
U.S. life expectancy declines for the first time since 1993 - Deinos
https://www.washingtonpost.com/national/health-science/us-life-expectancy-declines-for-the-first-time-since-1993/2016/12/07/7dcdc7b4-bc93-11e6-91ee-1adddfe36cbe_story.html
======
notadoc
The undeveloping world.

Widespread obesity, poor diet, sedentary lifestyles, the uniquely inefficient
health care system, wealth inequality, etc, will likely cause overall
expectancy to drop further.

Related and interesting:

> "As of 2010, the average, upper-income 50-year-old man was expected to live
> to 89. But the same man, if he's lower income, would live to just 76,
> according to the report."

[https://www.washingtonpost.com/news/wonk/wp/2015/09/18/the-g...](https://www.washingtonpost.com/news/wonk/wp/2015/09/18/the-
government-is-spending-more-to-help-rich-seniors-than-poor-
ones/?utm_term=.2ff0f4046c66)

~~~
yummyfajitas
While life expectancy is strongly correlated with income, it's actually
uncorrelated with inequality and access to health care.

[https://jamanetwork.com/journals/jama/article-
abstract/25135...](https://jamanetwork.com/journals/jama/article-
abstract/2513561)

~~~
xaa
It's difficult to interpret this because the paper defines income throughout
the text in terms of income _quantile_ (not absolute, COL-adjusted levels).

And oddly, in the FT, they show a significant negative correlation b/t Gini
index and life expectancy in the _upper_ quartile, and not the lower quartile
(you'd expect the opposite). In the lower quartile, it is p=0.11, r=0.2; i.e.,
a nonsignificant _positive_ association between income inequality and income
quartile. This suggests the effects of income inequality might actually affect
LE in different directions for high and low earners. This would explain why
they say in the abstract they don't see a LE-Gini correlation for the
distribution as a whole.

The story I would spin is that, within one geographic region, a high Gini
actually means that rich and poor are living in proximity and sharing social
structures. If you have low Gini in a compact region it likely means everyone
there is (uniformly) poor.

IOW, they very likely have a correlation b/t Gini and income levels they
aren't controlling for. This is why we use multivariate regression with
interactions, not just run a Pearson between every pair of variables. The
statistics in this article are really bad. JAMA strikes again.

------
gressquel
I was kind of wondering how this didnt happen earlier. I have been to US 3
times. NYC, Vegas, San Fran, Los angeles etc. and one thing I noticed was how
unhealthy alot of americans lived compared to europe.

Obsese parents together with children as small as 6 years old were all dining
at fast-food restaurants eating massive amount of food. The kids were very
obese too.

The entire culture seemed for _me_ as its rather normal to eat your dinner at
kfc or mcdonalds than making food at home. When we took the flight fra NYC to
Vegas we noticed there were more obese people than "regular sized". But when
we took fra SF to London it was opposite.

And whats up with the size of the meals served in restaurants? its huuge. alot
food for little money. Sometimes we split one dish in between us because it
was too much for a single person. The same when we went to movies, we got to
choose size of coke and popcorn. So we picked medium coke. Medium is like
extra-large in europe.

I think its sad because americans are missing out on really great food. It is
the food you cook yourself thats not only healthy but tastes so much better
and authentic.

I hope nobody is offended my post but I just felt its an area to improve on.

~~~
vinay427
> tastes so much better and authentic.

I agree with most of your post as I am fortunate to have been exposed to food
cultures outside the US, but I disagree with this point. Many people either
can't or won't cook food that is "authentic" to any reasonable standard
especially if it is, to them, a foreign cuisine. This applies in basically
every country around the world. That being said, I don't think the goal of
good food is to be "authentic" if restaurant critiques are any indication.

~~~
openfuture
I think you have different understandings of the word 'authentic' in the
context of food.

~~~
vinay427
Could you clarify what your definition is in this context?

~~~
gressquel
I think I left it open to misunderstanding, but what I meant by authentic in
this context was "shortest and less-tampered path from nature to ingestion".

Foe example, in restaurants they may have frozen meat for long time or in bad
condition. Vegetables and sauces maybe be re-used. Unknown ingredients may be
mixed to enhance taste, color or smell.

By authentic you kinda go to your local fishmarket, buy the fish (in here we
got fresh non-frozen), buy groceries and make that food the same day. By
making the food yourself you know what you are putting inside your mouth :)

sorry for any misunderstanding, English is not my first language.

~~~
vinay427
That makes more sense. I assumed that by "authentic" you meant "genuine,
traditional, etc."

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quickConclusion
Let's quickly interpret this to further our pre-existing agenda (healthcare,
guns, environment, vaccination, inequality, obama, immigration...)

~~~
eli_gottlieb
Well, without mentioning an agenda, stress causes heart disease. Obviously if
we could do something so that people could stress less, exercise more, and eat
fresh food more often rather than processed food, heart disease would drop and
people would die less.

~~~
yummyfajitas
There are quite a few things we could do in this direction.

For example, we could provide mandatory calisthenics classes for people on
medicaid - think some sort of watered down military PT class. If you need
medicaid, you need to show up daily and do jumping jacks.

Similarly, we could replace food stamps/welfare/etc with a government-issued
basket of healthy vegetables, complete with printed instructions on how to
cook them.

Utah has been having great success helping the poor with (secularized) Mormon
style paternalism. Perhaps the rest of us can learn from them.

[http://www.npr.org/2015/12/10/459100751/utah-reduced-
chronic...](http://www.npr.org/2015/12/10/459100751/utah-reduced-chronic-
homelessness-by-91-percent-heres-how)

~~~
eli_gottlieb
>Similarly, we could replace food stamps/welfare/etc with a government-issued
basket of healthy vegetables, complete with printed instructions on how to
cook them.

While many people don't have good cooking instruments where they live, I do
think making at least part of food aid into a direct provision of healthy
fruits and veggies, including those which can be eaten raw-at-worst, would be
a large improvement. Honestly, at this stage, government-run cafeterias
serving healthy food for free to anyone in need would be a massive
improvement.

It's a pity that people have such negative feelings about "paternalism" that
they'd rather give out food stamps for buying rice and beans at inflated
convenience-store prices than actually let the government provide healthy food
directly.

------
djklanac
The quality of available food in the US is a big part of the problem. A recent
TED speaker postulates 74% of food in the average US grocery store is spiked
with added sugar [1]. We also eat too few vegetables and too much meat in our
diets. And those foods are often raised with harmful pesticides and hormones
respectively.

I am a discerning shopper, avoid fast food and still get surprised by food
that is not good for me. For instance, I put a tiny amount of unflavored, low-
fat half & half in my coffee in the morning. I checked the label today and see
that it contains corn syrup. In my head, it was just skim milk and cream.
Silly me.

[1] [http://www.npr.org/2016/11/18/502171330/how-worried-
should-w...](http://www.npr.org/2016/11/18/502171330/how-worried-should-we-be-
about-sugar)

~~~
0xffff2
Could you post a link to/picture of said half & half? I have a very hard time
believing it's legal to call something with corn syrup in it "half & half" (as
opposed to "creamer" or something similar).

~~~
tomjakubowski
It's commonly found in "fat-free" or "skim" half & half, along with thickening
agents. You're right, it's pretty awful that this crap is labeled as "half &
half".

Here's an example: [https://www.landolakes.com/products/half-half-and-
whipping-c...](https://www.landolakes.com/products/half-half-and-whipping-
cream/half-half/land-o-lakes-sup-reg;-sup-fat-free-half-half/)

------
smaddali
one interesting note is that life expectancy at 65 years of age did not
change, Indicating that the diseases behind the lower life expectancy occur in
middle age or younger. The reasons behind the decrease. [deaths per 100K
population] The heart disease went up from 167 to 168.5 Also'Unintentional
Injuries' went up from 40.5 to 43.2.

On the positive side, the contribution of cancer has come down.

~~~
killedbydeath
People die of cancer if they don't die of something more treatable before that
so lower cancer contribution may be not for a good reason.

------
woodandsteel
Life span lessens, but food industry and health care industry profits have
never been higher. Could there be a connection?

------
yk
Probably just random variance. In particular, that most categories of cause of
death increased seems to point at random chance, since they should not
correlated strongly. (But this is probably something to watch next year.)

~~~
othello
Shouldn't this be exactly the contrary? If you have 10 independent coin flips,
the chance of getting 10 heads is < 0.1%, while if they are perfectly
correlated, then it simply becomes 50%.

Having 10 independent causes of death going up simultaneously is very unlikely
to be caused by random chance. Rather it's an indication of an external
phenomenon influencing all causes simultaneously.

~~~
yk
The argument is the other way round, they should not be correlated, or if they
are correlated they should be correlated in an obvious way, therefore it is
likely random chance compared to the situation were suddenly there is a spike
in violent death because of nuclear war or something.

------
bediger4000
What are we to make of this? Should this data be considered at all?

~~~
brianwawok
Eat healthy, exercise, don't smoke, stay a good weight.. you will do better
than average, on average. I think this is all just a trend of our not healthy
culture. If over 10 years everyone gains 10 pounds, your life expectancy is
not going to do awesome things.

~~~
CardenB
Is there evidence that our culture is becoming less healthy? It seemed to me
that we, meaning the US as a whole, have been building better habits.

I feel that this is an economic issue more than anything else.

~~~
mikestew
_Is there evidence that our culture is becoming less healthy?_

A trip to any U. S. major theme park ought to do the trick, preferably one of
the ones around Orlando.

 _It seemed to me that we, meaning the US as a whole, have been building
better habits._

I hesitate to pull the "you live in a bubble" card, but I think it applies
here. If I looked around me here in Seattle, I might agree with you. Buncha
fit hiker/snowboarder types driving Subarus on their way to the xTREME Mudfest
This Is Sparta Run Sponsored by Rockstar Energy Drink. You have nothing in
your profile for me to go on, so I'll go with assuming you're a
20/30-something bro living around SV who's into running/biking/whatever like
all of your friends. You look around and go, "obesity problem? What obesity
problem?"

Then I hop on a plane to visit my parents in Florida, and the bubble pops.
O...M...G, when did children turn into such butterballs? Oh, that explains it:
look at their parents. Pictures of friends in the Midwest? Same thing: when
did my classmates get so fat? Again, I don't know your background, but if
you're basing your opinion on what you've seen on the west coast, you're doing
it wrong.

~~~
munificent
If you think Florida is bad, try Appalachia. I moved from Orlando to Seattle
and earlier this year took a trip to Gatlinburg. The obesity there was just
insane.

~~~
mikestew
Good point; sadly it's been a good ten years since I've been near the NC
mountains and I've forgotten. I have no reason to think it has improved.
Though the fact that the wife and I lost weight when we moved from NC to
Seattle ought to tell you something.

------
jcl
I believe this is the actual report:
[http://www.cdc.gov/nchs/data/databriefs/db267.pdf](http://www.cdc.gov/nchs/data/databriefs/db267.pdf)

I noticed that the "top ten cause" chart doesn't have an "other" column, but
it looks like that can be computed from the total rates for top ten causes and
the total for all causes. If my math is correct, we went from 191.3 (2014) to
191.1 (2015). So I guess the good news is the death rate from unpopular or
unexplained causes went down a little. :|

------
duaneb
Why does this metric matter so much to so many people? Why not quality of
life?

~~~
mc32
It's an imperfect proxy for how well a population is doing. But, yes, yours is
a question we should peer into to know whether the presumption of longer life
= unqualified good.

That said, in this case, it's believed self-kill and opioid overdosing are
contributing to this trend and those are not good contributors.

------
dgudkov
Why wouldn't it decline if the middle class is shrinking?

------
disposablezero
It's another in a long line of examples underscoring massive inequality, but
it's about to be made moot by the 100's to 1000's of gigatons of methane (5 GT
in the air right now) from just the ESAS going to push global warming into the
+4C to +6C range within a decade. Global famines, wars, mass migrations and so
on. If a person today doesn't have a completely self-sufficient, off-the-grid
refuge in the far north or south, that person is suicidal or a Christian
fundamentalist praying for rain.

