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What's killing us? (econlib.org)
20 points by dxbydt 11 days ago | hide | past | web | 19 comments | favorite





> 4. Most of these leading killers are themselves mainly caused by old age. If "Old Age" were a category, it would be causing by far the majority of deaths. Again, it's not the case that nothing could be done about this. We could be doing much more medical research on aging.

I guess most of this article's discussion makes some sense, up until the point above. There will always be a top ten causes of death but those causes wouldn't always be interesting. If we lived 120 able-body-and-minded-years, I would call that success or at the very least progress. How would this top ten graph look then? Probably not very different. Before I read #4 I thought to myself: "gee, as long as we're dying of old age, then that's probably a really good sign." The author draws almost the opposite conclusion.

"We could be doing much more medical research on aging" -- yes, that's fair. What if research on aging led to us dying of Cancer and Alzheimers ten years later than the baseline? Twenty? Again, progress, but it wouldn't be reflected in this graph.

What might be a really useful use of this data is to show a fifty or hundred-year-ago baseline. What if fifty years ago the pareto included causes like auto collisions or home fires? If that were the case we might want to have some clever quip like: "Regulations: the silent lifesavers." (Regulations are often depicted as tools of the evil bureacracy).


Seems a bit of a stretch to say 'There are AIDS activists because there are people who want to express sympathy for gays, to align themselves against conservatives, and thereby to express "who they are". There are AIDS activists, but there aren't any nephritis activists.'

AIDS is a preventable in many cases if people practice safe sex - something that was not commonly known and/or a taboo topic for a long time. Activists helped change that situation, saving many lives.

If there were Nephritis activists, what exactly would they be doing? What sort of public awareness would they be promoting?

And then there is this: 'There are breast cancer walks, but there aren't any colon cancer walks.' Breast cancer can be prevented by frequent tests and self-examinations. Colon cancer cannot. Breast cancer awareness helps teach woman and society that tests and examinations should be done: not doing this simply because colon cancer is more prevalent (is it though?) seems a rather idiotic utilitarian argument.


> Breast cancer can be prevented by frequent tests and self-examinations. Colon cancer cannot.

Is that true? I was under the impression that colonoscopies can reveal polyps which can be removed, thereby preventing progression to full-blown colon cancer.


You're right, but my point is probably still valid: a quick check suggests women over 40 should get a breast exam every year, while men and women should get a colonoscopy every ten years, starting at 40.

It is very instructive to listen to Atul Gawande's series of Reith Lectures from a few years ago here.

in "the problem of hubris" (http://www.bbc.co.uk/programmes/b04tjdlj#play , transcript http://downloads.bbc.co.uk/radio4/open-book/2014_reith_lectu... ), he makes the very fair point that death is, ultimately, not something we can "fix".

We’ve had I think an about 50 year experiment with medicalising mortality, with casting it as just another problem for us to treat like any other, and I think that experiment is failing. But we have an alternative emerging. It’s one where we learn and elicit what matters most to people in their lives besides just surviving, and then we use our capabilities not to sacrifice it but to protect, to protect it – to protect those priorities that people have. And I think that is our opportunity.


As pointed out in the comments section, the chart does not account for years of life lost, simply numbers of lives. I'd be interested with whether the ex-post explanation still applies if we did a simple transformation like weighted each category by average age of death. Suicide, homicide and drugs skew a lot younger than heart disease.

That's a great point. An elderly man dying of heart disease may be sad, but not tragic in the way a 20-year-old overdosing on heroin is.

It feels like the author of this piece lists a variety of interesting observations, some useful facts, and then completely misses the boat.

As a society we put effort into finding ways to help sick people that are not old because we can generally expect them to have a good number of productive years if they are cured. There's a good return value, and it feels just.

This isn't the case with older folk. At a guess, if we found a magical way to cure heart disease and completely take it off the list there, most of those people will still die, a few months/years later, from something else (cancer maybe, or that very descriptive "other" block).

Old age isn't just some single disease we can fix, its a general purpose failure of the body. If you can heal that in a cost effective way (or in any way, really), congrats, you're a trillionare, but I'd bet we'll see full-body cybernetics before we figure out a way to cure aging.


To be fair, not everyone dying of heart disease is old.

Don't represent 1-dimensional quantities like proportions or numbers of people as area. This is actively misleading because area it squares the magnitude of differences.

> There are AIDS activists because there are people who want to express sympathy for gays, to align themselves against conservatives, and thereby to express "who they are".

Millions of people have died of AIDS, and more are dying every day (around 18 per day in the U.S. as of 2014, according to https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...). If your friend or family member died to AIDS, wouldn't you advocate for its prevention and treatment? To say that these activists are fighting simply to "align themselves against conservatives" is insulting, to say the least.

> There are no nephritis activists, because there's no salient group you align yourself with (kidney disease sufferers?) by advocating for nephritis research, there's no group you thereby align yourself against, and you don't tell any story about what kind of person you are.

What about organizations like this? http://advocacy.kidney.org


> Millions of people have died of AIDS

Note, people don't actually die of AIDS. They die of something else, that their body can't fight because they have AIDS. Which leads to the interesting question: what counts as a death by AIDS in those statistics? Are some deaths that might be rooted to AIDS not included somehow because of causality uncertainty? (it's not because you have AIDS and die that you died because of it)

> around 18 per day in the U.S. as of 2014

That's... less than 7000 a year, so according to the data from OP, less than homicide (15k), or illegal drugs (17k).


From the hiv.gov page: In 2014, there were 12,333 deaths (due to any cause) of people with diagnosed HIV infection ever classified as AIDS, and 6,721 deaths were attributed directly to HIV.

I'd dispute both the claim that nobody talks about heart disease, especially in relation to obesity, and also the claim that we "know" how to get people to lose weight in any but the most literal and useless sense. By my second point I mean to say, sure, we know that what we want to achieve is a caloric intake/use rate that leads to weight loss followed by a steady weight, but the real-world success percentage of people trying to do this is abysmal.

>Hypothesis: We don't much care about the good of society.

"We" is a very big blanket term. Quite a few of us care about preventable deaths from bad health choices.

However, quite a few people on this Earth exist that don't care very much about the good of society.

These people run the corporations that are VERY GOOD at selling things that kill us, namely junk foods, alcohol and tobacco.


Well, also, for any given problem, one might feel like the cure proposed is worse than the disease. Maybe we could "solve" obesity by strictly rationing every person's daily food intake and not allowing them to eat anything else besides what they've been provisioned. Who wants to live in that world?

Definitely not I, it's true :)

The nihilistic reality is that none of this matters, everyone will do what they want, people will profit, others will die.

All I ever try to do is provide true information- the user will need to draw their own plan of action from it :)


the image is completely illegible here: http://econlog.econlib.org/archives/Willis/huemer2.jpg

The illegible labels on this non-enlargable chart are currently what’s killing me.



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