Which is to say almost everybody knows this, very few people live it. The toughest battle isn't yet again telling people that 1+1=2, but rather figuring out ways to make it more accessible to people (read: cheap, low time commitment) and more sustainable as a lifestyle.
That's why ideas like HIIT and IM are interesting, not because they're superior to getting doctor recommended levels of exercise and eating the recommended nutrition but because people actually do them and stick to them, and they're "less bad" then doing nothing.
"Perfect is the enemy of good" is the enemy of people's health too, and the medical profession obsessed over what the Greek God tier lifestyle should look like while ignoring "easy wins."
Do you have data to back this up? I would have thought the exact opposite. That HIIT and IM are techniques that people try after having seen a Ted talk or something like that and don't make a life discipline out of them.
I also think plenty of people have some "common sense discipline" such as cycling/walking to work, and not eating junk food and sodas, and trying to eat fruits and vegetables. I feel this is very sustainable with a high ratio benefit/cost.
All it really is to me is skipping breakfast and not snacking after my evening meal. I only ever had breakfast because people told me it wasn't healthy to skip it. Not so sure they were right now. I still pig out at lunch, dinner and in between times.
In general electric measurements of body composition are just toys and not to be relied upon.
Intermittent exercise: https://www.nature.com/articles/0800533
> I also think plenty of people have some "common sense discipline" such as cycling/walking to work, and not eating junk food and sodas, and trying to eat fruits and vegetables. I feel this is very sustainable with a high ratio benefit/cost.
I agree. Those are also examples of "easy wins." We need more of exactly that, maybe even with support (e.g. cataloguing your life and looking for such wins). IM and HIIT are only as good as their adherence rates, but anything that people will stick to is worth serious evaluation and promotion.
> Results: Dietary adherence remained high throughout the controlled food intake phase (days adherent: 86%) and the self-selected food intake phase (days adherent: 89%).
> For both groups, moderate intensity, intermittent exercise showed excellent adherence and this may be a useful model for future research studies.
So I'm not sure, having read both links, you came to the conclusion that it "doesn't prove my claims." They both very directly do.
I was actually surprised by the low adherence rate. The studies were done on small sets of folks for a very short period of time (2/8months) with little effort to adhere and yet the participants couldn't even do that. I figured adherence rates for this would actually be 100%. After all, the researchers asked for 6 minutes a day, 5 days a week.
The question I was interested in is roughly: If i randomly select 1000 people from the population and introduce them to HIIT, how many will do it 3-5 times a week 6/12/18/24 months after the introduction without any reporting and supervision?
Again, sorry if i am totally misunderstanding the links.
Yes, that's generally how studies work.
> The studies were done on small sets of folks for a very short period of time (2/8months) with little effort to adhere and yet the participants couldn't even do that.
You have to view it in context, diet and exercise changes have a very low adherence rate historically. It may be "low" but even that is a marked improvement over a lot of the alternatives.
You asked for data that showed these strategies had good adherence rates, which I provided. I could find additional studies, but those too would have a scope and would therefore be dismissed just as readily. I don't have a population-level study to link.
I don't HIIT because I think it's more for runners (and I cycle), but Intermittent Fasting has been the easiest adoptable technique for me to keep my calorie intake in check. Just count the hours, really. I try to push a little bit more fasting hours than the typical 16:8, more like 18:6, and stick to a low carb, high fat sorta diet. I've been doing this for eight years and I don't see me stopping that soon, it's so simple to follow. There's no TED talk (not that I have seen one on IF) that can convince me more than direct first hand experience.
Establishing habits is difficult and complex. Finding highly efficient (in time, energy, drudgery, money, etc) ways to achieve a desired outcome is a critically important cornerstone of that process, in my experience.
Try this on—all you need is a little space: https://www.youtube.com/watch?v=q20pLhdoEoY
I hate gyms as well (I see them as a necessary evil these days). Personally I grab my bike and go mountain biking a lot. Not HIIT per-se, but very spikey bursts of effort.
You could accomplish some high quality interval work with a simple road bike (a hill helps) and a good attitude. The benefit to this being far less impact compared to sprints.
Just be a little careful starting with high intensity stuff - you want to slowly ramp this up over a handful of weeks or more. True high intensity work with insufficient muscle conditioning is a quick way to get injured (think ham/glute/calf pulls, tears, etc), and you do need to be careful when ramping up the cardio side - heart issues aren't fun.
For me, one beautiful thing about sprinting is that you can do it anywhere you have a sufficiently lengthy stretch of open, flat ground. You can also shorten the sprint and do more of them to accommodate less permissive situations. I've even done wind sprints in my basement!
But there are also more specialised classes if you have some equipment or are a certain body composition (e.g. easier on the knees).
The same can be said of any beneficial practice while it's trendy. HIIT and intermittent fasting are trendy right now. Nothing can stop the wheel of fashion from turning, so let's wait and see if they still stand out as "something people actually do" when they're passé.
Of course you can improve your odds, but acting like sickness is some sort of personal failing is a bad mentality, and one of the reasons American health care is so messed up.
"We observed a relatively small difference in life expectancies across different levels of alcohol consumption compared with other individual lifestyle factors. The cardiovascular benefits of moderate alcohol consumption have been consistently observed in large cohort studies, but alcohol consumption and risk of cancer showed a dose-response relation. Thus, current guidelines do not encourage a non-alcohol drinker to start drinking just for the benefit of preventing cardiovascular disease."
In the US daily drinking seems to be seen as bad (perhaps a legacy of prohibition?) while binge drinking once a week doesn't seem to be seen as particularly problematic.
We can work towards drinking from two directions: self report consumption and alcohol sales ought to lead to the same number. Not perfectly of course - drinks get thrown away, saved as gifts, used to cook, and so on. But last I looked, the ratio of drinks sold to drinking reported in the US was two to one. (I'd love to see the same data for other countries.)
So either people understating their drinking by a huge amount, or the studies are undersampling groups that do a lot of drinking. Probably both. We can make some good guesses: minors probably don't admit to their drinking, teetotalers probably self-report more accurately than occasional drinkers, and so on. But it's a gap so big that it's hard to talk confidently about what people here are doing.
I don't understand what you mean.
Public Health advice on alcohol in the UK has been pretty consistent for many years. There are 3 changes: the limits for men went from 21 units a week to 14 units a week; the advice to pregnant women to avoid all alcohol became stronger; and the advice about not allowing under 18s to drink alcohol became stronger.
In 1987 the advice was pretty close to what it is today.
We don't know if there's a safe limit
men should drink no more than 21 units per week
women should drink no more than 14 units per week
both men and women should have 2 to 3 days drink free
the total number of weekly units should not be drunk in 1 or 2 bouts.
> The most significant change to the Government guidelines was the move from weekly limits to daily limits.
"Drinking every night" = "[at least] 1 beer / night" in the minds of people who associate drinking with beer. There's no such thing as consuming a small glass of beer as it's not really a beverage you savour.
I doubt your claim that this sort of beer savouring is "common in US bars" (or if it is commonly available, I doubt that it is commonly ordered).
To put it another way, compare the amount of alcohol ingested on an average evening where beer was the primary beverage vs. an average evening where wine was the primary beverage.
I don't have data to back this up and it's not like I drink heavily myself, but my instinct and experience tells me alcohol-for-wine consumption is much lower than beer's, and so it is in most people's minds.
1. Drinks per week, eg 14 drinks/week
2. Average drinks per day, eg 4 drinks/day
If you drink your entire drinks per week in a day, that's really bad. If you drink your average drinks per day, every day, that's also bad.
For others who might be reading this: You should have some days (ideally a majority) in which you don't drink at all, some days in which you drink at or below the daily guideline, and you probably aren't all the worse off if you occasionally exceed the daily average guideline.
also collected alcoholic beverage consumption, including red and white wine separately (4 ounces, increasing to 5 ounces in 2006), beer (one glass, can, or bottle), and liquor (one drink or shot). We multiplied the amount of alcohol in grams per specified portion size by servings per day, determined the midpoint of the frequency category, and summed across all beverages to estimate the average alcohol consumption (g/day). We defined moderate alcohol consumption as 5-15 g/day for women and 5-30 g/day for men
Surely it cannot be 4 bottles of beer daily (or 4*7 bottles on weekend).
> A unit of alcohol is 8g or 10ml of pure alcohol, which is about:
> half a pint of lower to normal-strength lager/beer/cider (ABV 3.6%)
> a single small shot measure (25ml) of spirits (25ml, ABV 40%)
So a 12oz bottle (.75 pint) of 3.6% beer would be 1.5 NHS units. A bottle of 7.2% stout would be 3 units. A full 4 units per day would require a bottle of strong 9.6% beer, or two bottles of a 4.8%.
While less eye-popping than four bottles a day, that still seems like a lot of drinking to me, especially if concentrated around a few days. That's 14 bottles of 4.8% beer per week, so imagine four beers on a Wednesday, seven on Friday night, and another three over the weekend after the hangover's worn off – week after week. That seems like it would have to have a health impact, and it's surprising to see it as the limit for "moderate" drinking.
That being said, I don't drink, so I don't know for certainly what is culturally acceptable, I'm just going based on observations (lunches and dinners with coworkers and whatnot). However, this seems like it could be used to justify poor behavior, especially for health conscious individuals who like to check off boxes.
A bottle of beer is usually 330ml so 1.3 units, so moderate drinking would be defined as up to 2 pints or 3 bottles of 4% beer daily.
So, a 250 ml glass of wine at 12% ABV is 0.25 * 12 = 3 units.
In the past when units were created wine was about 8% ABV, and a serving size was about 125 ml, which gives 0.125 * 8 = 1 unit per glass. When you see advice saying "one small glass of wine is about 1 unit" it's a bit misleading, because currently in the UK one small glass is going to be about 175 ml, and the ABV is going to be about 12%, which gives about 2 units per glass.
I'd rather have the work out, good meal, hydrate, and get good sleep. It's obvious that good habits snowball into more good habits, while bad habits snowball into more bad habits.
i think it's funny that having a good (if not optimally healthy) time would be so ridiculed, but maybe that's just me. FWIW i know a lot of people who work out at 4:30am in order to gain that time for after work social activities which often include alcohol, so not mutually exclusive.
> Bar food with your beer and maybe a pizza?
> don't let that one beer turn in to a good time!
Personally, I prefer to enjoy the social benefits of going out without the consequences of alcohol or "bar food." I accept people's drug habits - it's fine to consume drugs responsibly (alcohol included). For me, I am able to have a good time and "let loose" without being under the influence of drugs.
There's nothing wrong with being sober. You can still participate in the local economy, engage in social events, and live a healthy life without fitting the routine you described of going to the bar and hitting the gym.
Anyways, my point of saying this is that I wonder if alcohol for most people increases their life expectancy because it lets them socialize more. In the same way that people buy essential oils and it has a placebo effect on the that make them feel better, I think the bar scene has the same effect on many Americans.
My social experience is that people are mentally unable to "let loose" and socialize without the aide of drugs.
The secret of junk foot is that junk food makes your mouth feel good for 20mminutes, but healthy food makes your body feel good all day, and gives you an energy level to live more actively.
I'm simply saying there's a real opportunity cost which is directly in context with the comment I'm replying to. Sorry you interpreted it differently.
Simply put, if you're out drinking, you're not in the gym or doing another activity that has more health benefits. Don't let that stop you from 'having a good time', but it's something to keep in mind when we talk about the health effects of having a couple drinks everyday.
It's possible drinking impacts their self reports :-)
That said, the individual-factor breakdown really did find that at low doses, rising alcohol consumption correlated with improved health. Undoubtedly some healthy-user bias between no and light drinking, but it's a pretty smooth curve through moderate consumption.
Of course I'm not implying that alcohol is in any way healthy, but it's probably healthier to have great drunk moments with your friends once in a while than it is to be lonely and not drink. It's important to note that you certainly can be social without alcohol though.
From the conclusion: "Our results show that the safest level of drinking is none."
From the study text:
> We observed a relatively small difference in life expectancies across different levels of alcohol consumption compared with other individual lifestyle factors. The cardiovascular benefits of moderate alcohol consumption have been consistently observed in large cohort studies, but alcohol consumption and risk of cancer showed a dose-response relation. Thus, current guidelines do not encourage a non-alcohol drinker to start drinking just for the benefit of preventing cardiovascular disease.
Female life expectancy peaks in the two lowest non-zero ranges, and disease-free expectancy at the second-lowest specifically; male life expectancy rises all the way to the top of "moderate" consumption, and disease-free peaks at the top two "moderate" doses. Presumably that's partly from men being larger and metabolizing alcohol faster, and partly from men being at higher risk of heart disease.
(There's probably a healthy-user bias here too, since there are conditions and medications which weren't checked for that would make people unable to tolerate alcohol, but that's less relevant when comparing different doses.)
Sharing a bottle of wine or champagne with my wife can be one of the most enjoyable experiences to us.. going out to the pub having some beer with family & friends is great.
An argument could be "you can have just as much fun doing something else", but I don't know.. that's not really my experience. A moderate amount of drinking usually makes things even more fun.
it may be that the act of consuming alcohol is a confounding variable in the underlying correlation of social interaction/un-stressing or something.
(Incredibly to me, even small doses of radiation can be protective against larger doses later.)
1. The social benefit. There's research showing that if you have a rich social life and friend network, you live longer. The assumption being that the drink is likely to be with other people.
2. The stress management benefit. It's not healthy to be stressed out. The alcohol's mitigating effect on stress may be greater than the alcohol's poisonous effect, in the right dose, for the right person.
Which I'm really not convinced that is even true.
Or, to put a cynical spin on it: noone becomes an abstinent by choice, usually people stop drinking once their doctor tells them they should, so obviously they will have worse overall health than moderate drinkers.
The one thing I don't like about drinking is that it's basically a cheat code. It makes mundane stuff fun, if it were removed as an option, then maybe I would try other stuff and live a more interesting life.
These figures are not absolute. Other studies consider someone an alcoholic as soon as there is a craving for alcohol. The risk is higher for someone who drinks daily.
Standards of what is acceptable also vary from country to country.
This part Of “stay healthy” advice has always puzzled me - it looks like full blown alcoholism. Am I way off?
And 4 units/day (which is not 4 beers in many cases, it is less, but let's say it is) is something a lot of people do; they are, again, not dependent on it.
Doing damage is something else. I think no alcohol (at all) (+no/little refined sugar, processed food, stress laden work, too much fat, smoking anything, living in smog infested cities, driving motorcycles etc etc) are better, but that's just a feeling; the 'advice' seems to change every few years. One year wine is good for your cardiovascular system, one year it's bad. And the amounts vary too. Etc.
Someone who "could stop drinking any time" and yet drinks every day year-round is de-facto addicted - among all the possible things they could do in the evening they always chose to do the same exact thing. Many addicts are high-functioning, but they are still addicts.
Yes, probably because you are mistaking a not-more-on-any-day-than level for a constant-consumption-every-day level.
Oh, and also confusing addiction with level of consumption.
Also those numbers are not adjusted for body size. Some non-obese people weigh 100lb and some weigh 260lb.
A single 7% beer bottle is 3 units.
9 beers a week is... Not quite full-blown alcoholism. But I can see why the study picked that as a threshold.
I don’t know how large beer bottles are in the US, but 330ml (11.2oz) at 7% is 2.3 units.
(These are all European measurements, if that makes a difference. The NHS is in the U.K., though, where 1 unit = 10 ml of pure alcohol).
I'm ignoring here the fact that drinking more might cause a cascading effect of bad habits, like eating more, exercising less, sleeping less, etc. Here I assume that you'd drink, but not degenerate your other habits as a consequence.
The consensus is slowly moving towards there not being a healthy amount of alcohol consumption.
STDs cause a lot of grief and arguably as much or more damage than diet. AIDS speaks for itself; herpes is implicated in Alzheimer's, heart disease and other ailments and is just a general curse without the modern antivirals (although many persons are naturally immune); gonorrhea and syphilis continue to mutate to new drug-resistant forms.
On the other hand, sex has been found to have lots of benefits (I'm at work so I don't want to be looking up citations, but intuitively a few minutes of cardio can't be a bad thing).
These findings are backed by two cohort studies, one on female nurses in the UK and one on male health professionals in the US. There's really not much chance their STD outcomes correspond to the general population.
This data comes from cohort studies on nurses and other healthcare workers, so it wouldn't generalize well at all. We can assume eating veggies and smoking cigarettes affect them similarly to other people. They might be more likely to recognize problems and seek treatment, but they're not actually getting more or less nutrition out of kale.
When it comes to sex though, doctors and nurses are likely to have very different risk factors than the population average, in ways that are hard to rigorously study. Even beyond using protection or getting tested, they probably don't have the same protection error rates, partner pools, etc., as the general public.
When was the last time you saw healthy parents with an obese child or obese parents with a healthy child vs. how often you see healthy parents with healthy children and obese parents with obese children?
HIV does not significantly reduce life expectancy for patients who consistently take retroviral therapy.
Maybe it's covered under "vigorous exercise?"
Don't smoke, drink little, keep a BMI of 18.5 to 24.9, exercise 30min per day, have a diet in the top 40-percentile most healthy.
These seems like feasible habits. Sure if you're overweight, smoking or drinking a lot changing the status isn't easy.
But you don't have to go vegan :)
Once you start it's a slippery slope to full on vegan. You will look at meat and dairy not as food but as liabilities to you and your earth.
Then it's just kinda depressing. Here you are in an alternate universe with hope and love and beauty while your friends and family stuff buttered bred muscle into their mouth and complain about all their health issues brought about by eating meat and dairy. These same friends look at you with concern for your life decision to not eat meat or dairy while you look at them with concern for their decision to eat meat and dairy.
You research it and realize the meat and dairy industries lobby and get our money for their ad campaigns.
beef. its whats for dinner
pork. the other white meat
For the last 70 years they have been programming us that this is how food should be three times a day, every day. We will look back on the cruelty it takes to buy meat on foam wrapped with cellophane and our grandkids will ask us how we disassociated ourselves enough to take part in it all. Why didn't we shout from the rooftops that we are destroying ourselves, our world, our dear sentient animals?
How the heck do vegans eat high-protein diets? I don't mean "get enough protein to avoid deficiency", there are lots of recipes for that. But practically every vegan food I see described as "high protein" is well under 1/3 protein, which is a pretty unremarkable target if you want to build muscle.
Eggs are a really easy way to fix that: you can eat a lot of them, you get a pretty good range of micronutrients, and their macros are majority-protein so you have "budget" for other foods. Is the vegan fix just getting really good at cooking seitan with green vegetables? That's (with tempeh and tofu) the only option I've found that's even in the right ballpark.
[EDIT] if there's one modification I'd really like to make to my diet, it'd be to add fish once or so per week, ideally the fatty, oily, low-on-the-food-chain sort that're supposed to be so heatlhy. I need some kind of guide for how to work up to enjoying fish when you didn't grow up eating it. I can tolerate larger fish when cooked & seasoned very well, but don't really enjoy it at all, and have no understanding of what even to do with the smaller, healthier sorts that isn't stomach-turning (to me) to even consider. Though for some reason I love sushi and calamari, so, go figure.
Correlation does not equal causation. It's obvious from this statement that the relationship is not (necessarily) causal. Yeah "top 10% of the people in study live longer" isn't really revolutionary.
You can have a mediocre diet and still see huge health benefits. The opposite is not true: a sedentary lifestyle will kill you and the last years will be miserable with little in the way of physical autonomy.
But no simple X is safe and X+n is bad formular to appease any concerns. Everybody is different and all these Recommended Daily limits are all based on an average that none of us fully fit into.
I will say though that anything in moderation is the only rule of thumb that still carries, after all - stress does kill and if by not having a few cig's you increase your stress then you may find that your reducing your health even more due to the stress.
Moral being, be happy and if you have to question it, then you already know the answer that's best for you.
"Ever smoking" looks like "smoked any amount but doesn't presently" rather than "occasional smoker through present", and the lowest bucket for current smokers is 1-14 cigarettes per day. <10 is, I suppose, 1/3 of a cigarette per day.
"Ever" and "1-14" show clear and substantial health effects, which isn't promising, but <10/month looks to be below any of the actual measured brackets.
Just don't start smoking, even small in quantities. It might not have significant drawbacks when you are young, but it absolutely will take a toll on your health eventually, just like drinking.
That page has some dietary recommendations:
- Eat more fibre (at least 30g a day)
- Cut down on saturated fat
- Get your 5 A Day (servings of fruit and vegetables)
- Cut down on salt (no more than 6 grams a day)
- Eat fish (at least twice a week)
It's a pet peeve of mine, but I really wish smoking weren't presented as a binary choice in medicine and science.
I know a lot of people who smoke socially but only socially. They probably have an average of somewhere between half to maybe five or six cigarettes a week -- less than one a day, universally.
(For comparison, it's believed that addiction only starts to kick it at around 5 cigarettes per day.)
It would be nice if studies used granularity for smoking akin to that used for alcohol.
So for example, I wrote that I was a smoker once on an insurance application (at the time as a 2-3 per day, 1 pack per week social smoker) and my insurance went up almost $100 per month. But the risk of not being truthful would be possible denied coverage down the road if I ever did develop respiratory problems. So insurance effectively encourages lying as a financial incentive (since the vast majority of people don't develop problems social smoking) as well as a racket (a loophole that corporations can use to deny coverage).
But there's no way to talk about something like this in polite society, because people effectively lose their minds. For example, I hate that my parents smoke, and often wish that tobacco never existed. Yet I treasure my memories of social smoking at parties, and consider counterculture stuff like that to be part of my ethos.
IMHO the only solution is to be vigilant in denying corporate control over our liberty and justice. Which is increasingly difficult in these times. I'm hopeful that the 2020s will unwind some of the oppression that's happened since 2001 though.
The whole point of insurance, as I see it, is that you pay based on your risk. Of course whether you smoke changes your risk of having health issues! Of course whether you're rich or poor, or male or female, affects your health risks.
For example, it's no surprise to me that my car insurance premiums are more expensive than my sister's, even though she's a year younger than me. Young men are much much more likely to be involved in car accidents than young women. But I've seen many Americans claiming this should be considered illegal discrimination. Isn't this discrimination the whole point of insurance?
The problem isn't that they factor in whether you smoke. The problem is that it's binary. You should find an insurance company that will let you specify how much you smoke. The insurance company should be delighted with that information: it allows them to model your risk more accurately and offer you more competitive prices!
This isn't 'corporate control over our liberty and justice' and it certainly isn't 'oppression'.
This has gone haywire in recent decades due to corruption. In their never-ending quest for more profit, insurance company lobbyists have bribed politicians to change the laws so that they can create new brackets. Now car insurance costs more for young drivers. Now people in the south find they have no flood insurance or that their coverage wasn't good enough to replace their home or that there is so much red tape that they have to sue their own insurance company to get paid. Or the company simply doesn't pay, and the US government has to bail everyone out.
The fact that smoking is the single biggest discriminator in insurance premiums after age is a huge red flag that corruption is afoot. Here are a few things statistically more dangerous than smoking:
* Texting while driving
* Not eating right or exercising
* Working a blue collar job
Corruption just shifts costs onto the poor in the name of efficiency.
The point is that you amortise your risk. You pay small affordable amounts because that's more reliable than a small chance of having to pay extraordinary amounts.
The point is not that everyone pays the same rate, or that people pay what they can afford. If that's what you want, you introduce a tax and a government program: government healthcare, government fire insurance, government flood insurance, etc. Most places effectively have this at the edges: any large scale event there will be significant government assistance, and insurance ends up only having to cover small incidents.
Fire insurance should be more expensive in Queensland than in Oslo. Flood insurance should be more expensive in New Orleans than in Qatar. Insurance is amortisation of risk, not a wealth redistribution service.
>This has gone haywire in recent decades due to corruption. In their never-ending quest for more profit, insurance company lobbyists have bribed politicians to change the laws so that they can create new brackets. Now car insurance costs more for young drivers. Now people in the south find they have no flood insurance or that their coverage wasn't good enough to replace their home or that there is so much red tape that they have to sue their own insurance company to get paid. Or the company simply doesn't pay, and the US government has to bail everyone out.
What are you even talking about? You don't need a law change to be 'allowed' to make premiums higher for younger drivers or people with houses that are prone to flooding. The default situation is that you can provide insurance to people at whatever price you feel like giving them, based on whatever factors you have calculated affect their risk. It's a free market.
If you live in an area that's basically guaranteed to flood in the next 10 years, of course you're going to have difficulty getting flooding insurance! They're basically guaranteed to lose money unless you're paying 20% of the value of your house in premiums every year.
I suspect you literally don't understand the concept of risk.
>The fact that smoking is the single biggest discriminator in insurance premiums after age is a huge red flag that corruption is afoot. Here are a few things statistically more dangerous than smoking:
How do you measure whether someone texts while driving? How do you measure whether someone gets enough exercise or has a healthy diet?
What do you even mean by 'corruption' anyway? This is how insurance works everywhere, in every country, every jurisdiction, universally. It's how insurance works as a very basic concept. The entire point is that you pay based on risk, and higher risk = higher premiums.
Working in a blue collar job already is factored into health insurance premiums. Go ask employers what their insurance premiums are for their employees in the United States. Obviously places with significantly dangerous jobs will have expensive health insurance premiums because that just makes logical sense for the health insurers.
>Corruption just shifts costs onto the poor in the name of efficiency.
It literally makes no logical sense for this to happen. Insurance is a very competitive market. If they are overcharging people relative to their actual risk, then someone that can measure that risk more accurately and charge you less while still making a reliable profit should exist.
And in fact that is exactly what happens.
I wonder if what's happening in the US though is that nearly all markets with inelastic demand curves have come to be dominated by a handful of companies (duopolies). So if I need an operation that I simply must have, or health insurance or internet service, I have a couple of companies to choose from that both charge roughly the same price, which is usually quite a bit more than what I'd like to pay.
The principle here is that markets with inelastic demand curves form natural monopolies:
But in the US, there has been no move to break up monopolies or transfer them into the public sector as utilities (like for water and electricity) since the Reagan era:
So the controversy you see in the media here about whether to have single payer healthcare, for example, stems from the fact that these natural monopolies are run by private sector corporations which have formed rackets within the government through the use of lobbying (a form of bribery). Their disinformation and smear campaigns across the major media outlets (themselves usually duopolies like CNN and Fox News) distract the populace so that basic economic principles take a back seat to political ideology. This keeps everyone divided in order to maintain the status quo of duopoly protection.
If the US were to move to public healthcare, the price would fall to a rate base (a legally determined profit margin above base cost) which must be determined through regulation since the free market can't find a fair price between supplier and consumer since the price is inelastic and/or there as an information or power imbalance which makes it a non-free market:
Looking to other countries as examples, this would lower the price to roughly 1/2 to 1/3 what it is now:
All of this is why when I see smoking singled out on health insurance applications, I tend to see corruption rather than market efficiency. Which is outrageous, because my vote would be to move health insurance into the public sector anyway. It feels like being kicked when I'm down.
I think what might be going on here is that you're thinking microeconomics while I'm thinking macroeconomics, but we can both be right.
I’m also having a hard time with the idea that insurance companies are using this policy as a way to get out of paying future claims. Is it really possible to prove that a condition is due to smoking? Also any time I’ve had to fill out that information on an insurance form and I’ve only ever seen it ask if I am currently a smoker. What’s to say I wasn’t a smoker before I was covered by that insurance company?
But jumping from "never" to "1-14 per day" does seem like a pretty massive gap, and one that makes these results harder to use for a lot of people. I've known plenty of social smokers, as well as people who almost quit smoking but didn't kick a final 1/day habit. It certainly seems useful for a 10/day smoker to know what their risk profile would be like at 1/day or lower, which isn't available here.
(I wonder if it's a data limitation here, though? Most of the social smokers are I know are 20-somethings who smoke when they're drinking with friends, or something similar. These cohort studies were on middle aged doctors and nurses, so there may not be many people falling between "nonsmoker" and "addicted"?)
I'm analyzing data for an epidemiological study now, we have such a binary smoking status indicator that you critique. Our issue is the data source has immense complexity, 3500 plain text entries on smoking status questions, it would take weeks of painstaking effort to develop the measure you speak of...whereas the current measure took us a morning to implement as someone had already done the legwork for 0/1 smoking or not.
It's that if light smokers self-identify as smokers in research, then it can mask the greater damage done in heavy smokers.
While if light smokers self-identify as non-smokers, it may reduce the overall difference between true non-smokers and heavy smokers.
Either way, it leads to the same kind of dangerous misinterpretation of data you'd have if there were only two categories "never drink" and "blackout drunk nightly".