Why Americans Die So Much More Than Europeans(theatlantic.com)
theatlantic.com
Why Americans Die So Much More Than Europeans
https://www.theatlantic.com/ideas/archive/2021/09/america-life-expectancy-spans-death-europe/620028/
37 comments
This and other things mentioned in the comments are all connected, especially the inequality aspect. If you don't have enough money, you save on everything, including your health. This means not just immediate health care and simple preventive measures, but also long-term approach such as a healthy life style.
One of these is the availability of highly-processed low-quality food everywhere and relative difficulty of getting higher quality food and finding the time to prepare proper meals. The substances used for conservation of foods such as sodium nitrate, sugars, etc. have overall adverse effects on health.
Moreover, the "food" industry doesn't stop here. They are trying to push the boundaries, and American institutions supposed to protect the rights of citizens are very weak when confronted with the lobbies. A good example is the infamous pink slime, approved by the FDA in 2001 but banned in the EU. Using these kinds of substances is considered a crime in Europe, and for a good reason.
One of these is the availability of highly-processed low-quality food everywhere and relative difficulty of getting higher quality food and finding the time to prepare proper meals. The substances used for conservation of foods such as sodium nitrate, sugars, etc. have overall adverse effects on health.
Moreover, the "food" industry doesn't stop here. They are trying to push the boundaries, and American institutions supposed to protect the rights of citizens are very weak when confronted with the lobbies. A good example is the infamous pink slime, approved by the FDA in 2001 but banned in the EU. Using these kinds of substances is considered a crime in Europe, and for a good reason.
Is there even an elephant in the room? Most of these other countries have effectively free access to health care, whilst millions of sick American's avoid seeking care because of the crippling debt that comes with it.
Also, I know how unpopular this opinion is, but as someone who's lived in America, several European countries, and Australia... the average American has a lower standard of living than the average European, and the bottom of society in America tends to fall much lower than the bottom in a European city.
Life is more civilized in France, Italy, Spain than in the US. Sorry :D
Also, I know how unpopular this opinion is, but as someone who's lived in America, several European countries, and Australia... the average American has a lower standard of living than the average European, and the bottom of society in America tends to fall much lower than the bottom in a European city.
Life is more civilized in France, Italy, Spain than in the US. Sorry :D
> Also, I know how unpopular this opinion is
I don't think this is unpopular at all, at least here. I've even avoided some nonessential medical care in the European country I live in due to the costs, and those prices would still be lower for nearly anything (with some exceptions) compared to in the US. I think this point is just not brought up here because it's well-enough understood in this audience that it's more useful to discuss other factors that might be more neglected, such as lifestyle, etc.
I don't think this is unpopular at all, at least here. I've even avoided some nonessential medical care in the European country I live in due to the costs, and those prices would still be lower for nearly anything (with some exceptions) compared to in the US. I think this point is just not brought up here because it's well-enough understood in this audience that it's more useful to discuss other factors that might be more neglected, such as lifestyle, etc.
I agree. Having lived, worked, and paid taxes in Denmark, England, Scotland, the US, and Australia. Most Americans have no clue and keep blindly thinking that the US is “better” than all other countries in every possible way. Completely ignoring all the statistics and real data showing that it simply isn’t true. The willingness to ignore reality is jaw dropping.
The elephant in the room is Obesity.
>> Americans die more from car accidents, not because our fatality rate per mile driven is unusually high but because we simply drive so much more than people in other countries.
This is ridiculous. I've lived over a decade on both continents and it's not the number of miles/kilometers driven that matters, it's how terrible American drivers are. In the USA I see things every 15 minutes on the interstate that in Europe I would have called the police on.
American culture seems to have this endless desire to grow, improve, escalate, promote, hustle. It permeates every single aspect of life, from home buying to what is put on the dinner table.
Live fast, die young, I guess.
This is ridiculous. I've lived over a decade on both continents and it's not the number of miles/kilometers driven that matters, it's how terrible American drivers are. In the USA I see things every 15 minutes on the interstate that in Europe I would have called the police on.
American culture seems to have this endless desire to grow, improve, escalate, promote, hustle. It permeates every single aspect of life, from home buying to what is put on the dinner table.
Live fast, die young, I guess.
Have you ever been to Italy?
Italian roads are mostly either tiny city streets or safe motorways. Deaths in vehicles I imagine are often on the intermediate roads where speed is high enough to kill but it’s not a motorway with on ramps and separators.
For example, it’s hard to find a large multi-lane 4-way intersection in Italy where both roads are over 70km/h (45mph) , meaning there is a risk of a T collision if a driver goes through the red light.
In the US this kind of intersection is pretty common, which surprises me when I drive there.
The conversion of intersections to safer roundabouts also seems to be stuck at a low % in the US compared to Europe, Italy included.
For example, it’s hard to find a large multi-lane 4-way intersection in Italy where both roads are over 70km/h (45mph) , meaning there is a risk of a T collision if a driver goes through the red light.
In the US this kind of intersection is pretty common, which surprises me when I drive there.
The conversion of intersections to safer roundabouts also seems to be stuck at a low % in the US compared to Europe, Italy included.
The design of roads and intersections is a great point. I've seen a number of them in the US that I found hard to believe had ever been through any kind of planning / design phase.
ive driven almost everywhere from nepal to zimbabwe ,and i gotta say american drivers are among the best behaved in the world
you should try Rome or, dog forbid, New Delhi to see what bad driving looks like
you should try Rome or, dog forbid, New Delhi to see what bad driving looks like
I don't know how to tell you this, except to say that how terrible drivers are is summed up in the fatalities/mile statistic, and the number of miles is indeed important here. The way you are responding is completely counter but you don't provide any evidence. If what you said was true then the fatality/miles ratio would be much higher.
Here’s evidence: Amongst OECD countries, US is near the bottom. One EU country is slightly worse (Belgium), Czechs are twice as bad, and every other EU country is better, the biggest at least a third less, the best being well under half the US rate of fatalities / km:
https://statlinks.oecdcode.org/752017011P1G002.xlsx
https://statlinks.oecdcode.org/752017011P1G002.xlsx
Yes, that is shown in the study where the author makes a link for the claim. Figure 2 of [1] even shows this, and by eyeball alone it looks like it is closer to 4X more. The point I'm trying to make is that the people who published this graph, who cited the original study, are saying that the total number of fatalities appears to be more impacted by the total miles driven rather than the rate. I tried to dig up where the comparison of miles driven is made but was unable.
In any case, the principle point is that while you are correct that American's have a higher fatality rate, if we are also driving significantly more then that could be a bigger problem. If we have 4X the rate, but 10X the miles, it would seem reasonable to say that the distance is the biggest factor.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112220/#SD1
In any case, the principle point is that while you are correct that American's have a higher fatality rate, if we are also driving significantly more then that could be a bigger problem. If we have 4X the rate, but 10X the miles, it would seem reasonable to say that the distance is the biggest factor.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112220/#SD1
Uh, no. I lived in Belgium for almost eight years, and I drove in many European countries over the years.
In every single country I drove in, they are much worse than the average American driver. In some places, like Paris and Rome, they are much, much worse. I managed to survive in Paris and Rome, but only barely.
To this day, when driving in the US, I hold this knowledge in reserve, for those rare times when I do need to be more aggressive and “Drive Belgian”.
In every single country I drove in, they are much worse than the average American driver. In some places, like Paris and Rome, they are much, much worse. I managed to survive in Paris and Rome, but only barely.
To this day, when driving in the US, I hold this knowledge in reserve, for those rare times when I do need to be more aggressive and “Drive Belgian”.
Take a drive down i95 or i495 in Massachusetts...
You barely survived, you say.
Two weeks ago I was in Italy, in one of the big cities, on a very heavily loaded cargo bike, and I made a mistake in a roundabout. Almost took the wrong exit and corrected too late. No problem — a car driver I cut off seemed to know the mistake before I did and slowed down to make space for me just in case.
If that's worse then the US, then the US must be heaven for cyclists.
Two weeks ago I was in Italy, in one of the big cities, on a very heavily loaded cargo bike, and I made a mistake in a roundabout. Almost took the wrong exit and corrected too late. No problem — a car driver I cut off seemed to know the mistake before I did and slowed down to make space for me just in case.
If that's worse then the US, then the US must be heaven for cyclists.
What are you talking about? Drivers in Paris are scary. I prefer US drivers.
When one corrects for obesity, this usually goes away. Put it another way, American obesity and metabolic disease can almost entirely account for the gap.
Regulation prevents market forces from correcting the gap. For example, insurance cannot charge higher premiums based on weight or lifestyle health status.
Regulation prevents market forces from correcting the gap. For example, insurance cannot charge higher premiums based on weight or lifestyle health status.
Insurance does charge higher for smokers and that is certainly a "lifestyle health status".
I quote at length: "Infants in the U.S. are considerably more likely to die in the poorest counties than in the richest counties, and this is true for both Black and white babies. Black teenagers in the poorest U.S. areas are roughly twice as likely to die before they turn 20, compared with those in the richest U.S. counties. In Europe, by contrast, the mortality rate for teenagers in the richest and poorest areas is exactly the same—12 deaths per 100,000. In America, the problem is not just that poverty is higher; it’s that the effect of poverty on longevity is greater too."
Are you suggesting that obesity makes a difference in the US but not in Europe? Or perhaps that obesity varies in the US but is uniform in Europe?
Are you suggesting that obesity makes a difference in the US but not in Europe? Or perhaps that obesity varies in the US but is uniform in Europe?
Obesity rates are significantly higher in the United States than in Europe. https://ourworldindata.org/obesity#what-share-of-adults-are-...
Yes, but if GP is right (and I understand correctly) then that should lead to a sloped graph for Europe and (significantly higher on the sheet) sheet another sloped graph for the US.
Whereas what the report finds is a flat line for Europe and a sloped graph (higher up) for the US.
Whereas what the report finds is a flat line for Europe and a sloped graph (higher up) for the US.
The other factor in Europe is the healthcare system. They have universal healthcare, and we don’t.
So, if you don’t have insurance in the US and you’re in a poor neighborhood, then yes — you’re likely to have a lower standard of care.
But in Europe, everyone has state-provided insurance, and the quality of healthcare is much more consistent.
So, if you don’t have insurance in the US and you’re in a poor neighborhood, then yes — you’re likely to have a lower standard of care.
But in Europe, everyone has state-provided insurance, and the quality of healthcare is much more consistent.
Most would agree that at least the richest in the US have better care than the lower percentile ms of Europeans. The outcomes according to the article suggests that even the richest don’t reach European longevity.
There could be multiple factors overlapping here though I suspect. For all but the richest, public healthcare helps, but for the richest the obesity gap closes any benefit in healthcare (diminishing returns in better care easily overshadowed by even slightly worse lifestyles).
There could be multiple factors overlapping here though I suspect. For all but the richest, public healthcare helps, but for the richest the obesity gap closes any benefit in healthcare (diminishing returns in better care easily overshadowed by even slightly worse lifestyles).
Until recently, insurance companies could refuse entirely to cover a "preexisting condition" such as obesity. Those market forces were good for noone but insurers.
Can you share sources/data?
The fact that Americans are so obese it’s draining down their lifespan in a collective way is still something that sounds worthy of study.
The fact that Americans are so obese it’s draining down their lifespan in a collective way is still something that sounds worthy of study.
Those market forces are present in Europe?
Obesity is a big factor cough but there are others.
I found this article (https://ourworldindata.org/us-life-expectancy-low) that shows a number of factors that contribute to the higher American mortality rate. Unfortunately it does not cover ALL causes of death, though if you want, you could independently investigate that[1]. Compared to Western Europe, Americans die at higher rates from smoking, obesity, homicides, opioid overdoses, and road accidents. There are two other graphed factors that don't have an option to compare with "Western Europe", but on those, it's relatively plain that the United States has a significantly higher infant mortality rate and significantly less access to healthcare.
And then there are suicide rates, which have increased some in the United States, but which are middle of the road compared to European countries (France is higher, Germany's about the same, Italy, the UK, and Norway are lower... I did not check these exhaustively). You'll have to click the button on the graph to change the country and then add up the rate by each age to get a comparison. I suppose the middle-range American suicide rate didn't fit the narrative of the article, but the author still wanted to highlight it as a concern given that it's been going up in the United States.
(Unfortunately, not every graph shows the same set of countries compared to the United States, which makes me think the author chose to cherry pick countries for specific graphs, and I'm not sure why, because it doesn't seem necessary. For example, the graphs in the article allow you to choose additional countries and sometimes regions to add to the graph; if I add "Western Europe" to each graph where it's an available option, the trends that the author is illustrating are completely preserved.)
[1] https://ourworldindata.org/causes-of-death
I found this article (https://ourworldindata.org/us-life-expectancy-low) that shows a number of factors that contribute to the higher American mortality rate. Unfortunately it does not cover ALL causes of death, though if you want, you could independently investigate that[1]. Compared to Western Europe, Americans die at higher rates from smoking, obesity, homicides, opioid overdoses, and road accidents. There are two other graphed factors that don't have an option to compare with "Western Europe", but on those, it's relatively plain that the United States has a significantly higher infant mortality rate and significantly less access to healthcare.
And then there are suicide rates, which have increased some in the United States, but which are middle of the road compared to European countries (France is higher, Germany's about the same, Italy, the UK, and Norway are lower... I did not check these exhaustively). You'll have to click the button on the graph to change the country and then add up the rate by each age to get a comparison. I suppose the middle-range American suicide rate didn't fit the narrative of the article, but the author still wanted to highlight it as a concern given that it's been going up in the United States.
(Unfortunately, not every graph shows the same set of countries compared to the United States, which makes me think the author chose to cherry pick countries for specific graphs, and I'm not sure why, because it doesn't seem necessary. For example, the graphs in the article allow you to choose additional countries and sometimes regions to add to the graph; if I add "Western Europe" to each graph where it's an available option, the trends that the author is illustrating are completely preserved.)
[1] https://ourworldindata.org/causes-of-death
Wait, France has a higher suicide rate than the US? I find that to be quite surprising.
"Infant mortality" plays a big role in life expectancy. The dividing line between a stillbirth and infant mortality can be a very fine line and varies widely in the developed world.
Strangely enough, the combined term (stillbirth + infant mortality) doesn't vary nearly as much. That says there's a big data problem with counting infant mortality, and thus a big data problem with life expectancy.
Strangely enough, the combined term (stillbirth + infant mortality) doesn't vary nearly as much. That says there's a big data problem with counting infant mortality, and thus a big data problem with life expectancy.
Everyone here knows the answer; it's barely worth an entire article.
In the USA there is a poorer segment of society that has much worse healthcare than the equivalent in European countries.
This is because they do not have the good health insurance policies that are needed to have good healthcare; even with insurance they can't afford the deductibles. This is largely because richer Americans get their good health insurance from their good jobs. It is also because poorer people's lives are more chaotic because life is harder.
In Europe those people's lives are similarly chaotic due to the struggle of living on low income in a low income area, but they have access to good free healthcare in many countries, and fairer insurance schemes in others.
In the USA there is a poorer segment of society that has much worse healthcare than the equivalent in European countries.
This is because they do not have the good health insurance policies that are needed to have good healthcare; even with insurance they can't afford the deductibles. This is largely because richer Americans get their good health insurance from their good jobs. It is also because poorer people's lives are more chaotic because life is harder.
In Europe those people's lives are similarly chaotic due to the struggle of living on low income in a low income area, but they have access to good free healthcare in many countries, and fairer insurance schemes in others.
I was surprised to see no examination of the American healthcare system vs. those of the European countries listed anywhere in the article.
Doesn't it make sense to see life expectancy fall for every age category when every age category and group have to contend with the same byzantine and terrifying medical industrial complex to get even the most basic care?
Doesn't it make sense to see life expectancy fall for every age category when every age category and group have to contend with the same byzantine and terrifying medical industrial complex to get even the most basic care?
My understanding is that "healthcare" in the sense of going to the Doctor doesn't impact life expectancy all that much. Public health on the other hand - think drinking/smoking/driving/diet/exercise/suicide - has a bigger hand to play. Somewhere else in this thread there was also mention of the potentially large effect of the way that you measure infant mortality.
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>"Psychologist Nancy Adler has demonstrated that how people rate how they are doing, relative to others, is at least as predictive of health or illness as are any objective measures such as actual income level, and research by epidemiologists Richard Wilkinson and Kate Pickett has shown that by just about every health indicator—infant mortality, overall life expectancy, obesity, you name it— inequality can be even worse than poverty. In the Whitehall studies, Marmot found a fourfold difference in rates of cardiac disease mortality between the lowest and highest rungs of the British Civil Service, despite the fact they were all paid a living wage"
All of the outcomes based effects on death in this article are of course real, but it's astonishing that, according to the research of Sapolsky and others, inequality itself can cause stress and inflammation responses that can account for up to half of perceived difference in health outcomes.
American society by and large is simply significantly more stressed and it has real impact on the biology of the population.
[1]https://newrepublic.com/article/153870/inequality-death-amer...