and so convenient that you can eat them right out of the can. $2 gets you two cans - 700 calories - full of fiber, protein, and vitamins.
Or, for the same price, you can get a 500 calorie Bacon McDouble.
The problem is not that "all healthy food is expensive" - it's not - it's that there are a lot of very tasty, very cheap, extremely _calorie dense_ foods, and a lot of people who lack the knowledge or willpower - yes, qualities that are often the product of poverty - to stop eating those foods all the time.
But the healthy food itself isn't expensive.
check my above post, you can eat healthy and cost effectively as well.
> Part of it is cultural, but part of it is economic. Healthy food is simply more expensive, especially if you want it to taste good.
This canard keeps getting thrown out, but it is absolutely not more expensive to eat healthy, apart from needing to have some tiny semblance of skill in the kitchen. Buying real food is cheaper than buying processed garbage, and it's not like an EBT card only works for buying eggo waffles and Doritos, rather than frozen peas and porkchops.
It's entirely cultural.
This canard keeps getting thrown out, but it is absolutely not more expensive to eat healthy, apart from needing to have some tiny semblance of skill in the kitchen. Buying real food is cheaper than buying processed garbage, and it's not like an EBT card only works for buying eggo waffles and Doritos, rather than frozen peas and porkchops.
It's entirely cultural.
Healthy food takes time to prepare and make as well, which is hard when you work 60 hour weeks to make rent before any other expenses.
That part is somewhat true. It's the illusive cheap, healthy, tasty, fast combo that's so hard to achieve. I have to agree with OP about cost though.
There are even decent healthy frozen products that are affordable (most people could spend $1 on veg; they wouldn't think twice spending that on a drink) and take no effort. Frozen chicken breasts can be thrown directly in oven and eaten with mixed spices and/or sauce. It is doable.
There are even decent healthy frozen products that are affordable (most people could spend $1 on veg; they wouldn't think twice spending that on a drink) and take no effort. Frozen chicken breasts can be thrown directly in oven and eaten with mixed spices and/or sauce. It is doable.
> There are even decent healthy frozen products that are affordable
Most of them cost a dollar or two extra, though. The people on HN probably have a skewed perspective on what amount of money starts to matter; for some people $1 more for a meal really does matter.
Most of them cost a dollar or two extra, though. The people on HN probably have a skewed perspective on what amount of money starts to matter; for some people $1 more for a meal really does matter.
Nope. I'm aware of this. It depends what you get; I've done it. There are absolutely low cost, high nutritional options that don't require effort. Some of the cheapest frozen food is high in nutrition.
You can get frozen chicken breasts cheap, not necessarily as cheap as fresh, but much less than the unhealthy options. Frozen vegtables are purchased on sale and cost 50c per serving. There's cans too. Carbs are easy.
If you manage your kitchen correctly, you don't even need to go frozen. Honestly, even the "banquit"/healthy choice options aren't always that much, and can be worked into a healthy diet. Fruit isn't that expensive either, if you buy in the right season and don't get something exotic.
I understand obesity is correlated with poverty, and don't blame anyone for it (I don't consider it their fault). The reality is that you can eat healthy on a budget, and nutritious food doesn't need to cost anything extra. Unfortunatly, many of these people are living in "food deserts" and good supermarkets aren't always available.
You can get frozen chicken breasts cheap, not necessarily as cheap as fresh, but much less than the unhealthy options. Frozen vegtables are purchased on sale and cost 50c per serving. There's cans too. Carbs are easy.
If you manage your kitchen correctly, you don't even need to go frozen. Honestly, even the "banquit"/healthy choice options aren't always that much, and can be worked into a healthy diet. Fruit isn't that expensive either, if you buy in the right season and don't get something exotic.
I understand obesity is correlated with poverty, and don't blame anyone for it (I don't consider it their fault). The reality is that you can eat healthy on a budget, and nutritious food doesn't need to cost anything extra. Unfortunatly, many of these people are living in "food deserts" and good supermarkets aren't always available.
Fancy food takes longer to prepare. Healthy food is pretty easy. Hell, dog food is healthy for dogs, and you can't get any easier than that.
It's not a matter of being hard / easy, it's a matter of highly processed foods being addictive even when they are actively bad for you.
It's not a matter of being hard / easy, it's a matter of highly processed foods being addictive even when they are actively bad for you.
A thing that always gets me when you see interviews with people that fixed their diet to be nominally healthy is how they always say something to the effect of: "I didn't realize you aren't supposed to feel terrible all the time"
Somehow that loop gets broken in people's heads (possibly because they've never been exposed to what its like to actually feel good), so they keep doing things that make them feel terrible hoping it will somehow make them better.
Somehow that loop gets broken in people's heads (possibly because they've never been exposed to what its like to actually feel good), so they keep doing things that make them feel terrible hoping it will somehow make them better.
Obesity is caused by shitty diet and "normalization of deviance" since a better term escapes me right now.
People eat too much low value food. Some of that is due to poverty, but when over half the population is overweight, it isn't just an issue of lack of good food.
It's bad choices. Largely brought on by bad government advice and incentives.
Edit:
Expanding a bit, I recently talked with a couple friends from college. One had lost 100lbs and another had lost quite a bit of weight. The main change they made was to cut out soft drinks. One of them said, "Why didn't anyone tell me that's a bad idea?"
Worded another way, I've heard it explained before that we tell people "eat more of this". People take that to mean "Eat what you already eat, plus these things, and you will be healthy."
What it actually means is "Don't eat this garbage that is making you sick." But it's never worded that way. Add to that the fact that all government nutrition advice is basically just pandering to the highest bidder with little regard for what actually makes for a healthy diet, and it's no wonder people have so many problems.
People eat too much low value food. Some of that is due to poverty, but when over half the population is overweight, it isn't just an issue of lack of good food.
It's bad choices. Largely brought on by bad government advice and incentives.
Edit:
Expanding a bit, I recently talked with a couple friends from college. One had lost 100lbs and another had lost quite a bit of weight. The main change they made was to cut out soft drinks. One of them said, "Why didn't anyone tell me that's a bad idea?"
Worded another way, I've heard it explained before that we tell people "eat more of this". People take that to mean "Eat what you already eat, plus these things, and you will be healthy."
What it actually means is "Don't eat this garbage that is making you sick." But it's never worded that way. Add to that the fact that all government nutrition advice is basically just pandering to the highest bidder with little regard for what actually makes for a healthy diet, and it's no wonder people have so many problems.
although it's true that poverty results in greater obesity in the US, it doesn't have to be this way. Some of the healthiest foods out there are also among the very cheapest.
You can construct an incredibly healthy diet on just 2$ - 4$ per day or less: rolled oats (70c/lb or less) -> can be used to make oat milk, oat meal, baked goods, etc and it lowers your LDL with tons of health benefits.
Other things all can be found for less than 1$/lb => bananas, apples, onions, beans, rice (38c/lb or less at costco!!), bell peppers, grapes (sometimes), potatoes, lentils, etc. Oatmeal and Beans are a superfood, greatly undervalued in our society. The key is to shop in the bulk section of the store.
All these things and more are at least 10 times less costly than mcDonalds, we just need to get the word out. Once there's consumer demand for these things we can start alleviating the food dessert areas in the US.
You can construct an incredibly healthy diet on just 2$ - 4$ per day or less: rolled oats (70c/lb or less) -> can be used to make oat milk, oat meal, baked goods, etc and it lowers your LDL with tons of health benefits.
Other things all can be found for less than 1$/lb => bananas, apples, onions, beans, rice (38c/lb or less at costco!!), bell peppers, grapes (sometimes), potatoes, lentils, etc. Oatmeal and Beans are a superfood, greatly undervalued in our society. The key is to shop in the bulk section of the store.
All these things and more are at least 10 times less costly than mcDonalds, we just need to get the word out. Once there's consumer demand for these things we can start alleviating the food dessert areas in the US.
Too much Freedom, more like. And not enough care for each other.
The opioid epidemic was unforeseen, but the obesity epidemic has been a steady and uninterrupted. Predictably, it causes a decline in life expectancy.
Suicide, liver disease and drug overdoses (recent large increases in these three are identified the source of the lower life expectancy overall) all stem from the same root cause: depression, despair and hopelessness.
This article was written a year ago. I know the opioid epidemic peaked in 2017/2018 but I don't know if it's as bad for 2019. A lot has changed, from lawsuits to China
I would be interested to see the correlation to income inequality and life expectancy.
I predict a direct correlation and all of the things discussed are symptoms of poverty.
I predict a direct correlation and all of the things discussed are symptoms of poverty.
All three categories are “deaths of despair”. Want to address them?
1. Provide meaningful work opportunities that allows a middle class existence.
2. Lower barriers to inter generational mobility.
3. Restore low cost college tuition.
4. Don’t allow medical expenses to bankrupt families.
The United States is in the Second Gilded Age. We need a new progressive movement to stand up for the majority of Americans.
2. Lower barriers to inter generational mobility.
3. Restore low cost college tuition.
4. Don’t allow medical expenses to bankrupt families.
The United States is in the Second Gilded Age. We need a new progressive movement to stand up for the majority of Americans.
Yes, when I phone-banked for Bernie in 2016, the we agreed we needed a new FDR-like administration and leader.
This dropped of the front page pretty quickly, someone must not like it.
Do we have evidence as to what is causing the insane rise in OD deaths?
A perfect storm of prescription opioids, government prohibition and cheap/plentiful Chinese and Mexican fentanyl.
>A perfect storm of prescription opioids, government prohibition, and cheap/plentiful Chinese and Mexican fentanyl.
I think it's actually the fact that the war on opioids has translated into a war on prescription pain drugs, in general.
So, when you're a chronic pain sufferer and have gone without and you get ahold of something - anything - to remediate the pain, you're far more likely to take a little extra just to get the pain to STFU for a while so you can do things like sleep through the night for the first time in seemingly forever.
I've heard tales of American veterans (through the VA) being referred to things like yoga to manage their chronic pain, when it's entirely due to neurological damage and things like yoga will do fuck-all to help with that.
Is it any wonder then that people might be more liable to OD when they obtain something to try to manage the pain that otherwise never ceases?
I'd say it is a fundamental issue in American society (the war on opioids translating into no pain management medications whatsoever) with callous indifference - rather than anything else.
I think it's actually the fact that the war on opioids has translated into a war on prescription pain drugs, in general.
So, when you're a chronic pain sufferer and have gone without and you get ahold of something - anything - to remediate the pain, you're far more likely to take a little extra just to get the pain to STFU for a while so you can do things like sleep through the night for the first time in seemingly forever.
I've heard tales of American veterans (through the VA) being referred to things like yoga to manage their chronic pain, when it's entirely due to neurological damage and things like yoga will do fuck-all to help with that.
Is it any wonder then that people might be more liable to OD when they obtain something to try to manage the pain that otherwise never ceases?
I'd say it is a fundamental issue in American society (the war on opioids translating into no pain management medications whatsoever) with callous indifference - rather than anything else.
I think it is also the lack of sick leave for many Americans so they take a quick pill to recover. Sometimes your body can recover by itself if only given time and physical therapy.
I had some excruciating peroneal tendonitis that made it hard for me to walk on rough surfaces. Foot doctor said the best treatment was a walking cast, rest and daily exercise. Fortunately my employer allows me to work from home as needed so I could give my foot a rest for a few weeks. But not everyone has access to that. Imagine if you are a server at a restaurant on your foot all day.
I had some excruciating peroneal tendonitis that made it hard for me to walk on rough surfaces. Foot doctor said the best treatment was a walking cast, rest and daily exercise. Fortunately my employer allows me to work from home as needed so I could give my foot a rest for a few weeks. But not everyone has access to that. Imagine if you are a server at a restaurant on your foot all day.
I used self guided physical therapy to improve a chronic nerve pain issue. I'm glad I had very moderate pain and a moderate accompanying physical issue, and I wouldn't want it to be the only option in a more severe situation, but it's not useless either.
Simple economics: expensive legal prescription drugs drives people to source cheaper alternatives. Unfortunately, the cheaper alternative is also much more lethal.
I think there's a narrative that is the opioid crisis is driven by addiction, when it seems to be, and has historically has been, inefficient drug pricing.
I think there's a narrative that is the opioid crisis is driven by addiction, when it seems to be, and has historically has been, inefficient drug pricing.
Escape from reality, thats what drug usage is. Fix your reality and you quit using drugs.
Problem is, many people simply cannot fix their reality and they realize it.
Problem is, many people simply cannot fix their reality and they realize it.
Many people take opioids for chronic pain.
The dirty little secret that no one talks about: Many of the Miracles of Modern Medicine that save lives don't restore you to full functioning. It's often a miserable existence with no hope of really getting your life back.
And it's not a small number. Up to 20% of people identify as handicapped while another 40% of the population has a milder degree of impairment and actively eschews the stigmatizing label of handicapped.
The dirty little secret that no one talks about: Many of the Miracles of Modern Medicine that save lives don't restore you to full functioning. It's often a miserable existence with no hope of really getting your life back.
And it's not a small number. Up to 20% of people identify as handicapped while another 40% of the population has a milder degree of impairment and actively eschews the stigmatizing label of handicapped.
Whats really interesting is you can go to mexico and get tramadol over the counter ( which has almost no side affect i know i take it for chronic nerve pain ) but doctors here want to use narcotics for pain management. demerol percocet vicodin etc etc
The opioid epidemic.
Which is caused by?
Pain relief induced by pleasure and physical dependence - constipation too. I am almost off morphine. 15mg a day now.
I have lost 30 lbs over 3 months. Chronic pain sucks but I despise opioids. They are seductive at first until one realizes their body is literally rotting away..
I was lifting 125lb dumbells before I got on morphine. Now I am feeble and haven't worked out in months. It kills your endogenous drive. If you care about your future self, please don't use opiates more than sparingly...
I have lost 30 lbs over 3 months. Chronic pain sucks but I despise opioids. They are seductive at first until one realizes their body is literally rotting away..
I was lifting 125lb dumbells before I got on morphine. Now I am feeble and haven't worked out in months. It kills your endogenous drive. If you care about your future self, please don't use opiates more than sparingly...
My mom said that, when recovering in the hospital from a certain operation, she was prescribed morphine for pain, and when she had some, "colors looked brighter, the air smelled sweeter, and everything just felt nicer"; when it wore off, she said, "Wooooow. So that's how drugs can be addictive." She refused all morphine after that.
Some people get that joy while others get nauseous upon first introduction to opioids. In any case, it's short lived, the honeymoon phase. Good on your mom - we will eventually get non-opioid, effective pain relievers. I am subbed to /r/drugnerds and there is a bit going on in the R and D of that area.
Well done, keep it going!
Thank you. Tapering at _just_ the right dose to not interfere with the grades in the master degree I am doing is quite tough.
Which makes me wonder...there's common regimens like the Ashton scale and whatnot for benzos but it's very boilerplate.
Unicorn Idea: Quantitative Withdrawal
User enters dosage each time they use. Datetime is auto filled, but can be altered for dosages that are entered belatedly.
ML is used to show charts with sliders based on speed of taper and severity of side effects. A time series showing the reduction in withdrawal effects over time with an ETA and other statistics. With labeled sections for certain parts of the withdrawal that are more severe (think a phase change diagram.) Seizure/epilespy zone would be clearly large on a configuration where the user chooses a ridiculously fast taper. The app would show a color, red in this case, warning of these symptoms and recommending against it. Baseline taper recommendations could be based on the medical literature out there with clinical trials. There is plenty of labeled data especially from the NIH.
The user can log their current symptoms to help the model learn their individual brain chemistry.
And vitals like HR, pulse, and o2 that are easily measured via pleasant APIs like Healthkit on iOS and Android. (Would be by proxy optionally compatible with iWatch, FitBit and other such sensors.)
These vitals are great features that the model can learn from.
The user can answer questions regarding the current state of their withdrawal symptoms, providing the model with labeled data to learn from.
Models can be pretrained on an individual in close proximity to the MLE on the distribution of human neurochemistry. And thus would work out of the box pretty well before the users input and vitals start to vastly improve it until it helps the user maintain AND gain :-)
just ideas..
Which makes me wonder...there's common regimens like the Ashton scale and whatnot for benzos but it's very boilerplate.
Unicorn Idea: Quantitative Withdrawal
User enters dosage each time they use. Datetime is auto filled, but can be altered for dosages that are entered belatedly.
ML is used to show charts with sliders based on speed of taper and severity of side effects. A time series showing the reduction in withdrawal effects over time with an ETA and other statistics. With labeled sections for certain parts of the withdrawal that are more severe (think a phase change diagram.) Seizure/epilespy zone would be clearly large on a configuration where the user chooses a ridiculously fast taper. The app would show a color, red in this case, warning of these symptoms and recommending against it. Baseline taper recommendations could be based on the medical literature out there with clinical trials. There is plenty of labeled data especially from the NIH.
The user can log their current symptoms to help the model learn their individual brain chemistry.
And vitals like HR, pulse, and o2 that are easily measured via pleasant APIs like Healthkit on iOS and Android. (Would be by proxy optionally compatible with iWatch, FitBit and other such sensors.)
These vitals are great features that the model can learn from.
The user can answer questions regarding the current state of their withdrawal symptoms, providing the model with labeled data to learn from.
Models can be pretrained on an individual in close proximity to the MLE on the distribution of human neurochemistry. And thus would work out of the box pretty well before the users input and vitals start to vastly improve it until it helps the user maintain AND gain :-)
just ideas..
Great ideas - you should build a start-up!
Thank you. I would finish one if I had collaborators. Unfortunately I have virtually no friends.
What sort of collaborators are you looking for? What data + assets do you have to work with?
Other devs. I do full stack. I don't have any training data, it was just an idea. Could probably develop it off of the metrics from my recovery.
[deleted]
Profits.
Several drug manufacturers flooded the market with pills exposing way too many people to opioids in a casual way. Once folks are addicted it’s very very difficult to break the addiction.
The Washington post has an excellent series on the topic if you are interested.
Several drug manufacturers flooded the market with pills exposing way too many people to opioids in a casual way. Once folks are addicted it’s very very difficult to break the addiction.
The Washington post has an excellent series on the topic if you are interested.
From what I have read OxyContin was sold as needing only two doses a day. At that level it’s not that addictive. But it soon turned out that two times a day is not enough so people took more to avoid crashing in between. With that amount it became very addictive but companies still kept selling the two doses a day although they knew that people would quickly take more.
The whole point of OxyCotin was that it was a long acting dose. So if they admitted it didn't last that long it would cause loss of business. This cause a lot of patients to be undertreated and seek alternatives.
How did life expectancy grow during the crack 80s? Seems fishy
Has anyone else managed to get past their horrific (and non-compliant) GDPR consent page? I selected the "Accept All" and it just thrashed away for ages running god knows how many scripts. I ended up killing it and opening it in Outline.com.
Displays only the title, than a blank page in Firefox. Displays endlessly the "accept cookie" page in Chromium. What's the conclusion of the article? Dunno.
It works if you disable your ad blocker. You aren't missing much. It's not a very good article.
It doesn't work in Safari, either. I don't use any ad blockers, and it states that I need to disable my ad blocker to continue.
These types of news/mag websites seem dead set on rendering themselves utterly pointless, frustrating, and irrelevant.
These types of news/mag websites seem dead set on rendering themselves utterly pointless, frustrating, and irrelevant.
It's a pretty effective failurewall. I get a GDPR notice and nothing.
The decline in U.S. life expectancy has disproportionately affected whites, especially in rural areas with decreased economic opportunity [0][1]. I think this economic shift and its consequences largely determined the result of the 2016 Presidential election.
I've only seen one 2020 Democratic candidate directly address this trend so far: Andrew Yang [2]. (I don't advise reading his tweet's replies, it's typical Twitter political hyperbole.)
[0] https://www.sciencedaily.com/releases/2019/07/190711122655.h...
[1] https://www.latimes.com/science/story/2019-09-06/economic-ha...
[2] https://twitter.com/andrewyang/status/1010207553324806150?la...
I've only seen one 2020 Democratic candidate directly address this trend so far: Andrew Yang [2]. (I don't advise reading his tweet's replies, it's typical Twitter political hyperbole.)
[0] https://www.sciencedaily.com/releases/2019/07/190711122655.h...
[1] https://www.latimes.com/science/story/2019-09-06/economic-ha...
[2] https://twitter.com/andrewyang/status/1010207553324806150?la...
The crazy thing about it, is most people are unwilling to discuss why Trump was elected in 2016, the concept of middle American whites on a rapid decline is almost never in the media. The democrats flat out ignoring this problem, even if they do win the next election, is going to cause more problems down the road.
They deal with it by labeling them as "nazis" it seems to me.
What exactly is the problem here? That middle American whites are falling out of the middle class? Or that the middle class is less white? Those are just two interpretations I could think of, but I am genuinely curious about what problem specifically you say Democrats are ignoring?
The current white working class in the Midwest was at one time, not too long ago, the economic backbone of this country. Economic policies propelling forward globalization directly destroyed the economic livelihoods of those people. And now we’re being told it’s racist to complain about, racist to argue against policies that are destroying the Midwest.
Actually the destruction was headed for us when billions of people overseas were going to rapidly develop to our level of technology. There’s only a few hundred million of us and over a billion more of them. The US positioned itself to be in the best possible posture as the market leader through setting the terms early to benefit themselves just enough, but also lenient enough to keep our real pressures for disruption. There’s a good Frontline episode with Kissinger about granting China MFN status. He clearly saw the writing on the wall.
If you drive through small to medium sized towns in Ohio, Indiana, etc you will often find a closed factory, mill, or some other manufacturing building that used to employ most of the town. But the jobs were shipped overseas or eliminated by automation, and the town is very poor and run down now. Previously the jobs paid a good wage and most of the town were middle class or upper middle class. Now they are largely lower class and are mad as hell about it.
Most Democrats blame racism, lack of education, etc on why Trump won. No Trump won because the people in those towns want to be middle class again and he campaigned on helping them. Clinton campaigned on helping the generic poor just like most of the current candidates except Yang. Trump clearly hasn't helped them but Democrats need a candidate who speaks directly to them too.
Most Democrats blame racism, lack of education, etc on why Trump won. No Trump won because the people in those towns want to be middle class again and he campaigned on helping them. Clinton campaigned on helping the generic poor just like most of the current candidates except Yang. Trump clearly hasn't helped them but Democrats need a candidate who speaks directly to them too.
What universe is this from? Immediately after his election there was a huge surge of articles centering around “wtf just happened, why did people vote for him.” Going into 2020, appealing to those voters is going to be a huge priority for both parties, and democratic candidates are already talking about how to get back Obama-Trump voters... the whole country is acutely, painfully aware of the despair of the Real Americans and their struggles.
Really? Because what I saw was two years of Russia conspiracy theories which have since vanished from the media
It wasn't a conspiracy theory. The Russians really did influence our election. The question of whether Trump was involved in the conspiracy too was answered by Mueller, it was no, and now there is nothing to report. Ironically Trump is now in trouble with Ukraine for the very thing he was accused of doing with Russia, and he admitted it so no conspiracy theories.
ianai(1)
Trump was elected because of Clinton. If the Democrats could field a candidate that wasn’t hell bent on gun banning, they’d probably win. As it stands, Trump will win again. The “hell yes, were are coming for your guns” probably cost them the election.
It wasn't just gun banning. Hillary was a terrible candidate. She didn't stand for much except her being elected. She wasn't likeable. She called half the country "deplorables" - the exact voters that we're talking about. She exuded this air of entitlement. And she had some scandals. (Yeah, I know, Trump wasn't exactly free from scandals either. But he didn't have the rest of the baggage.)
If the Republicans could come up with an effective plan for ending the regular mass shootings, perhaps some sort of compromise? Then there would be much less momentum for gun control or gun bans.
What if mass shootings are tied to the destruction of the white working class? You have an easy fix for that?
Are they? Some, like the Vegas shooter with his arsenal, appear to have been well off.
We already have a "fix" for domestic terrorists - arrest them or shoot them.
This hasn't stemmed the tide of mass shootings. Almost all of them are shot dead.
Doesn't seem like a very good fix when shootings keep happening.
When has police running around shooting people ever fixed anything
That’s what third world countries do, govern by violence first, instead of trying to solve underlying problems
Mass shooters do not have a legitimate place in any first world system of governance. Every country treats domestic terrorists the same way, regardless of whatever other solutions for the underlying problems might be attempted.
Ofcourse they should be felt with swiftly, but when it becomes a pattern you have to look at underlying causes
I don't see anyone arguing for letting mass shooters roam free.
The issue is: how to prevent those shootings in the first place. If you kill or jail them for life it doesn't exactly prevent the shooting they did, does it?
The issue is: how to prevent those shootings in the first place. If you kill or jail them for life it doesn't exactly prevent the shooting they did, does it?
I would agree. The Democrats could easily have won in 2016 if they had actually tried to win. Same may happen in 2020. Instead of coming up with a vision for the country they are wasting their time and energy in impeachment. Just get f...ing elected! Actually have a plan!
Democrats won in fact. Having 2,8 million more votes than the second candidate would qualify as winning in most definitions of democracy. The problem is that the system does not work like this.
They didn’t win. Maybe they should have read the rules...
You might want to go tell Justin Trudeau that.
Oh yeah, it’s not an issue if the candidate we like won.
Oh yeah, it’s not an issue if the candidate we like won.
Many ethnic groups in middle America are in decline. The narrative of the "angry, disenfranchised, rural white male" being the reason for Trump's popularity has been adopted by the right and discussed at length in the media in relation to the rise in white nationalist interest in Trump's campaign, and the attempts of such groups to reframe the populist zeitgeist of that election cycle around white identity and the preservation of white privilege in the face of shifting culture, politics and demographics.
Most Americans don't view economic and social issues through the lens of race war, however. Certainly, non-white Americans, who have also been affected by globalism, automation, unemployment and the collapse of traditionally stable industries like mining and manufacturing, would not be amenable to viewing themselves as either a symptom of, or merely collateral damage in, the narrative of the decline of white people.
Most Americans don't view economic and social issues through the lens of race war, however. Certainly, non-white Americans, who have also been affected by globalism, automation, unemployment and the collapse of traditionally stable industries like mining and manufacturing, would not be amenable to viewing themselves as either a symptom of, or merely collateral damage in, the narrative of the decline of white people.
>Certainly, non-white Americans [...] would not be amenable to viewing themselves as either a symptom of, or merely collateral damage in, the narrative of the decline of white people.
I'm not framing it that way. I think you're the only one here who's doing that. In my view, if we're going to break big issues down by race, it's smart to address and include all the races - especially the biggest one.
While it's nice to imagine that non-white Americans would care about the problems of their fellow citizens, the decline of white America is at least the concern of voting Americans who happen to be white, which is most of them. This fact may be of interest to candidates seeking an electoral majority.
I'm not framing it that way. I think you're the only one here who's doing that. In my view, if we're going to break big issues down by race, it's smart to address and include all the races - especially the biggest one.
While it's nice to imagine that non-white Americans would care about the problems of their fellow citizens, the decline of white America is at least the concern of voting Americans who happen to be white, which is most of them. This fact may be of interest to candidates seeking an electoral majority.
>In my view, if we're going to break big issues down by race, it's smart to address and include all the races - especially the biggest one.
This isn't a racial issue - the decline of Middle America is not the decline of white America. There is no reason to focus on race per se, much less one race in exclusion to others.
>the decline of white America is at least the concern of voting Americans who happen to be white, which is most of them.
I don't think even most American white people view their economic status and fear of the future through the lens of their own racial identity.
This isn't a racial issue - the decline of Middle America is not the decline of white America. There is no reason to focus on race per se, much less one race in exclusion to others.
>the decline of white America is at least the concern of voting Americans who happen to be white, which is most of them.
I don't think even most American white people view their economic status and fear of the future through the lens of their own racial identity.
>I don't think even most American white people view their economic status and fear of the future through the lens of their own racial identity.
Personally, I would also prefer to leave race out of it. However, in the Democratic Party 2020 primary, racial identity and "intersectionality" is at the top of everyone's mind. In that environment, I think it is unwise to address every racial group by name except for the largest one.
>This isn't a racial issue - the decline of Middle America is not the decline of white America.
The data shows that something uniquely bad is happening to white Americans [0]:
"We focus on non‐Hispanic whites because their mortality trends were particularly adverse in the last decade and differ from those of non‐Hispanic Blacks and Hispanics."
"The underlying mechanisms driving mortality trends for non‐Hispanic whites are fundamentally different from those driving trends for other racial/ethnic groups, as suggested by James and Cossman (2017)."
[0] https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12249
Personally, I would also prefer to leave race out of it. However, in the Democratic Party 2020 primary, racial identity and "intersectionality" is at the top of everyone's mind. In that environment, I think it is unwise to address every racial group by name except for the largest one.
>This isn't a racial issue - the decline of Middle America is not the decline of white America.
The data shows that something uniquely bad is happening to white Americans [0]:
"We focus on non‐Hispanic whites because their mortality trends were particularly adverse in the last decade and differ from those of non‐Hispanic Blacks and Hispanics."
"The underlying mechanisms driving mortality trends for non‐Hispanic whites are fundamentally different from those driving trends for other racial/ethnic groups, as suggested by James and Cossman (2017)."
[0] https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12249
> This isn't a racial issue - the decline of Middle America is not the decline of white America. There is no reason to focus on race per se, much less one race in exclusion to others.
Really? Because as someone from Middle America, lack of diversity is consistently brought up in conversations about about this area in every other context. Why is the Midwest dying? Why is the Midwest an "undesirable" place to live? Why is the Midwest conservative? Why does the Midwest support Trump? Lack of racial and cultural diversity is brought up in every single one of these conversations without fail.
So it seems appropriate that, in the context of the decline of Middle America, and in in the context of exacerbated declines in health outcomes particularly for white people, we at least consider the racial aspects as well.
Really? Because as someone from Middle America, lack of diversity is consistently brought up in conversations about about this area in every other context. Why is the Midwest dying? Why is the Midwest an "undesirable" place to live? Why is the Midwest conservative? Why does the Midwest support Trump? Lack of racial and cultural diversity is brought up in every single one of these conversations without fail.
So it seems appropriate that, in the context of the decline of Middle America, and in in the context of exacerbated declines in health outcomes particularly for white people, we at least consider the racial aspects as well.
As a counter to "diversity" and "conservatism", the entire South has plenty of non-whites, yet exemplifies even greater health dysfunction than anywhere in the Midwest.
[deleted]
> If we exaggerate the present and future value of the stock market, then as a society we may invest too much in business start-ups and expansions, and too little in infrastructure, education, and other forms of human capital.
Robert Shiller, Irrational Exuberance
Populism is here to stay (both of the left kind and of the right kind), until the root cause is addressed: income inequality. It's reprehensible to have life expectancy decreased in a first world country. In fact, because this is happening perhaps we should contend with the fact that America may be, as of recently, a third world country? There's a reason why Ray Dalio, the most successful hedge fund manager of all times calls this problem "a national emergency" that may be "an existential risk to United States".
Robert Shiller, Irrational Exuberance
Populism is here to stay (both of the left kind and of the right kind), until the root cause is addressed: income inequality. It's reprehensible to have life expectancy decreased in a first world country. In fact, because this is happening perhaps we should contend with the fact that America may be, as of recently, a third world country? There's a reason why Ray Dalio, the most successful hedge fund manager of all times calls this problem "a national emergency" that may be "an existential risk to United States".
Compared to most European countries, US doesn't really feel like a first world country anymore. As a lower class member, your life would be drastically worse in US than Europe. As a middle class member it would also be much easier to lose your position, just have some health issue and you'll see how fast it takes to burn your life savings.
This is me. Bad surgery and a failure of all the supposed support systems to help has ruined my life. Burned nearly everything I earned for my future. I've tried to get out of the US back to Europe where I lived before but the very losses I incurred here in health and financial security keep me from immigrating. The usual responses are victim blaming by nationalists, suggestions to pray from the religious, and "get a job" (ignoring all the health limitations I have explained as if I am making them up) from about everyone else as they deconstruct what THEY would do in their imagination. As if I would choose this life if I had better choices. I'll die in mid 40s because of this and if I was born in an actual first world nation with social systems I wouldn't have to. So add me too the statistics.
You cant take away someone's health, career, life, and leave them in constant pain for years and years, deny them assistance, and then expect them to live like any young/healthy person fighting in the grind for the "right" to pay for life, and then act shocked when they are forced to opt out of life. But if you bring this up to people all they have is the idea of locking you up in a mental hospital and adding more 6-7 figure bills. I want to live. America isn't going to let me. Most days anymore I am resigned to it and glad it will be over...but some I am angry af. The only thing I will miss of this miserable place is my cat, the only good thing in my life, and I cannot even assure her future here as the people I live with aren't responsible and nobody adopts around here. Maybe I will win the lotto before end of year and can move us both abroad.
You cant take away someone's health, career, life, and leave them in constant pain for years and years, deny them assistance, and then expect them to live like any young/healthy person fighting in the grind for the "right" to pay for life, and then act shocked when they are forced to opt out of life. But if you bring this up to people all they have is the idea of locking you up in a mental hospital and adding more 6-7 figure bills. I want to live. America isn't going to let me. Most days anymore I am resigned to it and glad it will be over...but some I am angry af. The only thing I will miss of this miserable place is my cat, the only good thing in my life, and I cannot even assure her future here as the people I live with aren't responsible and nobody adopts around here. Maybe I will win the lotto before end of year and can move us both abroad.
I'm so sorry you have to go through this. I hope you pull it through; there is no version of the future that is better with you gone. I know it's really hard, and I have little advice. Just wanted to tell you I'm rooting for you (and voting to make things hopefully better, but that won't help you directly).
"there is no version of the future that is better with you gone"
While I appreciate you as an individual, the above has objectively been proven false. Throughout this entire thing from the first surgery that took me out, no system or person here who was in a position to stop the "bleeding" and help me rebuild, or provide true safety to live, would do it. There were many people, programs, and moments where it could have turned around and they refused. Nobody here did what the promised, what they should, what was right. It was a series of blame and selfish rewriting of history and THAT is what really depressed me. Only one kind stranger from abroad offered a truly potentially workable situation a while back and my health prevented that from happening at the worst time. So the reality is whether I am here or not in a day, month, or year doesn't matter and won't matter. The ability to assure I would be has been actively denied repeatedly. Proof is in the pudding. I'd joyfully grab any realistic plan and take my cat and live a life...but there isn't one. Nobody chooses this...its forced upon them.
While I appreciate you as an individual, the above has objectively been proven false. Throughout this entire thing from the first surgery that took me out, no system or person here who was in a position to stop the "bleeding" and help me rebuild, or provide true safety to live, would do it. There were many people, programs, and moments where it could have turned around and they refused. Nobody here did what the promised, what they should, what was right. It was a series of blame and selfish rewriting of history and THAT is what really depressed me. Only one kind stranger from abroad offered a truly potentially workable situation a while back and my health prevented that from happening at the worst time. So the reality is whether I am here or not in a day, month, or year doesn't matter and won't matter. The ability to assure I would be has been actively denied repeatedly. Proof is in the pudding. I'd joyfully grab any realistic plan and take my cat and live a life...but there isn't one. Nobody chooses this...its forced upon them.
Your experience is probably worse. I had issues getting into school, and likewise, no one who said they cared actually did. It feels like my life was taken from me and given to someone else.
Suffering isn't a competition and you live your own pain. Worse doesn't matter. We should all be there for each other and nobody should be left behind but there are too many selfish people who try and justify that selfishness to make it logical or unavoidable. It's a hard thing to experience when you realize the people and systems and ideas you trusted were lies and that many people live in denial of that for their own mental comforts. It's like a kind finding out there is no Santa Claus x1000.
Did you realise that risk when you emigrated to the United States?
I was born in the USA...lived abroad for a time...had to return to the USA as my health deteriorated as a result of the American surgeries, which resulted in work aspect of European immigration failing, and then fiancee abandoned me right before our marriage so I had no legal way to stay. I never wanted to return to America. My life would never be amazing because of what was done to my health, but it was much better there. Here it's a dead end for sure.
Apologies, I should have phrased that question with a bit more care.
I'm a strong supporter of the socialised health care system we have in the UK - its not perfect, but I think it is notable that the book by the founder of the UK NHS was called In Place of Fear - I personally don't want anyone to suffer the kind of fear that comes with the problems you have had, in fact I'd agree with Bevan that:
"...no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means"
https://en.wikipedia.org/wiki/Aneurin_Bevan
I'm a strong supporter of the socialised health care system we have in the UK - its not perfect, but I think it is notable that the book by the founder of the UK NHS was called In Place of Fear - I personally don't want anyone to suffer the kind of fear that comes with the problems you have had, in fact I'd agree with Bevan that:
"...no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means"
https://en.wikipedia.org/wiki/Aneurin_Bevan
I didn't downvote you if it matters. I agree with you about society, but American culture does not in large. Even the family who has seen this happen to me is still staunchly hard right and against their taxes funding any social programs.
>As a middle class member it would also be much easier to lose your position, just have some health issue and you'll see how fast it takes to burn your life savings.
I am currently in that exact position. I have very bad RSI and can no longer write software full-time. On better days, I can drive and do errands. I've spend roughly $40k out of pocket on treatment so far, and my COBRA health insurance runs out in a year. I had looked into speech-to-text, but now I have bad TMJ syndrome and talking is difficult. I'm honestly very afraid for my future.
I am currently in that exact position. I have very bad RSI and can no longer write software full-time. On better days, I can drive and do errands. I've spend roughly $40k out of pocket on treatment so far, and my COBRA health insurance runs out in a year. I had looked into speech-to-text, but now I have bad TMJ syndrome and talking is difficult. I'm honestly very afraid for my future.
I’m a developer with mild RSI. I moved from pure software dev to devops. There is still some coding but most of it is automated. Now I’m mostly point and click.
Damn I know someone in SV who never types on a keyboard. Everything is speech to text. However if you’re getting issues with your mouth too. I’m really sorry.
> At the end of 2016, the rate of unemployment among young people was 42.91% [in Spain] https://en.m.wikipedia.org/wiki/Youth_unemployment_in_Spain#...
Not everything is unicorns and roses in Europe. They have massive structural issues.
Not everything is unicorns and roses in Europe. They have massive structural issues.
Those are ages 15 - 24 and the numbers are a little better now. Cost of living is so low where unemployment is highest that it's not the end of the world. Still free health care and education.
Pedantic point I know - but it's only 'free' at the point of access, it still has to be paid for by the taxpayer.
You're right, it is pedantic, it goes without saying that nobody is suggesting that Europeans have figured out how to bypass the laws of thermodynamics to generate free healthcare in the most literal sense.
Well, it isn't paid by the unemployed, and it doesn't impose exorbitant costs to unlucky people.
Or bankrupt anyone.
Well if you want to get more pedantic it's free for the unemployed since they are not paying taxes.
Heh, Ben Shapiro likes to make a point of "liberals" expecting his wife to work for free.
Yes, in the majority of societies "free" healthcare is free at point of access and subsidised by taxes. Much like trash collection or road renovations. It's underlying infrastructure for a healthy society.
FWIW the US actually pays more taxes towards healthcare than europe, but that's because your medical industry is price fixing and gauging.[0]
[0]: https://www.washingtonpost.com/business/2019/10/16/americans...
Yes, in the majority of societies "free" healthcare is free at point of access and subsidised by taxes. Much like trash collection or road renovations. It's underlying infrastructure for a healthy society.
FWIW the US actually pays more taxes towards healthcare than europe, but that's because your medical industry is price fixing and gauging.[0]
[0]: https://www.washingtonpost.com/business/2019/10/16/americans...
According to Trading Economics, Spain seems to be hanging around 32%~34% currently, with a clear trend of improvement since 2014. Portugal, right next door, is at 17%~19%, also after steady improvement since 2014. One of the good things about being an EU citizen is that you can just go work anywhere else in the EU... I mean, much like you can move to another state in the US, I suppose.
https://tradingeconomics.com/spain/youth-unemployment-rate
https://tradingeconomics.com/portugal/youth-unemployment-rat...
https://tradingeconomics.com/spain/youth-unemployment-rate
https://tradingeconomics.com/portugal/youth-unemployment-rat...
I'll take unemployment all the time over not being able to get health treatments due to their cost. Another important factor is that even though US has recently a low unemployment rate, jobs are not enough to sustain people's life, so it's not rare to be forced to have 2/3 jobs. Employment quality is as important as employment quantity, not many seem to consider it though.
Many employers are hiring for no-skill jobs paying $15-20 an hour in this country, you just have to show up on time and pass a drug test.
But will they hire you for 40hrs with benefits or 20 hours with none so you have to work 2-3 jobs on opposite sides of the city? I think that is the quantity/quality issue OP was referencing.
29 hours seems likely.
Mandating health insurance had predictable results. It is expensive, and no employer will pay for it if it makes up a significant portion of total compensation.
Highly paid employees: already have health insurance
Low paid employees: never going to get health insurance
Every employee ends up in one of those two categories. As needed to comply with the law, hours will be adjusted up or down. If a person worked 40 hours at a modest wage, there were two possible outcomes. One is that hours are cut below 30, keeping the low-paid employee without health insurance. The other is that the employee ends up with enough hours to be highly-paid, but there is a limit to the hours a human can work and there may be a higher overtime rate that prevents this solution.
As an example of the less-common solution, suppose the job was $18 per hour for 40 hours. That could be changed to be $8 per hour ($12 during overtime) with a total of 80 hours per week, with healthcare included.
It's easier to just cut hours below 30.
Mandating health insurance had predictable results. It is expensive, and no employer will pay for it if it makes up a significant portion of total compensation.
Highly paid employees: already have health insurance
Low paid employees: never going to get health insurance
Every employee ends up in one of those two categories. As needed to comply with the law, hours will be adjusted up or down. If a person worked 40 hours at a modest wage, there were two possible outcomes. One is that hours are cut below 30, keeping the low-paid employee without health insurance. The other is that the employee ends up with enough hours to be highly-paid, but there is a limit to the hours a human can work and there may be a higher overtime rate that prevents this solution.
As an example of the less-common solution, suppose the job was $18 per hour for 40 hours. That could be changed to be $8 per hour ($12 during overtime) with a total of 80 hours per week, with healthcare included.
It's easier to just cut hours below 30.
I felt the opposite when I visited Europe.
Everything is small in Europe, people seem to have bare minimums.
I suppose it's all about perception.
Edit- it seems like it depends on which quality metrics you use. I used "Stuff", other users choose life expectancy, and vacation time.
Everything is small in Europe, people seem to have bare minimums.
I suppose it's all about perception.
Edit- it seems like it depends on which quality metrics you use. I used "Stuff", other users choose life expectancy, and vacation time.
What do you mean by this?
"Everything is small", in what sense? Where in Europe?
If you mean: houses are small, yup, it's not common to have sprawling suburbia with rows and rows of single-family houses with a garage, driveway, lawn and backyard. At the same time, these are not necessities, apartments are small but you have plenty of access to public areas such as parks and squares where most people will congregate.
What are your bare minimums? What I notice here is people living much more sustainably compared to the US, consumerism still exists but it's not exacerbated by people buying every kind of gadget and permanently installing or fixing their houses with new stuff. Cars are necessities for people that live far away from the cities and/or have families, the rest can live comfortably without a personal car (and some families I know that live close to the cities depend entirely on car sharing).
It's a very different lifestyle and as an immigrant here, having visited the US and coming from a country very influenced by the American-way-of-life I'd say that it's much much better, even if you can't buy so much shit.
"Everything is small", in what sense? Where in Europe?
If you mean: houses are small, yup, it's not common to have sprawling suburbia with rows and rows of single-family houses with a garage, driveway, lawn and backyard. At the same time, these are not necessities, apartments are small but you have plenty of access to public areas such as parks and squares where most people will congregate.
What are your bare minimums? What I notice here is people living much more sustainably compared to the US, consumerism still exists but it's not exacerbated by people buying every kind of gadget and permanently installing or fixing their houses with new stuff. Cars are necessities for people that live far away from the cities and/or have families, the rest can live comfortably without a personal car (and some families I know that live close to the cities depend entirely on car sharing).
It's a very different lifestyle and as an immigrant here, having visited the US and coming from a country very influenced by the American-way-of-life I'd say that it's much much better, even if you can't buy so much shit.
I understand the appeal of moderation but in my experience a European is far more limited in what they can do for recreation, etc. In the US I am able to undertake fairly complicated hobby projects; most of my friends in the EU are not.
They do get to travel more and pay less for healthcare, but I do not think it is a trade.
They do get to travel more and pay less for healthcare, but I do not think it is a trade.
Again, could you be more specific? Most of my friends have quite complicated hobby projects, from welding to metalworking arts, carpentry, fixing furniture, making music, sailing (consequently fixing boats) and the list goes on.
Without specifics it's quite hard to judge what you are comparing against.
Without specifics it's quite hard to judge what you are comparing against.
Well, those count, I wasn't trying to be overly exclusive. I'd never met a European who has done those things; those I met usually traveled, played video games, or maybe did stuff with electronics or instruments. Notably all of these things don't take a lot of space or capital.
Now, not everyone in the US does those things; welding is particularly time consuming and expensive, for example, but I think most people I know in the US could take up welding if they really wanted.
Now, not everyone in the US does those things; welding is particularly time consuming and expensive, for example, but I think most people I know in the US could take up welding if they really wanted.
The amount of vacation time one receives and the amount of money one spends on health care and education isn’t something that can be chalked up to perception.
And yet most European countries have a greater life expectancy than the United States: https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...
If you consider "life" as a bare minimum, we are worse off.
If you consider "life" as a bare minimum, we are worse off.
Indeed. My perception is that well-off Americans have ridiculously excessive unsustainable lifestyles, with superfluously large cars, houses, whatever. And at the same time your poor have much less than those bare minimums that you mention.
It’s not just the very wealthy. The middle class in America also enjoy a much nicer standard of living than in Europe. Have a gander at the cost of living indices and there are very few categories where the US doesn’t fare better (and often dramatically better). Not to mention the takehome pay (post-pension, post-healthcare) are quite often 30-40% larger for working professionals. I think we still need a stronger social safety net, but Europe is not so dramatically better than the US as this thread makes it out to be.
I did mean to include the middle class (especially upper middle class) in my definition of "well-off".
What then do you mean that American cars/houses are unsustainable? I don't think big houses/cars is a good thing, but I think it probably is sustainable for quite a while (less climate concerns, in which case everything is unsustainable, depending on who you talk to) because we don't have the same density as Europe. I haven't thought much about this, but that's my hunch. I'd be really interested to hear counterarguments.
First, as in the US, there are large regional differences. Both between countries and inside of countries (eg Italy, UK).
But what do you mean with smaller?
Cars are much smaller, both because the infrastructure is not built for large ones and the huge US models are kind of pointless.
There are few large stores and many smaller stores instead. There are not many skyscrapers, in part due to relatively strict building regulations in the big cities.
There are only two really big metropolitan areas: London and Paris.
Also, there might be less of an interest in ostentatiousness. Bigger isn't always better.
That said, the US has a GDP per capita that's almost twice as high as the EU average. And even the most well-off countries, which had almost reached parity, have fallen behind very considerably since the 2008 financial crisis. The US economy has grown a lot since then, while the EU mostly remained stagnant.
(note that GDP/capita is a pretty bad measure, but it gives some idea)
But what do you mean with smaller?
Cars are much smaller, both because the infrastructure is not built for large ones and the huge US models are kind of pointless.
There are few large stores and many smaller stores instead. There are not many skyscrapers, in part due to relatively strict building regulations in the big cities.
There are only two really big metropolitan areas: London and Paris.
Also, there might be less of an interest in ostentatiousness. Bigger isn't always better.
That said, the US has a GDP per capita that's almost twice as high as the EU average. And even the most well-off countries, which had almost reached parity, have fallen behind very considerably since the 2008 financial crisis. The US economy has grown a lot since then, while the EU mostly remained stagnant.
(note that GDP/capita is a pretty bad measure, but it gives some idea)
GDP per capita only increases living standards when wealth is spread. Income inequality is significantly higher in the US than in Europe, so the middle classes in europe tend to have more.
But your points are valid, there's not many large cities, people tend not to have huge homes or sprawling lawns.
But your points are valid, there's not many large cities, people tend not to have huge homes or sprawling lawns.
True, and those two aspects actually go together.
Larger income inequality leads to more luxury: expensive cars, bigger mansions, etc.
Case in point: I saw way more luxury cars in Moscow than in New York or London, while large parts of the city are incredibly ugly and poor.
Larger income inequality leads to more luxury: expensive cars, bigger mansions, etc.
Case in point: I saw way more luxury cars in Moscow than in New York or London, while large parts of the city are incredibly ugly and poor.
The middle classes in Europe definitely don’t have more. Salaries are 30-40% higher in America (even accounting for healthcare and pensions) and the cost of living is quite a lot higher.
Salary in America vs Europe is apples to oranges. Much like your prices that do not contain sales tax.
For instance, my salary in a small Swedish city is 45,000Kr/mo. Of which I pay 6,000Kr in rent and about 3,000 for all my other bills combined (including gigabit internet). However there’s an unseen amount that my employer pays; my 45k salary is more like 90k in company costs.
Since the city is small, I would think of this as comparative to somewhere like boulder, CO. So you begin to get an idea of what purchasing power really is here and what things are paid for automatically (like insurances).
There’s also a large differentiation in regards to social norms (25 days vacation by law, income support in the event of unexpected job loss, generous maternity/paternity leave) muddying it even more.
For instance, my salary in a small Swedish city is 45,000Kr/mo. Of which I pay 6,000Kr in rent and about 3,000 for all my other bills combined (including gigabit internet). However there’s an unseen amount that my employer pays; my 45k salary is more like 90k in company costs.
Since the city is small, I would think of this as comparative to somewhere like boulder, CO. So you begin to get an idea of what purchasing power really is here and what things are paid for automatically (like insurances).
There’s also a large differentiation in regards to social norms (25 days vacation by law, income support in the event of unexpected job loss, generous maternity/paternity leave) muddying it even more.
I agree there are things you need to control for, but I don’t think its as hopeless a comparison as you seem to imply. As previously mentioned, I’m already controlling for healthcare and pension, for instance. What other insurances do European governments pay for? As for vacation days and maternity leave, I believe US professionals have pretty generous allowances as well, but I don’t have any data on hand—certainly an interesting question.
EDIT: This spurred me to do some research and I came across this analysis by Pew research: https://www.pewresearch.org/fact-tank/2017/06/05/through-an-... TL;DR: no matter how you measure, the standard of living is better in the US than in Europe.
EDIT: This spurred me to do some research and I came across this analysis by Pew research: https://www.pewresearch.org/fact-tank/2017/06/05/through-an-... TL;DR: no matter how you measure, the standard of living is better in the US than in Europe.
Someone else on HN made the same comment recently about the California power shutoffs.
To me it seems that the US is becoming a Latin American country, driven by the same forces that apply south of the border. The reasons that created the endless drug war and the original "banana republics" ruled by the United Fruit Company.
To me it seems that the US is becoming a Latin American country, driven by the same forces that apply south of the border. The reasons that created the endless drug war and the original "banana republics" ruled by the United Fruit Company.
> we may invest [...] too little in infrastructure, education ...
It sounds like a nice-to-have-thing but how on earth does that actually follow? The US spends enormous sums on education, the 2nd most of any country on earth (behind Norway) and ~33% more than OECD average. How can you be sure the problem is that we are investing too little?
Investment hardly seems like the issue, ROI seems a lot more pertinent. For infrastructure, even heavily unionized countries can build public works projects like subways at far less cost than the USA.
So its hard to buy that we invest too little per se. We get very little for our investments, whatever they are, which makes people in-my-opinion rightly cautious about investing more until some honest root cause analysis of the poor ROI is performed and openly acknowledged.
It sounds like a nice-to-have-thing but how on earth does that actually follow? The US spends enormous sums on education, the 2nd most of any country on earth (behind Norway) and ~33% more than OECD average. How can you be sure the problem is that we are investing too little?
Investment hardly seems like the issue, ROI seems a lot more pertinent. For infrastructure, even heavily unionized countries can build public works projects like subways at far less cost than the USA.
So its hard to buy that we invest too little per se. We get very little for our investments, whatever they are, which makes people in-my-opinion rightly cautious about investing more until some honest root cause analysis of the poor ROI is performed and openly acknowledged.
So what makes a country "third world" in your analysis?
The term arose out of the cold war, meaning countries that weren't aligned with either the United States (first world) or the USSR (second world). That can't be what you mean.
Later, it started to mean countries with poorly developed economies. That isn't the case, even if lots of our infrastructure is well used (really, if you have lots of infrastructure, you want at least some of it to be near the end of the useful life...).
I suppose a recent definition looks at places with stark disparities in wealth/income. The US has that, but low income people here are doing quite well compared to most of those places, with lots of support coming from the government. We are wealthy enough to do much more, but things like Medicaid are not worthless.
The term arose out of the cold war, meaning countries that weren't aligned with either the United States (first world) or the USSR (second world). That can't be what you mean.
Later, it started to mean countries with poorly developed economies. That isn't the case, even if lots of our infrastructure is well used (really, if you have lots of infrastructure, you want at least some of it to be near the end of the useful life...).
I suppose a recent definition looks at places with stark disparities in wealth/income. The US has that, but low income people here are doing quite well compared to most of those places, with lots of support coming from the government. We are wealthy enough to do much more, but things like Medicaid are not worthless.
> until the root cause is addressed: income inequality.
There isn't any evidence for that root cause though. If someone has a comfortable, secure life with food and shelter they aren't going to be unhappy no matter how much someone else has.
Fixing "income inequality" completely misses the actual root cause. I don't know what the root cause is, but I have lived next to some people who were substantially wealthier than I was and I didn't feel anything negative. Some inequality is healthy and nobody knows how much is ideal.
There isn't any evidence for that root cause though. If someone has a comfortable, secure life with food and shelter they aren't going to be unhappy no matter how much someone else has.
Fixing "income inequality" completely misses the actual root cause. I don't know what the root cause is, but I have lived next to some people who were substantially wealthier than I was and I didn't feel anything negative. Some inequality is healthy and nobody knows how much is ideal.
Income inequality includes the root cause, but more besides. It's not just that some people got really rich. It's that some other people got significantly poorer.
If I were to take a shot at a root cause, I would say globalization. The business owners got lower costs, so they made more money. The factory workers got laid off, and eventually their unemployment benefits ran out. That created income inequality, all right, but the real problem is that a bunch of people lost jobs that supported middle-class lifestyles, and didn't find comparable replacement jobs.
Increasing globalization may be a net win. But it happened too fast for people to adjust, and it destroyed a bunch of people.
If I were to take a shot at a root cause, I would say globalization. The business owners got lower costs, so they made more money. The factory workers got laid off, and eventually their unemployment benefits ran out. That created income inequality, all right, but the real problem is that a bunch of people lost jobs that supported middle-class lifestyles, and didn't find comparable replacement jobs.
Increasing globalization may be a net win. But it happened too fast for people to adjust, and it destroyed a bunch of people.
> If someone has a comfortable, secure life with food and shelter they aren't going to be unhappy no matter how much someone else has.
I believe there are studies showing that relative inequality is a factor in people's happiness. Here is literally the first link on the first search I did: https://www.sciencedirect.com/science/article/pii/S027656241...
Now, I'm sure you could make strong critiques of those sorts of studies, and I would probably agree with all our most of them. But ignoring the literature as you are is not likely to convince the people who actually need to be convinced. (And saying "well, I didn't experience it when I lived next to a rich person" is not going to go over well.)
I believe there are studies showing that relative inequality is a factor in people's happiness. Here is literally the first link on the first search I did: https://www.sciencedirect.com/science/article/pii/S027656241...
Now, I'm sure you could make strong critiques of those sorts of studies, and I would probably agree with all our most of them. But ignoring the literature as you are is not likely to convince the people who actually need to be convinced. (And saying "well, I didn't experience it when I lived next to a rich person" is not going to go over well.)
Well, how equal are you to your neighbour? I don't even know, I couldn't answer that question if it were put to me. Might be 10x as wealthy as my neighbour, 100x, 1x, 1/2x. I seriously don't know and I'm pretty sure they don't either.
People are notoriously bad at estimating wealth inequality. Something that they can't detect can't be the root cause of their unhappiness.
People are notoriously bad at estimating wealth inequality. Something that they can't detect can't be the root cause of their unhappiness.
My neighbor parenthetical was in direct response your own claim that you lived next to someone way wealthier than you, and it didn't make you feel bad.
And, just because people are bad at estimating something doesn't mean that they can't detect it, or that they won't make decisions (conscious or unconscious) based on their bad estimate.
Frankly, with the moving of the goalposts and clearly specious reasoning, I'm having a very difficult time believing you're arguing in good faith.
And, just because people are bad at estimating something doesn't mean that they can't detect it, or that they won't make decisions (conscious or unconscious) based on their bad estimate.
Frankly, with the moving of the goalposts and clearly specious reasoning, I'm having a very difficult time believing you're arguing in good faith.
> Frankly, with the moving of the goalposts and clearly specious reasoning, I'm having a very difficult time believing you're arguing in good faith.
I don't have any specific advice. Trying harder often doesn't work for that sort of thing; maybe try meditation or some other activity to make you relaxed and reflective?
> And, just because people are bad at estimating something doesn't mean that they can't detect it
Not in the general case, but in this specific case it is pretty clear that they can't detect it. That is central to my point - inequality can't be the root cause because people can't detect it and there is no reason to be unhappy about inequality specifically even if they could.
> My neighbor parenthetical was in direct response your own claim that you lived next to someone way wealthier than you, and it didn't make you feel bad.
So which inequality is the problem? It is much easier to go to the actual problem - people struggling to make ends meet. That isn't an inequality problem.
I don't have any specific advice. Trying harder often doesn't work for that sort of thing; maybe try meditation or some other activity to make you relaxed and reflective?
> And, just because people are bad at estimating something doesn't mean that they can't detect it
Not in the general case, but in this specific case it is pretty clear that they can't detect it. That is central to my point - inequality can't be the root cause because people can't detect it and there is no reason to be unhappy about inequality specifically even if they could.
> My neighbor parenthetical was in direct response your own claim that you lived next to someone way wealthier than you, and it didn't make you feel bad.
So which inequality is the problem? It is much easier to go to the actual problem - people struggling to make ends meet. That isn't an inequality problem.
> someone has a comfortable, secure life with food and shelter
That's the thing, they don't. If they did I'd agree with you that the problem isn't very bad. You just don't see it around you. If you don't believe me search the FRED database for rent inflation and median wages, for example.
Human brain is desperate for explanations. Populism is getting a lot of votes at the moment - people will prefer something that at least attempts to explain their pain over something that denies that the pain exists. "Drain the swamp" by Donal Trump and "Tax the rich" by Democratic hopefuls like Elizabeth Warren.
That's the thing, they don't. If they did I'd agree with you that the problem isn't very bad. You just don't see it around you. If you don't believe me search the FRED database for rent inflation and median wages, for example.
Human brain is desperate for explanations. Populism is getting a lot of votes at the moment - people will prefer something that at least attempts to explain their pain over something that denies that the pain exists. "Drain the swamp" by Donal Trump and "Tax the rich" by Democratic hopefuls like Elizabeth Warren.
But you have identified a root cause that wouldn't cause the problems you are observing.
If I changed things (eg, for sake of argument, a highly effective welfare program combined with non-transfer-payment spending cuts and a tax cut to the wealthy) inequality could increase and the problem could go away at the same time.
So the root cause is somewhere in the direction of 'people can't comfortable, secure and resourced'. That isn't related to inequality - people can be safe, comfortable, resourced and unequal.
Root cause has a specific meaning; I'm basically saying I've done root cause analysis professionally and you havn't actually picked a root cause. You've picked something closer to a guess at a solution.
If I changed things (eg, for sake of argument, a highly effective welfare program combined with non-transfer-payment spending cuts and a tax cut to the wealthy) inequality could increase and the problem could go away at the same time.
So the root cause is somewhere in the direction of 'people can't comfortable, secure and resourced'. That isn't related to inequality - people can be safe, comfortable, resourced and unequal.
Root cause has a specific meaning; I'm basically saying I've done root cause analysis professionally and you havn't actually picked a root cause. You've picked something closer to a guess at a solution.
Inequality is the problem because everything happens in a single market. Rich people push the real estate market high and suddenly no affordable housing exists.
I actually think that the FED is largely responsible for this setup. Unintended consequences of QE and cheap money - everything is now expensive. Same as the seeds for 2008 were laid out in the post-dotcom ultralow interest rates.
I actually think that the FED is largely responsible for this setup. Unintended consequences of QE and cheap money - everything is now expensive. Same as the seeds for 2008 were laid out in the post-dotcom ultralow interest rates.
Congress is responsible, because the reason the Fed had to push so heavily on blunt monetary policy levers is because Congress has been asleep at the switch on more targetable fiscal policy remedies to economic problems.
Monetary policy alone is useful for smoothing some of the edges of business cycles, but it's not—and not intended to be—the alpha and omega of economic policy.
Monetary policy alone is useful for smoothing some of the edges of business cycles, but it's not—and not intended to be—the alpha and omega of economic policy.
Concurrence has been reached, sir.
I am (mostly because I like interesting things) hoping to see the most stupid form of fiscal stimulus in the next deflationary recession - money handouts. It'd be interesting to see what happens if instead of buying $300B worth of bonds the FED with the help of the Treasury just airdrops $1000 into each citizen's bank account. Perhaps start with $100 and see how it goes. Anyhow, not sure if with this polarity the authorities could reach consensus on such drastic measures.
I am (mostly because I like interesting things) hoping to see the most stupid form of fiscal stimulus in the next deflationary recession - money handouts. It'd be interesting to see what happens if instead of buying $300B worth of bonds the FED with the help of the Treasury just airdrops $1000 into each citizen's bank account. Perhaps start with $100 and see how it goes. Anyhow, not sure if with this polarity the authorities could reach consensus on such drastic measures.
Don't forget wealth inequality, which is worse in some ways as it is less talked about but the gap is even wider there.
Income is the real deal. Point is people want to be able to afford normal things like housing, medical care and some good education for their children.
I don't see this as problematic that Buffett sits on hundreds of billions. But the fact that 150k annual income qualifies for subsidized housing in SF - well that's ridiculous.
I don't see this as problematic that Buffett sits on hundreds of billions. But the fact that 150k annual income qualifies for subsidized housing in SF - well that's ridiculous.
We had thousands of years to address the root cause and income inequality is still very much here. There are just too many forces in favor of keeping and expanding it.
> ...until the root cause is addressed: income inequality.
Agree. But I'd like to add:
- MLK was assassinated when he shift from civil rights to addressing poverty and income inequality.
- Bobby Kennedy was also making noise about the issue.
- Currently, the mainstream media narrative is a relentless Red v Blue. There is no narrative for Haves v Have-nots.
The System does work; quite well actually. And those who it works well for are not going to give up those benefits without a fight. But The People are too busy chasing symptoms and fighting each other. Change anytime soon feels unlikely.
Agree. But I'd like to add:
- MLK was assassinated when he shift from civil rights to addressing poverty and income inequality.
- Bobby Kennedy was also making noise about the issue.
- Currently, the mainstream media narrative is a relentless Red v Blue. There is no narrative for Haves v Have-nots.
The System does work; quite well actually. And those who it works well for are not going to give up those benefits without a fight. But The People are too busy chasing symptoms and fighting each other. Change anytime soon feels unlikely.
> Currently, the mainstream media narrative is a relentless Red v Blue. There is no narrative for Haves v Have-nots.
Are we following the same Democratic primary where Bernie Sanders and Elizabeth Warren both made these the centerpieces of their campaign and are 2 of the top 3 contenders?
It’s a bit much to say there is NO such narrative. Even Trump ran on this narrative, he just sprinkled some racism with it.
Are we following the same Democratic primary where Bernie Sanders and Elizabeth Warren both made these the centerpieces of their campaign and are 2 of the top 3 contenders?
It’s a bit much to say there is NO such narrative. Even Trump ran on this narrative, he just sprinkled some racism with it.
Agree, but it was definitely suppressed last election cycle (see negative coverage of Bernie until Hillary lost). And even now, Trump's racism gets magnified in a way that overshadows anything he has to say about income inequality -- not that there aren't good reasons for this.
Two candidates? That's a balance? I don't see that.
And, to my point (thank you), they are both Blue. So the narrative remains a Party v Party paradigm. How's that workin' out for us?
You have a point, but two is not a trend.
And, to my point (thank you), they are both Blue. So the narrative remains a Party v Party paradigm. How's that workin' out for us?
You have a point, but two is not a trend.
>Two candidates? That's a balance? I don't see that.
Two candidates who, combined, are polling at nearly 40% of the party vote.
>And, to my point (thank you), they are both Blue. So the narrative remains a Party v Party paradigm. How's that workin' out for us?
This is a tiresome cliche that ignores how politics structurally works. https://en.wikipedia.org/wiki/Duverger%27s_law
In multi-party democracies it doesn't end up being all that different in terms of any individual voter getting what they want, it's just that the tacking to the median voter happens after the election is done instead of through a primary process.
Two candidates who, combined, are polling at nearly 40% of the party vote.
>And, to my point (thank you), they are both Blue. So the narrative remains a Party v Party paradigm. How's that workin' out for us?
This is a tiresome cliche that ignores how politics structurally works. https://en.wikipedia.org/wiki/Duverger%27s_law
In multi-party democracies it doesn't end up being all that different in terms of any individual voter getting what they want, it's just that the tacking to the median voter happens after the election is done instead of through a primary process.
They are alledgedly __polling__ at 40%, the last week or so. That's not real votes.
Sanders is a second health issue from being out of it. Liz? After the Native American snafu it's hard to imagine she's sharp enough to beat DJT. It was him afterall that suckered her into that snafu.
In the theory, I would love to agree with you. I bleed blue. The reality is there's a lack of truth / data / facts to support doing so.
Sanders is a second health issue from being out of it. Liz? After the Native American snafu it's hard to imagine she's sharp enough to beat DJT. It was him afterall that suckered her into that snafu.
In the theory, I would love to agree with you. I bleed blue. The reality is there's a lack of truth / data / facts to support doing so.
>The reality is there's a lack of truth / data / facts to support doing so.
Only because you're making a point of pleading away any data that invalidates your conclusions. You just asserted opinion polls don't count because it's not votes, which is a far cry from you original statement that there is nobody talking about or supporting an agenda to reduce inequality and seems like you're just trying to juke your way out of reevaluating your priors.
Only because you're making a point of pleading away any data that invalidates your conclusions. You just asserted opinion polls don't count because it's not votes, which is a far cry from you original statement that there is nobody talking about or supporting an agenda to reduce inequality and seems like you're just trying to juke your way out of reevaluating your priors.
Btw. We're not a democracy. We're a republic.
This is meaningless nonsense people say to justify not letting people have a voice. Please explain to me what the practical difference is between these terms in the modern context.
>until the root cause is addressed: income inequality
As far as I can tell, income inequality mainly stems from inequality of opportunity. I think a country is as free as its ability to give all its citizens the same opportunities.
As far as I can tell, income inequality mainly stems from inequality of opportunity. I think a country is as free as its ability to give all its citizens the same opportunities.
I agree that the US economic system doesn’t give enough opportunities. After being highlighted by the GR, the economy really doesn’t produce enough work for everyone who needs work. Precisely the sort of thing government is meant to address: problems no other actor has incentive or ability to address.
If that were true, we’d be seeing high levels of unemployment. Except that’s totally not true, we’re past full employment and yet businesses are struggling to hire people and the economy is booming.
>Precisely the sort of thing government is meant to address: problems no other actor has incentive or ability to address.
I wholeheartedly agree. You've wonderfully articulated what an ideal government would be like.
I wholeheartedly agree. You've wonderfully articulated what an ideal government would be like.
Bernie Sanders commissioned a report on this back in 2016, before Yang was even in politics, and defense of the working class on issues like this describes pretty much his entire career:
https://www.vox.com/2019/9/10/20857668/life-expectancy-wealt...
https://www.vox.com/2019/9/10/20857668/life-expectancy-wealt...
Bernie also said, "When you're white, you don't know what it's like to be poor." [0]
While his policies and voting record may tell a different story, that comment left a lasting impression on a lot of people. I have yet to see him speak directly to poor white people as Yang did, and I suspect he (Bernie) is afraid of alienating his younger, left-learning base. To see who I mean, check out those replies to Yang's tweet.
[0] https://www.politico.com/story/2016/03/bernie-sanders-povert...
While his policies and voting record may tell a different story, that comment left a lasting impression on a lot of people. I have yet to see him speak directly to poor white people as Yang did, and I suspect he (Bernie) is afraid of alienating his younger, left-learning base. To see who I mean, check out those replies to Yang's tweet.
[0] https://www.politico.com/story/2016/03/bernie-sanders-povert...
This kind of laughable “gotcha” politics actually has no impact on his support. I’m from a poor white family in Michigan, Bernie is tremendously popular here, as he was in 2016 when he won the primary.
Working class people understand completely that Bernie and what he advocates for, things like Medicare for All, are what are in their interests. And likewise that Yang’s plans to dismantle the welfare state and replace it with a check that will get eaten up by all the landlords and insurance companies that have always preyed them will accomplish nothing. It’s why Bernie has the largest donor base of any candidate and especially among donations from working class people.
Working class people understand completely that Bernie and what he advocates for, things like Medicare for All, are what are in their interests. And likewise that Yang’s plans to dismantle the welfare state and replace it with a check that will get eaten up by all the landlords and insurance companies that have always preyed them will accomplish nothing. It’s why Bernie has the largest donor base of any candidate and especially among donations from working class people.
> Working class people understand completely that Bernie and what he advocates for, things like Medicare for All, are what are in their interests. And likewise that Yang’s plans to dismantle the welfare state and replace it with a check that will get eaten up by all the landlords and insurance companies that have always preyed them will accomplish nothing.
We know the mechanisms that cause these things to happen. Landlords lobby the government for restrictive zoning to constrain supply and cause rents to rise and absorb more of the tenants' income. Insurance companies lobby for laws against catastrophic-only plans so that people have to buy more expensive plans with higher premiums. These are their own battles and we should try to win them. But they're the same in kind as things like certificate of need laws that make medical services more scarce and therefore more expensive.
What I don't think you've explained is how that will happen less if the government is cutting checks directly to drug companies and the other government contractors/unions than if people are given cash to spend on whatever they choose and then at least have the possibility that there exists a substitute good which competes and thereby limits how much of the money can be captured by drug companies/landlords, which would leave the rest the money as surplus to actually improve their lives.
We know the mechanisms that cause these things to happen. Landlords lobby the government for restrictive zoning to constrain supply and cause rents to rise and absorb more of the tenants' income. Insurance companies lobby for laws against catastrophic-only plans so that people have to buy more expensive plans with higher premiums. These are their own battles and we should try to win them. But they're the same in kind as things like certificate of need laws that make medical services more scarce and therefore more expensive.
What I don't think you've explained is how that will happen less if the government is cutting checks directly to drug companies and the other government contractors/unions than if people are given cash to spend on whatever they choose and then at least have the possibility that there exists a substitute good which competes and thereby limits how much of the money can be captured by drug companies/landlords, which would leave the rest the money as surplus to actually improve their lives.
[deleted](1)
I'm not interested in comparing Bernie's policies vs. Yang's. I highlighted Yang's tweet specifically because it singles out the suffering of rural whites by name.
In a U.S. presidential election, I think perception is at least as important as policy. Most Americans aren't policy wonks, and they don't scrutinize all aspect of a candidate's platform. They simply choose the candidate who they feel will best represent their interests. When one candidate addresses them and their suffering by name but the other one doesn't (or even minimizes it, a la Bernie 2016), that second candidate's a tougher sell.
In a U.S. presidential election, I think perception is at least as important as policy. Most Americans aren't policy wonks, and they don't scrutinize all aspect of a candidate's platform. They simply choose the candidate who they feel will best represent their interests. When one candidate addresses them and their suffering by name but the other one doesn't (or even minimizes it, a la Bernie 2016), that second candidate's a tougher sell.
“The Vermont senator is the top recipient among farmers, servers, social workers, retail workers, photographers, construction workers, truckers, nurses and drivers, among several other groups. Each of those professions — which don’t typically provide much campaign cash — earn near or below the median income, according to data from the Bureau of Labor Statistics.“
https://www.opensecrets.org/news/2019/09/sanders-vs-warren-w...
I’ll just restate that all of this pointing at Yang’s Twitter account is nonsense.
https://www.opensecrets.org/news/2019/09/sanders-vs-warren-w...
I’ll just restate that all of this pointing at Yang’s Twitter account is nonsense.
I don't disagree with you about Bernie's fantastic support in the heartland. I think it stems from the strengths (EDIT: and consistency!) of his policies, despite the lack of attention paid by name to the largest American ethnic group.
For the other candidates with weaker policies, or less name recognition, I think my point is even more important. Intersectional politics have put race at the top of everyone's mind. When a candidate mentions every race by name but yours, and when yours is facing the steepest decline in life expectancy of nearly all of them (I haven't checked, but I assume life's worse as always for American Indians), folks tend to notice.
For the other candidates with weaker policies, or less name recognition, I think my point is even more important. Intersectional politics have put race at the top of everyone's mind. When a candidate mentions every race by name but yours, and when yours is facing the steepest decline in life expectancy of nearly all of them (I haven't checked, but I assume life's worse as always for American Indians), folks tend to notice.
But isn't there understanding that should Bernie win the fight he will never be able to implement one tenth of his policies?
There will be another four years of mutual accusations between "the idiots in the Senate" and "the idiot in the White House" with a bunch of policies implemented as executive orders adding to the mess.
There will be another four years of mutual accusations between "the idiots in the Senate" and "the idiot in the White House" with a bunch of policies implemented as executive orders adding to the mess.
A politics of surrendering before the fight or selling out the working class to your wealthy donors is not something people rally behind.
Nobody is talking about surrendering. Quite the opposite: big wars are won in small battles.
There are a lot of small changes which can improve US healthcare: untie health insurance from employers. Make hospitals responsible for the billing, do that people don't get separate bills from anesthesiologists and surgeons. Make catastrophic plans accessible for everyone. Give free health insurance to children under 5.
All these are small things, but they are doable. Once done, let's pause and reconsider.
There are a lot of small changes which can improve US healthcare: untie health insurance from employers. Make hospitals responsible for the billing, do that people don't get separate bills from anesthesiologists and surgeons. Make catastrophic plans accessible for everyone. Give free health insurance to children under 5.
All these are small things, but they are doable. Once done, let's pause and reconsider.
Medicare, Medicaid, and Social Security are all still here while the incrementalism of the ACA is being torn to shreds. Big battles won, incrementalism undone. That’s exactly what surrender and defeat looks like.
Thousands upon thousands are being denied care, bankrupted, and killed each year by the American healthcare system. This is the status quo you’re defending. People going broke because they have a disabled child, rationing care and medicines they can’t afford at great harm to themselves.
These people, the people being ground up by this system, aren’t interested in pausing things so you can get more comfortable than you already are with this state of affairs.
Thousands upon thousands are being denied care, bankrupted, and killed each year by the American healthcare system. This is the status quo you’re defending. People going broke because they have a disabled child, rationing care and medicines they can’t afford at great harm to themselves.
These people, the people being ground up by this system, aren’t interested in pausing things so you can get more comfortable than you already are with this state of affairs.
ACA is alive and chugging. An attempt to dismantle it has failed despite of a republican president with a republican congress.
Which means most people agree that ACA does more good than bad.
It may feel very good to fight for a noble goal without a compromise and half measures, but while you are fighting, the people you are fighting for are no better.
But that's not your fault, right?
Which means most people agree that ACA does more good than bad.
It may feel very good to fight for a noble goal without a compromise and half measures, but while you are fighting, the people you are fighting for are no better.
But that's not your fault, right?
ACA plans are incredibly expensive and deny one in 5 medical claims. The law itself is under severe legal threat in the Fifth Circuit and has seen it’s Medicaid expansion undermined in many states by work requirements. It unlikely to survive much longer, whether by judicial decree or continued side channel attacks.
I could care less about some contest of nobility, but I can tell you for certain that this kind of cowardly rhetoric, where you think you can deflect the blame of those who profit off the poor, the ill, and the disabled onto those who dare to fight for them, convinces absolutely no one.
I could care less about some contest of nobility, but I can tell you for certain that this kind of cowardly rhetoric, where you think you can deflect the blame of those who profit off the poor, the ill, and the disabled onto those who dare to fight for them, convinces absolutely no one.
Read the actual Kaufmann report that generated that 1-in-5 claim to see how not probative it actually is.
The actual rate of denied claims varies wildly from state to state and from insurer to insurer inside those states; some states have rejection rates in the single digits. Meanwhile, the report authors don't have the reason for rejection, and the reason matters a lot: providers have varying competence submitting claims, and a large chunk of denials are probably miskeyed services. Very, very few denials are appealed, suggesting either clerical errors or low-dollar claims (the financial value of those denials would be a number you'd really want to see but does not exist either). Much of this is covered in the Discussion section of the report.
Right now, this 1-in-5 thing really just seems like a cudgel for people to swing randomly around in message board arguments.
The actual rate of denied claims varies wildly from state to state and from insurer to insurer inside those states; some states have rejection rates in the single digits. Meanwhile, the report authors don't have the reason for rejection, and the reason matters a lot: providers have varying competence submitting claims, and a large chunk of denials are probably miskeyed services. Very, very few denials are appealed, suggesting either clerical errors or low-dollar claims (the financial value of those denials would be a number you'd really want to see but does not exist either). Much of this is covered in the Discussion section of the report.
Right now, this 1-in-5 thing really just seems like a cudgel for people to swing randomly around in message board arguments.
So if you believe this to be inaccurate, then spell out for precisely me what level of suffering and expense that people should have to endure for this system to continue? What are you comfortable with maintaining? How many people should be bankrupted, denied care or self-ration to the point of harm? We should only have 25000 people go bankrupt each year or 25 million uninsured? What level of damage to these people’s lives do you think needs to be “reformed” away vs preserved?
If there is one take away from The Art of The Deal. You ask for a lot and negotiate until you find a success. He has made no friends in healthcare by saying he wants a public system that does not include private management. Those healthcare companies are marketing and packing in benefits like crazy in the hope they don’t get made irrelevant. Bernie has lit a fire under the asses of companies who believe the it’s their right to charge you ~$1000/month for a service they don’t want you to use.
Ask a lot - and you will get a little.
Ask too much and you will get nothing.
One thing that always kept me wondering: all politicians readily talk about their priorities. I want to know what is not their priorities. What are they willing to offer in their negotiations?
Ask too much and you will get nothing.
One thing that always kept me wondering: all politicians readily talk about their priorities. I want to know what is not their priorities. What are they willing to offer in their negotiations?
it sounds like it is self-inflicted?
Decreased economic opportunity is self-inflicted? It seems to me that many people are far more comfortable attributing blame to people that could very well be victims to a certain degree--and not the main perpetrators, in fact--than to make an unbiased and braver observation of the facts.
responses to decreased economic opportunity is a choice
Yeah, that's easy to say when you are a privileged person belonging to the bourgoisie instead of a dude born in the middle of God knows where. You think people living in poor countries have any reasonable margin to act on their lack of economic opportunity?
I'm done with this site.
I'm done with this site.
i'm originally from South Africa, having lived through apartheid as a black person. i am certainly not privileged. these americans are way more privileged than I am and are still killing themselves
There are no perpetrators. In 2019, anyone with a pulse in the United States can find a $15/hr service job. In most of the country that’s a living wage. (Except for California, ironically, one of the places instituting the policies people here advocate for). In fact, a couple making 60k is in a position to buy a house in most of the country.
Now, will most of these people save up and become millionaires and by a condo in San Francisco? No. But life isn’t fair. I wish I could afford a few Supercars and an oceanfront villa, but I can’t and I don’t blame that on income equality.
Now, will most of these people save up and become millionaires and by a condo in San Francisco? No. But life isn’t fair. I wish I could afford a few Supercars and an oceanfront villa, but I can’t and I don’t blame that on income equality.
>In 2019, anyone with a pulse in the United States can find a $15/hr service job
Source?
Source?
This is exactly what I saw too. I'm surprised that obesity isn't up there with how Americans eat and our food culture. Food is as much a drug as actual drugs or alcohol. Don't I know it.
Edit - Obesity does contribute to liver deaths, so it's there.
Edit - Obesity does contribute to liver deaths, so it's there.
Life expectancy is also falling in the UK: https://www.theguardian.com/society/2019/mar/07/life-expecta...
Perhaps not entirely coincidentally, the UK has also seen an intentional and systematic erosion of the basic institutions of a welfare state by the neoliberal bloc, including the Blair "labor in name only" governments.
Blair massively expanded the welfare state by any measure. The Tories wouldn't have had anything to cut from 2010 onwards if that wasn't the case.
I get that you back Yang but it’s weird to say he’s the only one talking about a trend which Obama, Clinton, Sanders, Warren, Harris, etc. have all talked about, often starting before Yang got into politics. It’d be more useful to talk about actual policy differences or why you think his plan would be more successful — especially in the context of an entire political movement having been funded into existence to oppose the previous attempt.
I'm not interested in a discussion of Yang's policies, or a debate of his plan for UBI. I highlighted his tweet specifically because it singles out the suffering of rural whites by name.
Bernie, Warren, Harris, etc. speak directly to issues which disproportionally affect other groups (police violence against blacks, immigration policy that mainly affects Hispanics, etc.), but never this one. It gives an impression of unequal treatment, and leaves some feeling unnoticed and ignored. This creates opportunity for the first politician to say, "I see you, I see your suffering, and I will not ignore you."
Bernie, Warren, Harris, etc. speak directly to issues which disproportionally affect other groups (police violence against blacks, immigration policy that mainly affects Hispanics, etc.), but never this one. It gives an impression of unequal treatment, and leaves some feeling unnoticed and ignored. This creates opportunity for the first politician to say, "I see you, I see your suffering, and I will not ignore you."
So you already moved the goal posts by quietly removing Bernie Sanders from your list of people who supposedly aren't talking about these things.
I don't know if she says "rural whites" verbatim, but Warren talks about rural issues all the time. It's one of the central tenets of her campaign -- that previous Democratic candidates (other than Sanders) ignored rural America, and she isn't. She campaigns in small rural towns that few other candidates will campaign in.
https://medium.com/@teamwarren/my-plan-to-invest-in-rural-am...
I don't know if she says "rural whites" verbatim, but Warren talks about rural issues all the time. It's one of the central tenets of her campaign -- that previous Democratic candidates (other than Sanders) ignored rural America, and she isn't. She campaigns in small rural towns that few other candidates will campaign in.
https://medium.com/@teamwarren/my-plan-to-invest-in-rural-am...
Thanks for the correction. I've included Bernie in my comment.
They all talked, and did then nothing to adress the issue. You need a new deal for that- something nobody opposes.
I don't think he's the _only_ one but his typical campaign messaging puts an awful lot of effort into addressing poverty and lack of opportunity in manufacturing which is interpreted by many on the left as pandering to the alt right (the very comments about white male suicides and overdoses is literally treated as a "dogwhistle for the alt right" by hypersensitive leftists). Yang spins this kind of socioeconomic disaster into an automation focused explanation for why Trump won 2016, which is what many on the left do not accept either because they oftentimes accept the Clintonian explanation of Russian, racism, etc. rather than a terrible (well-qualified, still terrible) candidate and campaign (that ignored middle America and presumed it'd win).n
At its root we can go back to Bill Clinton and MFN and fast tracking into WTO —with no plan to address displacement in the workforce and no milestones by which to measure China’s adherence, which did happen yearly before the fast tracked admission into WTO. People blame reaganomics, but it was Clinton’s globalism that plunged the dagger into the blue collar worker of America and he gets very little Fl.a.k. for it.
Damnit. Mr Perot was right. We’d have been better off with him than the guy who sold us off.
Damnit. Mr Perot was right. We’d have been better off with him than the guy who sold us off.
The biggest lie in economics is that aging workers are retrained for completely new fields
Really? I don't think this is a lie people believe, nor is it the biggest. The biggest lie, I think, that Americans tell themselves is that hard work always leads to success.
If we're getting into politics, I can't leave this uncontested. I think this is very disingenuous to say it didn't start with Reagan's "starve the beast".
He brought deregulation and busted some unions. He didn’t sell off the workforce wholesale to ship the jobs overseas and tell them to be happy because they’ll get cheap disposable stuff we can fill landfills with instead.
Busting unions looks bad. Shipping jobs overseas is magnitudes worse but it’s indirect and underhanded so you don’t get the blame. Actually, even better, you get to blame people for not “skilling up”!
Busting unions looks bad. Shipping jobs overseas is magnitudes worse but it’s indirect and underhanded so you don’t get the blame. Actually, even better, you get to blame people for not “skilling up”!
Reagan started the "trickle down" BS, and manufacturing globalism really started in the 80s. You are right that Clinton promoted it and Reagan didn't.
Seems to be a meme that rural whites are the strong voting block for republicans in 2016. Any stats to suggest it wasn't the suburbs? That's what I've seen but seems like people who at least represent themselves as liberal only want to blame the white rural folks.
Rural whites are the strongest voting block for Republicans, but Republicans in the general win pretty much ALL whites at any given economic or educational level. The only white economic/education subgroup that didn't go for Trump in 2016 were educated single white women.
Curious a Yang/Bernie fan who is aware of populism/demagoguery.
How is this not a repeat of the ancient Greek Athenians?
(Serious)
How is this not a repeat of the ancient Greek Athenians?
(Serious)
What myth of Athens do you have in mind? Athens isn't without publically supported dickery given it was kind of a long history. The closest examples I can think of are voting to go to war for slaves and establishing a naval power empire extorting tribute until their vassals allied agaist them. Neither are exactly applicable to even strawmen interpretations.
Except the whole thing about increasing rural white poverty is largely a myth caused by failure to properly analyze the data. Adjusted for cost of living, rural areas have lower poverty rates: https://www.ers.usda.gov/amber-waves/2006/november/adjusting.... Employment suffered less during the Great Recession in rural areas than in urban areas. Many of the places tagged with the travails of white rural people, in the Midwest, have some of the highest incomes for rural people relative to urban people in the country.
Your link only examines data up to 2003, accounts only for poverty vs. other measures of economic opportunity, and does not account for the steeper decline in life expectancy among white Americans vs. other groups.
Other sources show the trend only getting better through the recession.
Then link them.
Adjusting for cost of living is a little bit risky though; because part of what that means is that they don't buy things they can't afford. It doesn't matter how low the cost of living goes; a rural hospital is not going to have the same resources as a city-centre hospital attached to a university with a strong medical research focus.
And there are probably other confounding factors; eg, it may be much more difficult for a homeless individual to exist in a rural town than a city - the stats would show that as more homeless in the city, even though the ambient conditions are better. So sure the stats say that there is more poverty in the cities - but that might just be signalling that poverty is much more painful in rural areas. This means that people could be saying things that are technically wrong (hence the myth) but are very accurate to the lived experiences and pressures on someone in a rural area.
And there are probably other confounding factors; eg, it may be much more difficult for a homeless individual to exist in a rural town than a city - the stats would show that as more homeless in the city, even though the ambient conditions are better. So sure the stats say that there is more poverty in the cities - but that might just be signalling that poverty is much more painful in rural areas. This means that people could be saying things that are technically wrong (hence the myth) but are very accurate to the lived experiences and pressures on someone in a rural area.
> Adjusting for cost of living is a little bit risky though; because part of what that means is that they don't buy things they can't afford. It doesn't matter how low the cost of living goes; a rural hospital is not going to have the same resources as a city-centre hospital attached to a university with a strong medical research focus.
Only a small number of people need things that a rural hospital can not offer. Meanwhile, everyone needs things (food, housing, etc.) that are much more expensive in the city. Likewise, cheap housing can mean that it’s much easier to afford to live in a decent school district. And the same amount of government funding for say schools goes further in rural areas. In NAEP tests, rural schools perform comparably to suburban schools, and better than urban schools: https://nces.ed.gov/programs/coe/figures/images/figure-tla-5...
Only a small number of people need things that a rural hospital can not offer. Meanwhile, everyone needs things (food, housing, etc.) that are much more expensive in the city. Likewise, cheap housing can mean that it’s much easier to afford to live in a decent school district. And the same amount of government funding for say schools goes further in rural areas. In NAEP tests, rural schools perform comparably to suburban schools, and better than urban schools: https://nces.ed.gov/programs/coe/figures/images/figure-tla-5...
The CDC report[1] that the article cites contradicts your statement.
Life expectancy, both sexes, at birth:
2013: hispanic 81.9 white 78.8 black 75.1
2016: hispanic 81.8 white 78.5 black 74.8
Delta: hispanic -0.1 white -0.3 black -0.3
I would say that the decline has affected blacks equally, but considering their lesser overall life expectancy this otherwise equal decline has a greater negative impact for blacks.
[1] https://www.cdc.gov/nchs/data/hus/hus17.pdf
Life expectancy, both sexes, at birth:
2013: hispanic 81.9 white 78.8 black 75.1
2016: hispanic 81.8 white 78.5 black 74.8
Delta: hispanic -0.1 white -0.3 black -0.3
I would say that the decline has affected blacks equally, but considering their lesser overall life expectancy this otherwise equal decline has a greater negative impact for blacks.
[1] https://www.cdc.gov/nchs/data/hus/hus17.pdf
The trends examined by UPenn researches in the paper [0] from my first link span from 1990-2016, vs. that CDC report's 3-year span. From the paper:
"We focus on non‐Hispanic whites because their mortality trends were particularly adverse in the last decade and differ from those of non‐Hispanic Blacks and Hispanics.
In contrast to non‐Hispanic whites, mortality has continued to decline among Hispanics and non‐Hispanic Blacks, although death rates remain substantially higher for Blacks than for whites (Harper, MacLehose, and Kaufman 2014; Murphy et al. 2017; Stein et al. 2017). The underlying mechanisms driving mortality trends for non‐Hispanic whites are fundamentally different from those driving trends for other racial/ethnic groups, as suggested by James and Cossman (2017)."
[0] https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12249
"We focus on non‐Hispanic whites because their mortality trends were particularly adverse in the last decade and differ from those of non‐Hispanic Blacks and Hispanics.
In contrast to non‐Hispanic whites, mortality has continued to decline among Hispanics and non‐Hispanic Blacks, although death rates remain substantially higher for Blacks than for whites (Harper, MacLehose, and Kaufman 2014; Murphy et al. 2017; Stein et al. 2017). The underlying mechanisms driving mortality trends for non‐Hispanic whites are fundamentally different from those driving trends for other racial/ethnic groups, as suggested by James and Cossman (2017)."
[0] https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12249
The CDC report[1] has data that spans the years 2006-2016, eleven years not three. However, all racial groups have greater life expectancy now that they did in 2006.
I was specifically addressing the comment's statement that "The decline in U.S. life expectancy has disproportionately affected whites". The CDC report seems to disagree.
Specifically looking at declines: the highest white life expectancy is in 2012 and the highest black life expectancy occurred in 2014:
2012 white 78.9 years
2014 black 75.3 years
2016 white 78.5 (-0.4, a 0.51% decline)
2016 black 74.8 (-0.5, a 0.67% decline)
Black life expectancy appears to have declined more (an even bigger concern to me is the absolute disparity between white and black life expectancy).
[1] https://www.cdc.gov/nchs/data/hus/hus17.pdf
I was specifically addressing the comment's statement that "The decline in U.S. life expectancy has disproportionately affected whites". The CDC report seems to disagree.
Specifically looking at declines: the highest white life expectancy is in 2012 and the highest black life expectancy occurred in 2014:
2012 white 78.9 years
2014 black 75.3 years
2016 white 78.5 (-0.4, a 0.51% decline)
2016 black 74.8 (-0.5, a 0.67% decline)
Black life expectancy appears to have declined more (an even bigger concern to me is the absolute disparity between white and black life expectancy).
[1] https://www.cdc.gov/nchs/data/hus/hus17.pdf
Sorry, I'd assumed your first comment which diffed 2013 and 2016 was a comprehensive summary. Now it looks like we're shifting the brackets around, and I'm not sure where the goalposts are. I'll defer to the study in my original link.
While Yang seems nice on the surface, his policy idea to finance 1000€ in cash per month for everyone by a VAT is a prime example of a regressive tax policy. If you spend ~2000€ a month at ~10% that is 200€ already gone. So you end up paying out something like Hartz IV Level (German Social Security) to everyone. I can’t imagine that it would be particularly fun to support yourself based on that.
I think statistics proved the opposite overall with affluence overall even though it was an especially popular hairshirting trope.
Meanwhile, HN is more concerned with censoring opinions that have more to do with why life expectancy is decreasing than this popsci article can state.
What are those opinions?
sunkenvicar(2)
Ad-block friendly article: https://www.aafp.org/news/health-of-the-public/20181210lifee...
> "The latest CDC data show that the U.S. life expectancy has declined over the past few years," said CDC Director Robert Redfield, M.D., in a Nov. 29 statement.(www.cdc.gov) "Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide.“
Of the various things that have been discussed as causes, one thing that gets overlooked is declining religiosity: https://www.wsj.com/articles/is-god-the-answer-to-the-suicid...
> A 2016 study published in JAMA Psychiatry found that American women who attended a religious service at least once a week were five times less likely to commit suicide. The findings—based on data from 90,000 women from 1996 to 2010—are consistent with 2019 Pew Research findings that regular participation in religious community is clearly linked to higher levels of happiness. It’s true that correlation doesn’t prove causation, but there’s strong evidence that people who attend church or synagogue regularly are less inclined to take their own lives.
Decreasing marriage and fertility rates are another potential cause, especially given that suicide rates have increased fastest among women: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
https://www.thecut.com/2016/04/the-suicide-statistics-releas...
> Marriage rates have declined, particularly among less educated Americans, while divorce rates have risen, leading to increased social isolation, she said. She calculated that in 2005, unmarried middle-aged men were 3.5 times more likely than married men to die from suicide, and their female counterparts were as much as 2.8 times more likely to kill themselves.
Which all makes some sort of sense, right? Life expectancy has been increasing for decades, and the US has lacked universal healthcare this whole time. With ACA, healthcare coverage has never been higher. So it seems hard to chalk declining life expectancies to factors that have only been getting better over time.
Economics is likewise a suspect causal factor. The last time suicide rates were this high was the Great Depression. Unemployment and wage stagnation were worse in the 1970s yet suicide rates were never so high.
> "The latest CDC data show that the U.S. life expectancy has declined over the past few years," said CDC Director Robert Redfield, M.D., in a Nov. 29 statement.(www.cdc.gov) "Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide.“
Of the various things that have been discussed as causes, one thing that gets overlooked is declining religiosity: https://www.wsj.com/articles/is-god-the-answer-to-the-suicid...
> A 2016 study published in JAMA Psychiatry found that American women who attended a religious service at least once a week were five times less likely to commit suicide. The findings—based on data from 90,000 women from 1996 to 2010—are consistent with 2019 Pew Research findings that regular participation in religious community is clearly linked to higher levels of happiness. It’s true that correlation doesn’t prove causation, but there’s strong evidence that people who attend church or synagogue regularly are less inclined to take their own lives.
Decreasing marriage and fertility rates are another potential cause, especially given that suicide rates have increased fastest among women: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
https://www.thecut.com/2016/04/the-suicide-statistics-releas...
> Marriage rates have declined, particularly among less educated Americans, while divorce rates have risen, leading to increased social isolation, she said. She calculated that in 2005, unmarried middle-aged men were 3.5 times more likely than married men to die from suicide, and their female counterparts were as much as 2.8 times more likely to kill themselves.
Which all makes some sort of sense, right? Life expectancy has been increasing for decades, and the US has lacked universal healthcare this whole time. With ACA, healthcare coverage has never been higher. So it seems hard to chalk declining life expectancies to factors that have only been getting better over time.
Economics is likewise a suspect causal factor. The last time suicide rates were this high was the Great Depression. Unemployment and wage stagnation were worse in the 1970s yet suicide rates were never so high.
>Of the various things that have been discussed as causes, one thing that gets overlooked is declining religiosity: https://www.wsj.com/articles/is-god-the-answer-to-the-suicid....
Because that isn't a cause
Here's some excerpts on a study about religion and suicide:
>We found that past suicide attempts were more common among depressed patients with a religious affiliation
>Suicide ideation was greater among depressed patients who considered religion more important, and those who attended services more frequently
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990512/
Because that isn't a cause
Here's some excerpts on a study about religion and suicide:
>We found that past suicide attempts were more common among depressed patients with a religious affiliation
>Suicide ideation was greater among depressed patients who considered religion more important, and those who attended services more frequently
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990512/
That’s not inconsistent with the studies I linked. Yours are looking at the subset of depressed patients. Mine are looking at people in general.
>...one thing that gets overlooked is declining religiosity...
I think, maybe, you're mistaking the community that forms around religion (e.g.: churches, friendships, church groups, etc.) for religion, itself.
If the argument were that lack of religion is a precursor to increasing suicide rates, then we in Europe should be killing ourselves off in droves because we're the least religious lot (compared to our North American counterparts).
I think, maybe, you're mistaking the community that forms around religion (e.g.: churches, friendships, church groups, etc.) for religion, itself.
If the argument were that lack of religion is a precursor to increasing suicide rates, then we in Europe should be killing ourselves off in droves because we're the least religious lot (compared to our North American counterparts).
I’m speaking within an American context. The decline in organized religion in the US has been very rapid (since 1998, really, after decades of stability), and other community constructs have not arisen in their place. For example, living with parents or extended family is much less common in the US than in Italy or Spain (which have particularly low suicide rates).
Likewise, the drop in fertility rate has been steeper in the US. Rates dropped from almost 4 in 1960 to 1.8 today. Sweden dropped from about 2.5 to 1.85.
Likewise, the drop in fertility rate has been steeper in the US. Rates dropped from almost 4 in 1960 to 1.8 today. Sweden dropped from about 2.5 to 1.85.
> and other community constructs have not arisen in their place.
This is really the issue. If the Church had been replaced by some other form of community, that would be one thing, but it has been replaced by nothing.
This is really the issue. If the Church had been replaced by some other form of community, that would be one thing, but it has been replaced by nothing.
>I think, maybe, you're mistaking the community that forms around religion (e.g.: churches, friendships, church groups, etc.) for religion, itself.
If countries are having difficulty replacing it is there really a meaningful distinction? Even Europe doesn't have as much atheism or deaths of despair as the US.
If countries are having difficulty replacing it is there really a meaningful distinction? Even Europe doesn't have as much atheism or deaths of despair as the US.
> one thing that gets overlooked is declining religiosity
Maybe people are realizing that prayers don't pay bills.
Maybe people are realizing that prayers don't pay bills.
The cause has some parallels too. Despite being a nonfree repressive society, the Soviet Union provided the basic services of life to most of its citizens pretty effectively. Its collapse left them with nothing, and much of the actually valuable resources were stolen by the oligarchs who consolidated power.