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Iceland radically cut teenage drug use (weforum.org)
221 points by known 8 months ago | hide | past | favorite | 97 comments

Since Nordic countries are very similar in many ways, Finnish social scientists specializing on youth recently visited Iceland in attempt to learn about the system and wrote a report about it (in Finnish) https://www.nuorisotutkimusseura.fi/nakokulma53


* They didn't find any clear Icelandic model. Icelandic politicians promoting it. Icelandic researchers don't know if it exists.

* Icelandic experts are not unanimous that there is causal link between the advertised methods and effects. Halldór Hauksson has noted that increasing the age of adulthood with two years might have been the real cause. Many young people having problems stayed within the children programs and could be treated under them and not as adult alcoholics.

* It's very adult oriented model. Teenagers are just subjects.

* There was clear distrust against unsupervised gatherings among teenagers. Adults don't seem to see any value or learning in stuff that young people do among themselves.

* Nobody have studied what teenagers think about the system. Apparently they didn't even think to ask it.

* There are parts of the system that might violate agreements that protect children rights. (Yes, Nordic countries take things like United Nations Declaration of the Rights of the Child seriously) Some methods violate Finnish constitution of equality and equal rights (when people are subject to government actions they must have an opportunity to voice their opinion) so they can't be directly used.

If you look at other things like alcohol use, things don't look good.

* Teenage suicides have grown off the chart. Boys: 42.5 suicides per 100k. For comparison Finland 12, Sweden 8.5, Norway 6.5, Denmark 5.5

* Psychotropic medication among teenagers if many times what it is in other Nordic countries. UN children rights commission has notified Iceland about child medication.

> If you look at other things like alcohol use, things don't look good.

What? Why is alcohol not regarded as a drug in this kind of research environment? Is the aim of this research to save teenagers from drug abuse, or is the aim to have lower numbers of illegal-drug-abuse?

Overall, this seems questionable at best. Not letting teenagers spending unsupervised time surely has ripple effects in most, if not all, areas of society, the most of which I'd consider highly undesirable (not granting autonomy leads to severe psychological issues down the line)

Given that the article talks about Icelandic kids no longer being heavy drinkers and the fact that nabla9 can read Finnish and so is probably not a naive English speaker, that sentence may just be an erroneous version of an intended "If you look at other things than alcohol use".

Both "like" and "than" express comparisons, that may cause confusion.

Tangent: this neatly illustrates that trying to express yourself in a foreign language and failing outright, such that what you said doesn't make any sense, is not actually the biggest problem you can run into. It's much worse when you try to express yourself and come out with a perfectly-formed sentence that means something quite different from what you were hoping.

It's easy for people to make adjustments allowing for your badly-formed sentences. It's much harder for people to make adjustments allowing for the possibility that even though you said something natural, you might have meant something else entirely.

The linked article stated that the impetus for the research was mainly a long-standing issue with the alcohol consumption levels of the young, so I think it's an issue they consider very important and related to drugs, but they separate it as drugs and alcohol have a different social and legal stigma and thus aren't directly comparable to each other.

As a Finn I wouldn't take any findings from our social scientists very seriously. By treating teens and children like adults they have already ruined our once great education system.

I suggest everyone to ignore any criticism that uses broad brush like you do.

That's a little self-referential, no?

Everything in moderation, including moderation.

Iceland also has a total population less than any major city in the US until you get far down the line into 2nd biggest cities in states or cities in small states.

Not to mention entire state populations or anything close to any other relevant country’s total population.

Which matters a lot when taking lessons from other countries IMO (including banking and restrictions like gun ownership). It’s like taking lessons running a startup vs a multinational corporation.

The total population matters only when you measure effects that change when the scale changes.

I see no reason why small cities and countries can't be used as examples in youth health. They are often perfect places to used for testing things.

> The total population matters only when you measure effects that change when the scale changes.

> I see no reason why small cities and countries can't be used as examples in youth health.

This is not correct; you're assuming that every location always expresses the average of every effect.

In reality, small absolute populations mean more variance in the measurement/expression of everything. This is why the top and bottom of lists of statistics per capita are always dominated by small populations. Doesn't matter what statistic you're measuring.

This makes it very dangerous to try to generalize from a finding in an anomalously small population.

Iceland only has about 50,000 teenagers.

"Sample size!" is absolutely a valid criticism.

It also is not geographically diverse... over half the national population lives within a 10km circle around the capital.

Presumably population density is the more relevant factor.

Population density of Reykjavik is 3,077/km². Most the population lives in urban areas. You can basically treat Iceland as City State.


With increased size, government becomes less efficient (as you need to have more layers of management) - so any policies that require implementation by the administrative bodies should work better in Iceland than in countries with one/two/three/four orders of magnitude more people.

It's not that the scale changes, it's that the statistics count too few events to properly handle external factors. When you're looking a cohorts of around 4000 people, small things can change things by multiple percent.

It's almost as if even nonprofits were interested in furthering their own agenda instead of rigorously seeking the truth in order to inform people.

Great comment, by the way. Thank you for the summary.

Were DNA tests made? Iceland is a homogeneous society. It's possible that nurture doesn't explain the cause but rather nature.

Particularly with respect to alcoholism, that it was quite a very long trend downward, and the fact there's only 400k people it would seem there's been a generational and fundamental change in societal attitude towards alcohol.

It means 'everyone' was thinking about it different over time, and this thinking would have manifested in a variety of policies, awareness, socialization, and probably a lot of 'indirect shaming' i.e. getting alcohol distributors to realize the consequences, bar owners taking underage drinker more seriously, police actually nabbing drunk kids as opposed to turning a blind eye. IE 'hey, we drink here in Iceland, it's normal' to 'we have a drinking problem, let's talk to our kids about it'.

We've seen a significant change in all the Western world on smoking for example, so it's no surprise they couldn't change drinking and tobacco over time.

The marijuana thing is different obviously given the more liberal attitudes in many places, but consider the supply issue in Iceland, as compared to Canada. In Canada, there are grow-ops everywhere with low-level organized crime involved sometimes (not always). In Iceland, it just maybe 'that much more difficult' to get a hold of, thereby limiting the possibility for weed to establish it's behavioural premise as 'being cool' or whatever. The critical mass might not have developed.

It's highly unlikely that 'one policy' was the deal maker on any of these issues, though surely some had more of an effect than others. For example, raising the drinking age by 2 years will have not much effect if it's a social custom to simply ignore those rules anyhow. But raising the drinking age, coupled with public awareness, with messages from law enforcement to alcohol stores saying 'we mean it, we will find out' to random checks to make sure they're following the rules whereas there were none before etc. - this will surely have some change.

I object to anything that the UN has to say about 'Children's Rights', the wellbeing of children is a function of the overall wellbeing of a society, and Iceland, like other Nordic countries, is way ahead of the curve already. Ironically, only such advanced countries would even care about what the UN has to say in the first place. The UN is a highly politicized body of people usually very far removed from any given situation and though I don't doubt their intentions, these things become entirely academic in their hands. The 'real good' they will do is in developing places which are in need of economic development, which in turn provides the basis for the wellbeing of children and all citizens and not just in terms of 'rights' but in everything else as well.

Any nation that has managed to create some kind of positive social change is probably worth studying, that there is ambiguity is fine, the facts are what they are i.e. that substance abuse of certain kinds has dropped quite a lot. That evidence is the underlying bit of credibility which makes the mystery worth solving, or at least learning from.

Hi, person from Iceland here. Drug use has actually been going up since these numbers were reported. It's true that alcohol use went down compared to the decades before but you must understand teenage drinking was so common. It's the only thing teenagers used to do for years and years. For us to get these numbers down is groundbreaking yes but drinking is still a huge problem for Iceland and drugs kind of just took over from alcohol.

It's true though that the increased focus in activity such as sports etc does actually work. As soon as the city allowed people to use a sort of point system were they get x amounts of points per year which can be used for sports and such things got much better. This means poor families can also send their kids to activities which is really positive.

Drugs in general are really popular now. The drug market in Iceland in general has been growing extremely fast over the past years and it's become really professional in terms of quality and delivery. We have a relatively small police force right now and the size of the drug market is way beyond their control.

I just find it kind of misleading everytime I see these articles. It's true we got drinking down but in general Iceland deals with a lot of depression, a lot of suicides and a lot of narcotic related issues every year. We have a very high suicide rate per capita, especially for men.

What I mean is that these articles express this like we got rid of the problem, we totally did not. The fact that the state gives credits for sport activities etc each year is an extremely positive thing though.

Absolutely, I was in an Icelandic elementary school about a decade ago. While i was in school i saw a general decline in anti-social behaviour, now in that same school i see a dramatic rise in anti-social behaviour (violence drugs & drug use) through my siblings.

I volunteer at a drop-in center for kids at a local public housing project. For what it's worth, we've started springing for music, dance, martial-arts lessons for our teens. These are the kids who can't afford the fees for school sports, and who don't have reliable ways to get around (parents with cars).

It's making a big difference. We're facepalming for not starting to use our budget for this purpose sooner. These young are getting more engaged with school.

We explicitly avoid taking surveys about substance type stuff, so it's hard to know for sure how much a difference it makes. Plus the program is too young. (We don't take surveys because "n" is too small to ensure anonymity and the kids know it. We have a "no judgement ethic to uphold.)

But the kind of stuff suggested in this article seems to work so far.

My purpose in working with these kids is convincing some of them "do your math homework, and you'll get a good job. It's your ticket out of housing."

Would love to hear more about this. Do you have a blog or something? Where is the center located?

Iceland has a population of a provincial town. I noticed it's often featured in news headlines as some sort of an example in relation to other countries this fact being omitted.

Yeah, small population size creates fake outliers. "Rural states have both the highest and the lowest rate of kidney cancer" - what they in fact have is small populations, so they just have much larger variance.

It's not "just". Cancer isn't purely random on its own authority. It has causes.

Variance could be due variation in environment, pollution, personal habits, quality of record keeping, and many other meaningful or spurious causes. Outliers and 95%iles are worth studying, not merely writing off.

Iceland's models might not work for larger countries due to size difference, and might not work for other cities due to differences in sovereignty structure, but it's worth investigating.

While the data might not be ‘just’ caused by random variance, it provides little evidence that there is something more going on than just randomness.

You have no particular reason to study those cases more than anything else, since the data we have does not suggest that there is anything actually going on.

Things are not as simple as one or the other.

The uneven spread of heavy industry creates pockets where cancer rates are higher becausw of environmental factors.

Random variance is responsible at a micro-level but at a macro level the trend still holds true.

I wasn't making any claim about the actual causes... I was simply stating that the statistical effect you see can be completely explained by random variance, so you can't use the result as an argument for a cause. You have to search elsewhere for that evidence.

Since people frequently miss this point, the population of Iceland is approximately the same as the Kalamazoo, MI metro area.

Compare this to growing up as a teenager in suburbia. I could not play any sports, despite wanting to very badly. My neighborhood had few kids, spread in housing developments that stretched for miles. I loved basketball but there were no courts anywhere. My parents worked till 5, so I did not have someone to pick me up after school activities. I had zero after school activities my entire life. This was in one of the richest, "best" (that means whitest) schools in NJ. I had a hoop at home and would play with my dad and sister sometimes. That's it. There was literally nothing else. Just coming home after school and locking myself in with my sister. Luckily we had each other. I read, taught myself programming, watched tv, etc. but nothing social. Maybe once a month or even less I could get a ride or my friend could get a ride and we could spend time hanging out. Otherwise it was just loneliness outside of school. I never got the opportunity to learn how to socialize with peers outside of school. I already had social anxiety. Almost suicidal. So of course, when I had that first drink and the first weed smoke, it was heaven. I thought drugs were the only way people socialized. I had finally discovered something that made it bearable. Addiction was inevitable. Of course, it was. Now, twenty years later I still have major issues socializing, still dealing with addiction, still dealing with anxiety, still isolating. Suburban USA was hell. I'm just lucky I don't enjoy opiates like my sister. I wouldn't wish this upon my worst enemy.

Is it really a surprise that caring about children, giving them a chance to learn and enjoy activities together makes them not want to get high? That's what I'm doing now with my life, but it's hard to break old habits. I wish I could have played sports in my teens. I wish I could have done many things and learned to socialize and deal with feelings. I will never raise children in such a horrific environment as the US. I'd rather be childless.

By 1992, his team in Denver had won a $1.2 million government grant to form Project Self-Discovery, which offered teenagers natural-high alternatives to drugs and crime. They got referrals from teachers, school nurses and counsellors, taking in kids from the age of 14 who didn’t see themselves as needing treatment but who had problems with drugs or petty crime.

“We didn’t say to them, you’re coming in for treatment. We said, we’ll teach you anything you want to learn: music, dance, hip hop, art, martial arts.” The idea was that these different classes could provide a variety of alterations in the kids’ brain chemistry, and give them what they needed to cope better with life: some might crave an experience that could help reduce anxiety, others may be after a rush.

Iceland has a population of 364,260. Changing the behavior of just one group of teens would lead to "radically" different numbers. Especially considering the fact that the bulk is concentrated at the capital Reykjavík.

Herefor numbers regarding Iceland should always be interpreted with great caution since they are likely not projectable onto other countries.

It's a good point though I content that it depends on what you mean. I'd argue that there are measures which are enforcable and feasible on a small scale which may be far less so on a larger scale (ex: the USA) due as much to politics as anything else. I don't think there's any reason to same the same measures, were they applied likewise elsewhere, would not be as effective.

I interpreted the parent's comment to mean that it could just be an artifact of the small size of the country. After all, there are almost certainly cities in the US where hundreds of teenagers have recently decided not to do drugs, but it wouldn't impact national statistics at all. If hundreds of teenagers in Reykjavik decide not to do drugs, it looks like they have "solved" the problem.

On the other hand, why not at least try out the approach? (Including the nasty curfew.) Is USA so poor they cannot get $250 in to send teens to do extracurriculars/sports?

Iceland is not exactly super rich.

Iceland might very well be the richest country (Non city /oil state) in the world per capita. Measured both in monetary and non monetary terms. See: https://en.wikipedia.org/wiki/Economy_of_Iceland

Curfew does happen from time to time in pockets across the US. And it does work.

the bulk is concentrated at the capital Reykjavík

That's the point, isn't it? You'd think that Reykjavik as the capital has resources and money that are not available in Aberdeen, SD or Americus, GA. In the US, the countryside has been systematically hollowed out.

I think bigger issue these days is anabolic steroid abuse which goes unnoticed. And only few people die from it, but it might lead to greater health care cost as most abusers die from cardiac issues young, 30s or 40s.

In many countries, it's pushed underground but they aren't hard to acquire like hard drugs.

There should be companies searching for safer compounds which help achieve same results without any of the long term risks.

Wouldn't dying in your 30s or 40s allow you to avoid the elderly years when you rack up the most health care expenses?

If you killed yourself at 10 you could avoid the difficult teenage years too.

It also cuts off productive working years.

I find it... interesting.. that when cis women take steroids, that's birth control or a treatment for menopause, when trans people of both genders take it, it's a necessary part of gender affirmation treatment, but when cis men take them, it's abuse and illegal.

It's not surprising that there are bad outcomes without medical guidance and best practices. I, for one, fully intend to start supplementing male hormones the day I turn 50.

I don't think the stigma surrounding this is helping anyone.

that some people need to take certain kinds of steroids to be healthy doesn't mean you don't get to talk about people taking 100x->1000x the normal dose of anabolic steroids to get huge muscles being a bad idea.

if you can't separate the stigma of that kind of abuse from the use of normal human doses of different compounds then maybe earth is too complex a place for you to live.

I've never heard anyone taking 100x, testosterone replacement is 100mg/week and guys in gym take anywhere from 150-600mg/week.

Thank you for the clear demonstration of the stigma I was referring to.

How do "few people die from it" and "most abusers die [...] young, 30s or 40s" fit together?

A few people die from it, and most of them die young. Facts presented after a preposition should generally be read within the context of the preposition, not as independent phrases.

If only a few people, like three out of twenty million die from it, then their age doesn't matter.

At 300,000 people and 8 political parties - the people still kind of ARE the state.

They are an incredibly homogenous people as well, so generally, most are in favor of the same types of social programs, as they almost all benefit from them. Income inequality is incredibly low, some of the best in the world. So yes, most of the ruling class are the people.

> Milkman’s doctoral dissertation concluded that people would choose either heroin or amphetamines depending on how they liked to deal with stress. Heroin users wanted to numb themselves; amphetamine users wanted to actively confront it.

This seems kind of silly in retrospect. In the US, most heroin users chose heroin because they got addicted to prescription painkillers, and heroin has a similar effect while being much cheaper.

Loads of my friends deal with stress by actively confronting it and none like numbing themselves..weird. Its almost like they chose amphetamines cos raving on herion doesn't really work.

Maybe tenageers changed old standard drugs by digital adictions...

I would rather my teenager have a digital addiction than a drug addiction.

I think I'd rather mine used drugs socially (and infrequently) and had a social life....

Both of these answers are overly simplistic however.

You can have a social life while having a "digital addiction", with fewer risks to your health than a drug addiction, social or not.

I'm not sure you can, and there are health risks from digital addiction too.

My point was that the original statement was overly broad and simplistic.

Unless “social life” just means “physical proximity to other people” for you, social interactions over the internet while having a “digital addiction” can be more meaningful than social interactions with fellow drug addicts.

> Unless “social life” just means “physical proximity to other people” for you

It would certainly be part of it, interacting IRL, yes.

> can be more meaningful than social interactions with fellow drug addicts.

Can be, sure, but aren't necessarily, and people with digital addictions can become very isolated and have health problems from inactivity.

I'm not trying to say drug addiction is a good thing, but that the initial comment was silly. Not all drug use is problematic, and digital addiction can have a real impact.

Surely this depends on the drug?

Indeed, and how often/under what circumstances.

Gaming can be perfectly a healthy hobby as well, when not done to the exclusion of all else.

Who would have thought: yet another indicator that drugs of all kind (yes, including coffee!) are basically self-medication by people to deal with external stress.

Happy to hear that there's an ever growing base of data to support this, but sadly acting upon that data is not exactly top priority for politicians :/

That's not true. A lot of people's stress is internal. And what's the difference anyways? The human condition is to suffer, get old, and die. Sounds to me like drugs are probably the most rational and logical thing you can do, besides suicide. I'm being a little bit of a downer, I know, but the reality of life is pretty terrible. Fortunately, me and most others can just ignore what life is about (most of the time) and carry on like anything we do makes a difference.

Moreover, if politicians wanted to act upon it, they would just legalize all drugs and call it a day.

Is interesting how americans have the need of discrediting iceland & scandinavia in general. You can read that between the lines of the comments. Really great countries to live, people gets a real chance at developing their potential.This article is an example of that.

I think the undertone of the reaction actually varies a lot. Some people are dismissive, but I think a lot of people find it frustrating because the approaches and solutions that work when a group the size of a small American city has full national sovereignty are generally not workable in the many-layered federal system with city, state, and federal jurisdictions each many times larger.

Many people (Americans included) also fail to recognize that the majority of governance happens at the city and county level, then the state, then the least at the federal level.

So if you have a situation where a policy only works if “everyone does it,” that’s basically impossible in the US. Individual cities can (and do) act on all sorts of lessons learned from around the world, especially including the Nordic countries, and point to them as inspiration all the time. But just because an Austin or a Seattle wants to copy what was done elsewhere does not mean they can: it may conflict with state or federal law they cannot change, or it may be unworkable when half the population of their economic area is distributed among dozens of small and entirely independent suburban governments.

So in short, yes some Americans are dismissive of things that “worked in Iceland,” but I think most Americans are merely jaded that it’s much easier to accomplish significant change in city states and small countries, particularly with more homogeneous populations. It’s nothing against Iceland or any other country, except perhaps fatigue at people from those places wagging their fingers at America and saying how easy things are in a place completely unlike this one.

it’s not that most governing magically happens at the local/state level, but that the US govt is explicitly designed such that the state is the canonical governing unit, delegating responsibility to both cities/counties and deferring very limited powers to the federal level.

we’re not designed to have many national programs to address domestic issues. it’s up to the states to address domestic issues, with the added benefit that the country can iterate faster to solutions through states working on them in parallel and piggybacking on each others’ successes.

It's simple recognition that Iceland is a very homogenous place so homogenous solutions to problems are more likely to be effective. Iceland doesn't even allow baby names that aren't listed in their book of acceptable names. Now try to come up with a solution for homelessness that works in both Spokane, Washington and Coral Gables, Florida. They're very different populations with very different needs. It's great that Iceland has been able to reduce youth drug use but it's not applicable to the wider world except in limited circumstances.

> Now try to come up with a solution for homelessness that works in both Spokane, Washington and Coral Gables, Florida

Isn't homelessness generally handled at the city and county levels? Both places can independently look at how different areas of the world have combated homelessness, and also share their successes (or failures) with each other without being forced to both do the same exact thing.

Freedom of movement between municipalities makes most attempts at solving homelessness difficult if not impossible. NY simply shipped them out; cities with nice climates and access to welfare see a large influx from elsewhere. The harder a city works to solve the problem, the bigger the problem becomes.

A friend's mother- a chronic drug user who lived off of welfare- moves from state to state as she uses up whatever benefits they offer.

Not all people are in that situation or abuse the system like that, of course, but small countries with tighter borders have a much easier time dealing with a less mobile population of homeless and indigent.

Why wouldn't it be applicable to small homogenous US towns?

Parts of it certainly could be...but a major difference is Federal law versus state/city law. In Iceland where you basically have one city where everyone lives it's all sorta the same thing no? In the US, that can vary widely. Texas is incredibly different from Washington state not to mention Houston vs. Seattle.

Personally think there's got to be parts of this though that would be applicable somewhere. Seems rash to be completely dismissive (and to be fair not much of that in these comments).

Not from the US, but it seems there's a widely internalized view of the US being so big that it's ungovernable in some ways, so things that are learned in other countries can't be applied. A variant is that the population is not as "homogenous".

I've not yet fully understood why a large population or area or ethnicity would generally impede things so much, but maybe it's just misattributed and there's sometihng about system of governance or the population's general distrust of government makes it hard to get things done there.

Of course there are some genuine things that scane sub or superlinearly with population size. For example network effects are bigger in bigger populations.

The "homogeneity"/"diversity" argument for why things that work elsewhere won't work in the US is often just racist dogwhistling. The Nordic countries are not actually as homogeneous as Americans seem to think, and the US isn't as diverse as they seem to think, either (hint: diversity != skin colour). See for example the lists here:


I checked your link. It says the exact opposite of what you claim.

The second list says - Sweden Ethnic Fractionalization : 0.060000

US EthnicFractionalization: 0.490100

So it says America is 8 times more diverse than Sweden.

Sounds about right. That makes Sweden a lot more homogenous than the US.

The first list is really screwed: it lists Italy and China as among the least diverse - which is rubbish.

That’s because it only includes linguistic diversity- not ethnic diversity. So Sicilians and Milanese are grouped together, as are Han and Tibetans.

Latin America becomes much less diverse, because the many ethnicities speak Spanish, etc.

Look at how undiverse Cuba is!

America has a large number of different cultures, ethnicities and religions, but to get a decent job you need to English.

Consider immigrants: https://en.wikipedia.org/wiki/List_of_sovereign_states_and_d...

My link shows that there is a bigger share of immigrants in Sweden (19%) than in US (14%).

I think cultural diversity weighs more here than skin color.

the largest nordic population is sweden, which is less than 10% the population of the US. it is also ethnically significantly more homogenous than the US, which by your own standard is dizzyingly diverse ('white' contains dozens of ethnicities, along with regional and class subsets and period of integration). assuming that the same policies work for everybody in all circumstances is willful blindness.

Have you been to swedis cities lately? It's diverse.

i do not doubt that there art parts of sweden with significant diversity; it still pales in comparison with america, one of the most diverse nations in history

Everyone is saying your thinking doesn't apply because scandinavian countries are small and homogeneous and the policies wouldn't work in the US Some of this is just BS. It's like if the US had no public education and people just shrugged "Free basic education for all doesn't work and Scandinavia doesn't count, they're too small and homogeneous."

> You can read that between the lines of the comments.

Yes. I see the veiled racist comments, the completely anecdotic evidence, the sofa-experts disregarding the article findings... It is tiresome the coordinated attacks against progressive views.

We should work together to make this a better world. I really do not get what is the goal of the people that writes this kind of comments. Don't they have families? Don't they depend on the same world stability and technological advances?

I am happy for Iceland and I hope that their example extends.

The flip side of this is Europeans discrediting America because it doesn’t perform as well as Nordic countries. This kind of chauvinist attitude is really common on this site and it’s super obnoxious, because Nordic countries really aren’t comparable to the US as a whole, on basically any measure that you choose.

Iceland has roughly the population of Glendale, California, which is one of a couple dozen satellite cities which, along with Los Angeles proper, make up the Greater Los Angeles area, which is one of two major metro areas in California, which is one of 50 states of the US. You can find plenty of ~300k metro areas in the US that are a good match for Iceland, and plenty that aren’t. If you want to understand American over and underperformance on various metrics, you have to look at why, say, Sweden does so well on various metrics and, say, Greece does not. Because the scale of the US is similar to Europe as a whole.

...because many nothern european countries provide a much higher quality of life than the US without being wealthier.

I recall post financial crisis there was untold amounts of gibberish about using Iceland as an example. It's a city block of a country. It's completely irrelevant in every way when extrapolating for a real country

We're not discrediting it because it's Scandinavia, we're discrediting it because iceland has a miniscule population and actual effects of interventions are difficult to meaningfully tease out from chance on this scale. I looked it up, and I'm unsure if in reading this right, but Iceland has 360,000 people? That's it? If I'm not reading that wrong, my small suburb of ny has 1% of the population of the entire country - and size effects matter in terms of how easy strategies are to implement and whether changes are from natural variance or real fundamental progress.

> we're discrediting it because iceland has a miniscule population

So find one or more groups of 360,000 people in your country and start testing it on small parts of your population.

Don’t just ignore the findings because you can’t apply it to your whole country at once (which is a bad idea anyway: e.g. some nation-wide education changes at home have been big mistakes).

I find it more curious if there won't be sequelae such as overweight rates going up instead. That would be interesting.

Iceland is not that small. It's comparable to many medium sized cities in Europe, or a district of a big one.

You're comparing a country to medium sized cities though - on a continent with a population of 750 million people, versus a country like America with 350 million, it's like 350 thousand. What small City governments can do and how they govern is different from alrger cities like NY, different again from states and from the monster of the federal government or the European union

I spent a month traveling around Iceland. My suburban neighborhood is more populous than 99% of the town/villages on the island. Even the largest “cities” are smaller than any town where I live. It’s really hard to see how anything that works for such a tiny homogenous population could apply to us.

Maybe they just got better at hiding it.

Isn't gaming responsible for some fall in substance abuse just by giving kids something to do?

I would contend that video games, cell phones, etc have made a bigger difference than anything else.

Other cities would likely show similar patterns if that was the case, no?

Iceland. Population 300,000. Something to keep in mind.

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