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How Americans Die (bloomberg.com)
378 points by minimax on Apr 17, 2014 | hide | past | web | favorite | 141 comments



The data is interesting, but somewhat difficult to draw conclusions from without considering how different rates are impacting other rates. What is really noteworthy here is the approach to showing the data. Its effortless to scroll through.

Here are some things I noticed after the fact:

1. I naturally wanted to finish the presentation and was compelled to click to see if there were any amazing insights.

2. After the fact, I have no idea how I even advanced the presentation, all I knew was that I clicked something. It was 100% natural.

It fully pulled me in. I can't remember if there were ads on the sides or more information.

[added] I went back and looked at it again and I think what made it so flawless is that the first page gave me no option but to click the right hand arrow which taught me what to look for. I clicked the right arrow, and then I knew to click it again to advance. The progress dots on the top let me know that I didn't have much time left. Really amazing work here.


Agreed the data is interesting and the UI is pretty slick. I found the graphs to be poorly designed, both in terms of y-axis labeling and transitions (sometimes it's %, sometimes deaths/100,000, etc.), as well as things like labels.

In some cases, the findings in the text don't seem to be reflected in the graphs.


My thoughts exactly. The axis labeling could have used some units, and for me, the colors were too similar to differentiate and pair up with the key at the bottom. The data seemed interesting, but these issues kept me from fully appreciating the data.


It doesn't really solve the problem of similar colors, but clicking on the legend entries highlights the data on the graph.


Interesting. That's helpful. For some reason I wasn't seeing that behavior on my ancient FF that I use at work. Thanks!


You can click the key at the bottom to dim other things, and light up only one that interests you.


So to achieve longevity escape velocity [0]

1. Don't have unprotected sex if you're less than 44 years old.

2. Don't kill yourself, or do drugs, if you're less than 54 years old.

3. Invest heavily in heart disease, cancer, and alzheimer's research.

[0] http://en.wikipedia.org/wiki/Longevity_escape_velocity


Diabetes, heart disease, and arguably some forms of cancer are diseases of affluence [0] with known risk factors that are avoidable through lifestyle changes. If you're enumerating things to avoid in order to achieve longevity escape velocity, #3 should read something more like "Eat healthily and exercise daily to reduce your chances of getting diabetes and other vascular diseases."

Incidentally, there is also some evidence of Alzheimer's disease being linked to risk factors typically associated with type 2 diabetes. [1]

[0] http://en.wikipedia.org/wiki/Diseases_of_affluence

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/


Thanks, I agree.

Of course my post is a bit tongue in cheek. Healthy nutrition and exercise are probably the biggest factors in living longer setting aside physical trauma. It even improves your mood, so I'm sure it lowers the suicide rate too.

I considered listing it, but this is a list of things that will kill you, not a list of things that will make you live longer, healthier, and happier... I would love to have that list please.


Not really. Actuarial escape velocity is a concept that emerges from the SENS proposals [0]. Next to nothing you do with your life has truly significant expected impact on your future longevity other than providing support and funding for SENS and SENS-like research aimed at repairing the root causes of all the big killer age-related conditions.

(Less significant here means a ten year swing in life expectancy. Exercise, not smoking, calorie restriction - these are things that can make 5-10 year expected differences. Everything else is pretty marginal if you exclude the obvious exogenous line items like risk of accident. But an improving implementation of SENS provides indefinite extension of healthy life out to the expected limits due to accident rates, which is somewhere in the 1000-5000 year range for present data).

The mainstream medical research community is largely focused on patching late stage manifestations of aging. Most work and funding goes towards either manipulating proximate causes rather than root causes, or trying to find ways to alter the operation of metabolism to make the disease process less terrible - but again without addressing causes. Until such time as the research community is overtaken by the "address root causes" disruption currently taking place, of which SENS is an exemplar, but by no means the only movement, then progress towards extended life and defeat of age-related disease will continue to be painfully expensive, slow, and marginal.

The trends in life extension achieved through medicine to date are all largely incidental, unintentional. Where aging itself as a collection of processes [1] has been slowed it wasn't because that was the deliberate intent. Again, because until very recently no-one has been trying to address aging itself rather than focusing on the nature of its outcomes. It is the same difference as that between working to reverse or prevent rust in metal structures versus working on repairing structural failures that occur due to that rust.

[0]: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC423155/

[1]: http://sens.org/research/introduction-to-sens-research


Well you'd have to agree killing yourself at 44 has a pretty significant impact on your likelihood of reaching longevity escape velocity, no?


I'm a bioinformatics guy trying to move toward this research. Do you work in the field?


I do research at the interface between aging and bioinformatics.

It's a great place to be because many aging researchers, while smart and capable at their own techniques, are basically in the informatics stone age. So there is a lot of collaboration potential.

As for GP's comments, I'd agree that there needs to be more focus on "root causes" and fundamental mechanisms in aging research. But SENS itself is broadly considered hokum.


I expect the informatics stone age in aging research will start to dissipate more rapidly in the years ahead, given that Calico and Human Longevity look to be focused in that direction.

I would love to see more of the people who dismiss SENS criticize it on the published details of ongoing or proposed research rather than just hand-waving. Sadly all too few seem to be willing to do so. Clearly it isn't nonsense, since there are SENS labs and allied research programs in a number of universities now, including Cambridge, Wake Forest, etc, and a range of important figures in aging research and other life science fields relevant to regenerative medicine support SENS.


My concern about Calico and the other commercial efforts at aging research is, will the tools and data they develop be made public so that others can build on them? Also, supposing they succeed, I find the idea of commercial ownership of a (real) anti-aging drug morally repugnant in the extreme, perhaps even dystopian. But I certainly can't deny that Google has informatics experience.

SENS, as I understand it, can mean (at least) 3 different things:

a) The idea that we should focus on root causes rather than late-stage manifestations. I agree with this.

b) The idea that we should attempt to repair aging-related damage without needing to know what caused the damage. I find this debatable. We have stumbled on to some big treatments (aspirin, penicillin), without knowing how or why they worked. But in general, if you take a broken, complex system (e.g., a car, some source code) and attempt to repair it without understanding how it works, you will fail. With aging, many changes occur. How can you determine which changes are "damage" and which are compensatory regulatory changes without understanding the chain of causation?

c) A specific list of 7 aging-associated markers of damage and proposals to clear that damage, with the implication that if we do so, we will drastically reduce or eliminate age-associated morbidity and mortality. This is the part that is seen as hokum. At best, it is a hypothesis. Let de Grey get a grant and prove it, like everyone else does, rather than publicity-hunting and implying that it is only the stodgy old aging research establishment keeping us from eternal youth. But if you want semi-technical criticisms:

- On what basis are these 7 types of damage chosen and not others?

- One of the proposed treatments for the natural shortening of telomeres over time is the periodic, whole-body addition of telomerase or the equivalent. Considering that telomerase is overexpressed in cancer and is an important ingredient to uncontrolled cell division, do you think this is a good idea?

- On a related note, SENS presupposes that a cure for cancer must be found before the entire program can be made practical. A minor problem.

- The technology for several other of his other proposed interventions does not currently exist; for example, expressing mitochondrial genes only in the nucleus.

Anyway, I actually share SENS' goals but not its unwarranted confidence in its specific proposals to achieve them.


Thanks for your comment. I'm really fascinated by the efforts people/organizations/corps are putting into such research and the roadblocks that are potentially in the way of progress.

One thing I'm also fascinated by are the bio "hacker" labs/spaces, and I was wondering if you think something in that direction would be more suited for people to build on and if you think that such labs are even close to being in a position to pursue such endeavors that have mostly been relegated to universities (and the funding environment for such research) and corporations (and the closed source environment typically better suited to monetization)?


Every aspect of wet-lab biology is very expensive. Beyond the equipment and reagents, if you want to do in vivo aging research, you need a pathogen-free environment to house rats/mice for months or years and food to feed them.

Hackerspaces are promising in that they are finding ways to do certain techniques inexpensively. But to do the kind of wet-lab research that results in a published paper requires a wide array of equipment that I don't see available to the layman anytime soon (unless they're independently wealthy).

On the other hand, there is nothing specifically preventing interested amateurs from doing bioinformatics or aging informatics themselves. Only a few things (e.g., sequence analysis) require big clusters; you can do quite a lot on your home PC. If you need data, tons of it is freely available: http://ftp.ncbi.nlm.nih.gov/ is a good place to start. http://rosalind.info/ provides good tutorials.

I wish we would see more open-source developers creating well-designed bioinformatics platforms under the auspices of e.g., Apache or GNU. In general the programming experience of bioinformaticians is quite low, and we are under tremendous pressure to publish often, so there is little incentive to maintain projects over the long-term.


Know any labs in the US that are looking for help and would hire an MS? I'm really excited about HLI but their openings filled quickly!


We have an open position. Contact this gentleman:

http://omrf.org/research-faculty/scientists/wren-jonathan-d/

The brief research blurb doesn't specifically mention aging, but we in fact have heavy collaborations with:

https://www.oumedicine.com/ROCA

and the position is funded by them.

In general however, if you are really interested in aging research you should just bite the bullet and get a PhD. It's necessary to have independence.


SENS = "Strategies for Engineered Negligible Senescence" ie prevention of aging, if I understand correctly.


Self-driving cars will be the biggest humanitarian boon since the Green Revolution or the invention of antibiotics.


Lumping all "drugs" together is pretty lazy. I'd like to know a lot more. Alcohol, Warfarin, and cocaine are all drugs. Alcohol, for example, tends to INCREASE life expectancy when consumed in moderation (1-2 drinks for women, 2-3 drinks for men).


Apparently moderate alcohol consumption only increases life expectancy for people who are generally unhealthy (by reducing risk of heart attack) http://nutritionfacts.org/video/alcohol-risks-vs-benefits/


Ugh, the fact that many of these charts show raw # of deaths versus deaths/100k really masks how much things have improved. In 1968, the population was 64% of our current population... So a flat line is actually a pretty massive improvement.


Thank you, so THAT'S why in the 10th slide it says, "cancer and heart disease have become much less deadly over the years", but the data in the graph says the opposite?

I.e., the graph in slide #10 says:

Cancer in 1990 killed 40422, but in 2010, 50962.

Heart disease in 1990 killed 36545, but in 2010, 45783.

That seems like cancer and heart disease have become worse, not less deadly over the years. That slide is baffling unless you realize that the population must have increased significantly between 1990 and 2010.


In short: more people die of cancer and heart disease now that communicable diseases are more under control in first world countries. The AIDS death epidemic was the rare exception.

Graphs like this are misleading and it's often difficult to collect all the raw data to do the datacube aggregations across multiple dimensions to visualize the data and understand these sorts of details.


Also, the population was older in 2010, and older people are much more likely to die of cancer and heart disease.


Thanks for mentioning this, I was confused about statements like "death from heart disease has become less prevalent" while the chart showed a horizontal line.


Yeah, agreed. The graphs looked great, but it was difficult to cull important comparisons.


Probably the four most important things you can do to change your odds of making it past 80 are:

    1. Not smoking.
    2. Eating healthily (fiber, vitamins, low sugar; this is a nascent field).
    3. Exercising regularly.
    4. Wearing sunscreen and minimizing sun exposure.
These will collectively reduce your risk of common cancers significantly, as well as protect against heart disease. Additionally, they can help strengthen your immune system and body against other diseases that e.g. the malnourished or obese would be more likely to succumb to.


But don't minimize your sun exposure too much or you may end up depressed and kill yourself. Maybe the lesson is one of moderation (but not for smoking!).


Or just take Vitamin D to sidestep this rather terribly "designed" body mechanism.


I can attest that Vitamin D is no substitute for outdoors / sun in combating depression and/or SAD.


It's not just vitamin D that's created in the skin during UV exposure, many closely related substances are also made. The exact purpose or effect, if any, of these is unknown.


Scientists still don't fully understand all the effects sun exposure has on our bodies, so passing judgment on this biological mechanism is premature.

A list of benefits that aren't associated with vitamin D production can be found here: http://articles.mercola.com/sites/articles/archive/2012/09/2...


the hard part not mentioned is, being born to the right parents. Genetics are such a big part of it. The items you listed are more short term boosts to longevity. I am sure many of can point to countless relatives who don't do a thing on the list and just keep on going and others will have done everything right and drop dead before 60.


An interesting theory that seems to make sense to me, is that in a sense who you're born to determines your eating habits. The recipes handed-down from the ages are my wife and I's go-tos, even when they are unhealthy at times.


Actually, human behavior genetics studies suggest that all-cause mortality (and, thus, longevity) has about the lowest calculated "heritability" (which concretely means resemblance among closely related persons) of any measurable human behavioral characteristic. Increases in life expectancy are happening to everybody, and most causes of death have a big stochastic or environmental component in their actual manifestation in individuals.


I disagree completely with #4. The conclusion is, IMO, based on only looking at one side of the coin: the damage over-exposure to the sun does, while ignoring the positive benefits of sun exposure. I'd rewrite it as "Prudent exposure to sunlight while preventing sunburns".

On eating healthily, it is sad that over a century after we started nutrition research, we are still so clueless. There is actually a lot of good information out there, but what conclusions to draw are hard to determine. This is for a variety of reasons: government policy interference, nutritional "belief" fiefdoms, a lot of very bad research, media preferring a sensational story, and certain interests with a strong incentive to confuse the matter. It takes effort, but a person can come up with a scientifically supported diet (in fact, more than one).

The place where we are still in the dark ages is the impact our gut biome plays. As the recent article about African hunter-gatherers show, we are completely clueless about what constitutes a good gut biome. Instead, I feel like much of our knowledge is of the analogous form, "smoking one pack a day is more healthy than smoking two packs, so smoking one pack is the healthy choice" (this analogy holds for many aspects of nutritional health, for example, sugar). We don't have access to a truly healthy gut biome, so our baseline comes from the "least unhealthy" group.


It's not just about making it after 80. Quality of life > length of life.


True. I'm not sure I want to hang out with a bunch of 80 yr olds who can't grab a burger or a drink and spend all day indoors to limit sun exposure.

:)


you forgot car driving. that's high risk/.


"And, how do suicide and drugs compare to other violent deaths across the population? Far greater than firearm related deaths, and on the rise

In 2010, 19,392 of the 38,364 suicides were "by discharge of firearm" [the same term used for classifying 11,078 homicides and 606 accidental deaths]. Seems a bit odd that the report classifies the accidents and homicides as "firearm related deaths" but the suicides as unrelated.

From a public health perspective, a 50% reduction in suicide by firearm would save more lives than the complete elimination of HIV deaths or cervical cancer deaths or uterine cancer deaths.

http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf


> From a public health perspective, a 50% reduction in suicide by firearm would save more lives than the complete elimination of HIV deaths or cervical cancer deaths or uterine cancer deaths.

That's not necessarily true. Various methods of suicide are subject to substitution effects. As shown by several recent studies in Australia, a decline in the share of suicides by firearm results in a consummate rise in suicides by hanging.


The commonly cited studies supporting the 'substitution' hypothesis are based on data right up to the point when Australia's rate began to decline and tend to be short on demographic analysis. The correlation was found at a time of increasing male suicides where most of the increase was by hanging.

http://www.nisu.flinders.edu.au/pubs/bulletin23/bulletin23-3...

Note also that the substitution hypothesis is not consistent with the overall decline in female suicides during the same period.

This more recent Harvard study indicates that reducing the lethality of suicide means correlates with a decline in deaths. Interestingly, it postulates that the age demographic which saw an increase in hanging deaths was the same younger population more likely to be familiar with sexual asphyxia and thus the mechanics of hanging while older males did not see a significant decline in firearm suicides.

http://dash.harvard.edu/bitstream/handle/1/10579072/3434145....


It seems odd to conflate person-on-person crime with a choice to kill one's self. Further, in my limited experience with suicide, firearms are part of the planning process and not the impetus of death. It seems just as likely to me that a 50% reduction in suicide by firearm would be followed by 1000% increase in suicide by hemlock.


I think the question is the substitution effect. If easy access to firearms really did increase the total number of suicides by a substantial amount (i.e. they were more effective, or people were not willing to use other methods), then I'd view it as something specific to firearms.

I'm pretty sure there is near 100% substitution, but that firearms are a much more effective method, which accounts for the net difference.


Having a gun around is a constant reminder of death in a way that having a rope or a drawer full of kitchen knives is not. The objects in your environment are directly related to the choices available to you and are part of the framework you use when trying to think about what actions to take.


Clearly false: In Switzerland, even though one likely posses a gun, one is more likely to use a rope to commit suicide.

While we, being simple humans, may project feeling upon an inanimate object, it's a mistake to assume a god's eye view, objectivity, or universal reality.

Bringing it back around: Are you suicidal? We're here to help. ;)


I am not sure that you fully understand my point as the method used is not what I was getting at exactly. Even if the majority of people do not reach for the gun as the method does not say whether the availability of the gun made the suicide more likely. It also matters what you associate with the gun, you could have very different thoughts about a gun kept for hunting deer, than one kept for shooting potential attackers, for instance.


I read your argument as (1) humans are entangled with the environment and (2) a judgement that guns are related (mind) to death more so than edged weapon or rope (hence my question of your mood or state). Following your logic, shouldn't we expect a higher rate of suicide in Switzerland than the US?

As for intentionality, proper reference to cultural symbol and relation, as you state in your last sentence, is essential but seemingly ignored in favor of how one believes, desires.


Every gun-owning person I've known who did kill himself actually didn't use a gun (sample set of maybe 5?)


This is interesting, but I have no idea if it is true or not. Would love to seem some data on this.


The Golden Gate Bridge might be a well studied form of this (it's a fairly common suicide location, and a visible landmark across much of SF). i.e. do people commit suicide more frequently if they have a view of the GG Bridge vs. a view of something else?


Going to link to WP because it links to further sources: http://en.wikipedia.org/wiki/Suicide_barrier

Looks like it's a combination of factors. The Toronto case I've heard before. Although some substitution took place, overall rate went down.


Should also point out:

   The category ‘‘drug-induced causes’’
   includes not only deaths from dependent and nondependent use of
   drugs (legal and illegal use), but also poisoning from medically
   prescribed and other drugs. It excludes accidents, homicides, and
   other causes indirectly related to drug use. Also excluded are
   newborn deaths due to mother’s drug use. (For drug-induced causes,
   see Technical notes.) Between 1997 and 1998 the age-adjusted death
   rate for drug-induced causes increased 5 percent from 5.6 deaths per
   100,000 U.S. standard population to 5.9, the highest it has been since
   at least 1979.
And doing a little searching for number of deaths from prescribed medications:

    In 2010, there were 38,329 drug overdose deaths in the United States; 
    most (22 134; 57.7%) involved pharmaceuticals; 9429 (24.6%) involved 
    only unspecified drugs. Of the pharmaceutical-related overdose deaths, 16,451 
    (74.3%) were unintentional, 3780 (17.1%) were suicides, and 1868 (8.4%) 
    were of undetermined intent. Opioids (16,651; 75.2%), benzodiazepines (6497; 29.4%), 
    antidepressants (3889; 17.6%), and antiepileptic and antiparkinsonism drugs 
    (1717; 7.8%) were the pharmaceuticals (alone or in combination with 
    other drugs) most commonly involved in pharmaceutical overdose deaths. 
    Among overdose deaths involving opioid analgesics, the pharmaceuticals 
    most often also involved in these deaths were benzodiazepines (5017; 30.1%), 
    antidepressants (2239; 13.4%), antiepileptic and antiparkinsonism drugs (1125; 
    6.8%), and antipsychotics and neuroleptics (783; 4.7%)." - 
    See more at: http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.gaJ8WlzN.dpuf
I think the "drugs kill more people than guns" statement in the slide show is a little disingenuous because "drug deaths" implies "illegal drugs" and not "your doctor gave you some shit that killed you". Also, I find it hard to believe that that number starting in, what, the late 70s? is anywhere near accurate. I'll ask you this: do you think more or fewer people were using dangerous drugs in the 70s than today? During disco, coke, free sex, and a general environment of nihilism? My guess is same or less, not the quite significant growth suggested in the slideshow.


> [...] "drug deaths" implies "illegal drugs" [...].

This probably depends on your community/social circle. Some groups heavily advocate that pharmaceuticals be limited to life saving emergencies and not ongoing usage ("pill for everything").


True, provided we don't see a commensurate increase in suicide by some other means. Considering how effective suicide by firearm is at accomplishing that goal it probably would significantly reduce first-attempt "success" rate.


If you liked this, you might enjoy some of their previous articles. It's interesting to see them iterating on the technique.

Consumer spending (from last December): http://www.bloomberg.com/dataview/2013-12-20/how-we-spend.ht...

Housing prices (from February): http://www.bloomberg.com/dataview/2014-02-25/bubble-to-bust-...


"This is particularly striking since cancer and heart disease - the two biggest killers for 45-54 yr olds - have become much less deadly over the years"

Except your graph shows that cancer death rates have increased by almost 20% from 1968-2010... Am I missing something here?


I noticed that too, my guess is that the amount of people killed by cancer in the total population that has decreased. (example with made up numbers: 1968 has 1000 people, cancer killed 100 of them. 2010 has 2000 people, cancer killed 150 of them, thus it is both a increase and a decrease)


Heart disease is killing fewer people allowing more to reach an age where cancer becomes a major killer. Since cancer treatments have advanced the number of deaths due to cancer looks flat.


Because the graph is not accounting for population increase. The deaths increased, but the population increased even more. The percentage decreased.


Ah yes!! That is why, how silly of me. When put into the context of population increase, it is an incredible decrease in percentage of people who die from cancer.

1968 US Population: 200.71 million

2010 US Population: 309.35 million


That was my takeaway, too. I stared at this particular slide for quite some time because I was sure I must be missing something.


Very nice graphs and visualisations, but am I alone in finding most of them hard to understand?


Agreed. They inconsistent in whether they're showing total deaths or deaths per 100,000 or normalized death rate from some starting year, etc.


Design issue - the graph titles and legend are stuck between the data and the x-axis labels. Makes it harder to visually parse the information.


Nope. I had to think about Slide 3 for a few minutes: "...because old people die sooner than the young".


Yeah that slide made me lose it and I gave up on the rest of them without even bothering. How anybody could look at the statement "Old people die sooner than the young" and think "yeah, that definitely explains what I want to say" is both baffling and hilarious.


Either I am blind, or they aren't there but there were a few slides where I was trying to figure out the Y axis representation because it wasn't labeled clearly.


I heard once that one cigarette a day as a stress relief may actually extend your life. I'm not sure about that, but I do think we need to be mentally and emotionally healthy too. Our health and well-being is not purely physical.

I would think that happy people who are not constantly under stress live longer.


Obviously, there are stress reliefs that don't carry a risk of giving you lung cancer. I'll take those, thanks.


I agree, and I think that the COPD is probably worse than the cancer.

I only meant to point out that many people in affluent western countries smoke, over eat, drink excessively and do other physically unhealthy things (because they have the money) in order to reduce mental and emotional stress. If we could reduce stress in general then we'd probably live longer, healthier lives.

General social issues lead to general health issues.


This reminds me of the book Island by Huxley. One character (like all the characters, are just Huxley giving a lecture from an eastern perspective) talks about how in the West we treat the symptoms of physical sickness and patch up mental sickness with pills, but we don't, as a society, care much for prevention by producing healthy bodies and especially care little for producing healthy minds:

"Well, there was that group of American doctors," she answered. "They came to Shivapuram last year, while I was working at the Central Hospital." "What were they doing here?" "They wanted to find out why we have such a low rate of neurosis and cardiovascular trouble. Those doctors!" She shook her head. "I tell you, Mr. Farnaby, they really made my hair stand on end—made everybody's hair stand on end in the whole hospital." "So you think our medicine's pretty primitive?" "That's the wrong word. It isn't primitive. It's fifty percent terrific and fifty percent nonexistent. Marvelous antibiotics—but absolutely no methods for increasing resistance, so that antibiotics won't be necessary. Fantastic operations—but when it comes to teaching people the way of going through life without having to be chopped up, absolutely nothing. And it's the same all along the line. Alpha Plus for patching you up when you've started to fall apart; but Delta Minus for keeping you healthy. Apart from sewerage systems and synthetic vitamins, you don't seem to do anything at all about prevention. And yet you've got a proverb: prevention is better than cure." "But cure," said Will, "is so much more dramatic than prevention. And for the doctors it's also a lot more profitable."

"About the way they treat people with neurotic symptoms. We just couldn't believe our ears. They never attack on all the fronts; they only attack on about half of one front. So far as they're concerned, the physical fronts don't exist. Except for a mouth and an anus, their patient doesn't have a body. He isn't an organism, he wasn't born with a constitution or a temperament. All he has is the two ends of a digestive tube, a family and a psyche. But what sort of psyche? Obviously not the whole mind, not the mind as it really is. How could it be that when they take no account of a person's anatomy, or biochemistry or physiology? Mind abstracted from body—that's the only front they attack on. And not even on the whole of that front. The man with the cigar kept talking about the unconscious. But the only unconscious they ever pay attention to is the negative unconscious, the garbage that people have tried to get rid of by burying it in the basement. Not a single word about the positive unconscious. No attempt to help the patient to open himself up to the life force or the Buddha Nature. And no attempt even to teach him to be a little more conscious in his everyday life. You know: 'Here and now, boys.' 'Attention.' " She gave an imitation of the mynah birds. "These people just leave the unfortunate neurotic to wallow in his old bad habits of never being all there in present time. The whole thing is just pure idiocy!"

Out of context it reads a bit funny, but the whole book is compelling. Everything Huxley and Watts took from eastern philosophy is interesting.

Full book here: http://www.huxley.net/island/aldoushuxley-island.html


We also say, "stop and smell the roses", but we don't do that either ;)

We're so busy rushing here and there that we never touch nor live in the now. And we have children and expect them to just do the same. It's sad really.

We think to ourselves, "If I had a billion dollars, then I would be happy" yet all we need in order to be happy is to fully live every moment and stop looking to the future or regretting the past. Just live right now.


So in 1968 all age cohorts had the exact same mortality rate of 100 per 100,000? Why is that?


I believe the 100 (or any of the numbers in that chart) are scores which he normalized to 100 in each age category for 1968. I don't know what the per 100,000 is supposed to mean. As a death rate per year, it doesn't seem possible. Consider that it's showing ~70/100,000 in the 85+ category. Given that they'd all be dead in 25 years, that number can't be right.

This presentation is style over substance.


About three or four slides in you get the take-away message, which is often missed in discussions about mortality here on Hacker News: "If you divide the population into separate age cohorts, you can see that improvements in life expectancy have been broad-based and ongoing." And this is a finding that applies not only to the United States, but to the whole developed world. I have an eighty-one-year-old mother (born in the 1930s, of course) and a ninety-four-year-old aunt (born in the 1920s) and have other relatives who are quite old and still healthy. Life expectancy at age 40, at age 60, and at even higher ages is still rising throughout the developed countries of the world.[1] An article in a series on Slate, "Why Are You Not Dead Yet? Life expectancy doubled in past 150 years. Here’s why."[2] explains what incremental improvements have led to better health and increased life expectancy at all ages in the United States. The very fascinating data visualizations in the article submitted today highlight the importance of research on preventing suicide, reducing drug abuse, and preventing senile dementia such as Alzheimer disease, which is where some of the next progress in prolonging healthy life will have to come from.

Professional demographers try to think ahead about these issues, not least so that national governments in various countries can project the funding necessary for publicly funded retirement income programs and national health insurance programs. Demographers have now been following the steady trends long enough to make projections that girls born since 2000 in the developed world are more likely than not to reach the age of 100,[3] with boys likely to enjoy lifespans almost as long. The article "The Biodemography of Human Ageing"[4] by James Vaupel, originally published in the journal Nature in 2010, is a good current reference on the subject. Vaupel is one of the leading scholars on the demography of aging and how to adjust for time trends in life expectancy. His striking finding is "Humans are living longer than ever before. In fact, newborn children in high-income countries can expect to live to more than 100 years. Starting in the mid-1800s, human longevity has increased dramatically and life expectancy is increasing by an average of six hours a day."

I was in a local Barnes and Noble bookstore back when I was shopping for an eightieth birthday gift (a book-holder) for my mom, and I discovered that the birthday card section in that store, which is mostly a bookstore, had multiple choices of cards for eightieth birthdays and even for ninetieth birthdays. We will be celebrating more and more and more birthdays of friends and relatives of advanced age in the coming decades.

[1] http://www.nature.com/scientificamerican/journal/v307/n3/box...

[2] http://www.slate.com/articles/health_and_science/science_of_...

[3] http://www.prb.org/Journalists/Webcasts/2010/humanlongevity....

[4] http://www.demographic-challenge.com/files/downloads/2eb51e2...


There are a couple of messages later on that are important as well.

1. AIDS was a really important retrograde factor in this general story, and developing the commitment to research and deploy strategies for dealing with it was a major victory.

2. Alzheimers and similar illnesses are a huge factor in terms of healthcare for the elderly. A similar success there would yield tremendous results.


I'm not so sure you can really sketch thing out like that.

AIDS was a virus-born epidemic and it is normal for such things to experience exponential growth and decline.

Dementia is part of the process of degeneration resulting from aging, from people basically wearing-out. Like with heart disease or cancer, it seems likely we can only really expect halting and expensive progress in this field.

The most problematic thing is that extending the life of a cancer victim ten years without an actual cure would be seen as a modest gain. Similarly extending the life of an Alzheimer's victim wouldn't be so seen.


The precipitous decline in AIDS deaths (not HIV infection) after 1995 was due to the introduction of protease inhibitor drugs like Crixivan.


The life expectancy gain of 2.5 years every decade is for life expectancy at birth.

Remaining life expectancy in old age is growing by about 1 year per decade.

An interesting, albeit a little too populist take on the options for the future of medicine and longevity:

http://inthetank.newamerica.net/blog/2013/09/drooling-your-s...

As I mentioned elsewhere, the current trends are all due to entirely incidental effects on the processes underlying aging. We should expect to see a great discontinuous leap upwards in life expectancy in the next few decades if the present disruption in the field of aging research takes hold and wins control of the mainstream, such that there is a sea change in the community to focus on actually treating aging itself rather than focusing on patching over its late-stage consequences. This hasn't been done yet to any meaningful degree, and so we should expect interesting results once it is a going concern.


"If you divide the population into separate age cohorts, you can see that improvements in life expectancy have been broad-based and ongoing."

Here, I claim "broad-based" depends heavily how you choose your cohorts. For example, the life span of the least educated whites in the US has shrunk (which might be relate to the increase in drug deaths mentioned by the article).

http://www.nytimes.com/2012/09/21/us/life-expectancy-for-les...


Any info on how they create these visualizations? Are they using any particular libraries or frameworks?


I'll ask the team if they're using anything special beyond d3/jq. The team is run by Lisa Strausfeld, an MIT Media Lab alum. You can also find videos of her talking about them floating around Youtube, etc.


That would be great, thanks. I suspected they were using d3, but based on how consistent some of their visualizations are with each other I suspect they have an in house library that they are using as well. Would be cool to hear from the source :)



JQuery Cycle is used for the IE<9 version, which is a slideshow of screenshots taken from the piece. Everything else is done with d3 and jquery as mentioned. We have a custom framework for these dataview pieces, all other work is just based on the same style guide. As seen here: http://www.bloomberg.com/visual-data/


There is a hint at a job posting for their Visual Data Team here: http://www.linkedin.com/jobs2/view/6994300

They ask for Experience in Javascript, JQuery, CSS, HTML, XML, HTML5 Experience in QGis, ArcGIS , Google Maps Api and large government open data APIs Expertise in standard design tools (Illustrator, InDesign, Photoshop)

Also: source code references D3


I work on the team, but didn't do this interactive, but I sit next to the guy who did. The other comments in this thread are correct, it's d3 and some jQuery. D3 is an amazing library and well worth learning. Thanks for all the feedback, we're reading it all.


Whatever they used they deserve big credit for making it a great experience even on iOS. I was very surprised how well this worked on the iPhone.



Looks like d3 (http://d3js.org/) with some jquery to me. Viewing the source supports that.


The part about suicides is pretty interesting and perplexing. Are there any insights into why the rate has increased?


I think the drug and suicides, that affect mostly males, might be related to the social changes and gender role changes.

There is some research about "happyness" that started around 1970, two difference scientists asked more or less similar question since then: what you did in your day, and how happy you felt.

In 1970 women used to claim to be happier than men, there was a very large gap there.

Currently the gap is smaller, but reversed (men are happier instead), also both men and women are unhappier than in 1970s.

Regarding workload, women are working now (summing home chores and outside work) much more than 1970, men are also working more, but one thing that the researcher was noted, is that the time specifically dusting the house decreased a lot, since there is no major invention in that field since 1970s, he had the conclusion that maybe the source of unhappyness is that people don't have time even to keep their home clean, and are living in homes that are dirtier than they were in 1970.

Now I need to figure where was those articles (there are two of them with published data), I frankly don't remember :( (I stumbled on them on a night of random reading on internet)


One can spend a billion of studies on the causes of increasing suicide rates, really. I can name a few random causes:

* The US economy, at least for part of the populace, is pretty crappy; working three jobs, money worries, the financial crisis, it all adds up. * The internet; more (negative) news from all over the world, telling people how terrible it all is. At the same time, "Facebook Envy", people getting told how bad their life is in comparison to their facebook friends (which is skewed because a lot of people only put the good stuff on there). * People are dicks.


I wonder how much of this is also veterans.


It's a lot more socially acceptable to commit suicide for the elderly and terminally ill these days.


How can suicide become "more socially acceptable?" What does the delta consist of, between suicide being "not socially acceptable" and suicide being "socially acceptable?"

I've had no experience with anyone I know of committing suicide, but I am not seeing how to evaluate whether it is or isn't socially acceptable.


In conversations about suicide the suicidal person can be talked of as "having given up"/"took the easy way out", "been selfish to their loved ones", "gone against god's will".

On the other end of the scale we can talk about "Dying with dignity", "Not being a burden to loved ones", "finally at peace", "being in a better place".

When more people hold the later views then it is more acceptable in society for someone to commit suicide because they don't feel that they are hurting others as much/aren't as evil for doing it (not that I believe they're at all evil I used that wording as those considering suicide may be self loathing).

You could even make arguments on a case by case basis if you wanted from the heroic last stand to a single parent leaving behind their children. It all comes down to what obligations we feel people have to stay alive.


If your country has an assisted suicide clinic, it's probably more socially acceptable. When I get old and start forgetting people's names, I'll move to one of those countries in preparation.


The economic downturn is believed to play a big role:

http://www.nytimes.com/2013/05/03/health/suicide-rate-rises-...


That seems to be around the age that people start feeling like they've 'missed the boat' if they aren't married, or didn't achieve their childhood ambitions.


<script src="global/js/jquery-1.8.3-min.js" charset="utf-8"></script>

<script src="js/modernizer.2.7.1.js" charset="utf-8"></script>

<script src="js/underscore.1.5.2.js" charset="utf-8"></script>

<script src="global/js/less.js" charset="utf-8"></script>

<script src="global/js/d3.v2.js" charset="utf-8"></script>

<script src="js/jquery.cycle.all.js" charset="utf-8"></script>

It looks like the majority of this visualization was from the D3.js library. I've been seeing more and more web-documents of this style, it must be because of the rise of D3.


Black males die at such a higher rate from AIDS. Are they having that much more unprotected sex, taking that many more drugs from dirty needles, or getting that much inferior treatment than the general population?


A big heaping of options 1 and 3, with a bit of 2 tossed in.

Homophobia has AIDS and AIDS-related mortality as comorbidities. There exist fewer support structures for gay black men than exist for gay white men, which e.g. reduces knowledge transfer, makes it less of a cultural norm to stay on your drug regimen, provides fewer role models for how to live as an HIV-positive man.

It's also important to note another factor: our disproportionately black prison population and our epidemic of prison rape. Anal rape by multiple men, many of them with one or more other STDs, is an ideal way for an HIV infection to be transferred. HIV also gets transferred in prison through consensual sex: most prisons don't offer free condoms to inmates. The net result is the rate of contracting HIV is 10 to 100 times higher within prison than outside it.


I wish we would treat prison rape like rape which is wrong, period, with no exceptions. I also wish we would treat the mental problems that lead to depression and suicide with the same seriousness as that which leads to drug addiction, prison, and AIDS.

We've greatly reduced death by cigarette related diseases. That was mostly a behavioral problem, so is AIDS. The rest of the items on this site seem to be scientific problems.

Not to get too political but we want to do our best to eliminate all these causes of death. Black males with AIDS seems like low hanging fruit disguised as a real problem with our society.


I wouldn't be surprised if it boiled down to three things:

1) HIV is more easily transmitted man-to-man or woman-to-man than it is man-to-woman or woman-to-woman. Thus, all else being equal, men are more likely than women to get HIV, and therefore AIDS.

2) For various historical and political reasons, race and class are closely correlated in the US. Black men are more likely to be poor than white men.

3) Poor people are much less likely to have access to condoms and be educated about safe sex, and are more likely to use street drugs and share needles. They're also less likely to have good access to health care, meaning than HIV won't be treated properly and is more likely to progress to AIDS and, eventually, death.

Put those three factors together, and you end up with black men having a much higher incidence of AIDS than other groups.


To elaborate - my experience here in anecdotal having worked in a HIV/AIDS - the larger issue among this cohort is usually compliance with treatment and medication management. Yes, the factors you cited are all what leads to a higher rate of infection, but mortality increases when people don’t adhere to treatment.

There’s all kinds of reasons for that, many of which are related to lifestyle. Payment is an issue, but there are programs in the US available for the those that have no other option to afford treatment thanks to the Ryan White CARE Act. But even if the medicine is paid for, unfortunately in this cohort we see a lot of additional issues prevalent such as: drug use, homelessness, mental instability - all leading to patients not staying on their drug cocktail regimen.


Yes


It interesting to see that drugs and suicide are the highest causes of death, well over that of guns. But we seem to be progressing more towards a drug open world and gun closed world. Do you see the Irony?


No irony at all. Tobacco is the biggest killer, about 5X alcohol, and alcohol is about 10X illicit drugs. On top of that, illicit drug deaths could be brought down by taking the prison and police resources used in the Drug War and using them for harm reduction. Another thing about the Drug War is that zero deaths result from marijuana, and that's still a big component of the Drug War.

On the other hand, guns are used in about 2/3rd of suicides.


"guns are used in about 2/3rd of suicides" - correlation does not imply causation, it is especially clear in this case


Yeah, but which drugs? There is no laxity for meth, crack or pain killers, which I would assume account for these deaths--not marijuana.


Alcohol is probably included in these deaths.


Maybe one day we'll extend natural life expectancy so far that suicide and drugs are the primary causes of death?

Is immortality the presumed goal?


Immortality is always the goal. You can't have a goal without having time with which to achieve it. Assuming you never stop wanting to have goals, you should never want to die. Given that death is something people tend to accept rather than wish for, almost everyone wants to be immortal.


"That's why total deaths in the 75+ category has stayed constant"

I thought that was a particularly funny statement. Reminded me of the onion: http://www.theonion.com/articles/world-death-rate-holding-st...


I created a visualization on a similar topic that looked at mortality rates state-by-state using the 2010 census data. It was on HN about six months ago.

http://www.matthewisabel.com/projects/deathrates/geographic....


Thank you for sharing this. It's effective and straightforward.


I got the presentation's/graph's main takeaway, but did anyone else notice that women's mortality rate hardly changed since 1968? Why was this, I wonder? Is this a population thing or because women were mostly kept inside doing safer house duties or what?


My initial guess would be that Patriarchy historically oppressed women off of the battlefield, kept them out of the coal mines, prevented them from enjoying asbestos work, excluded them from steelworking and construction, and barred their empowering path to firefighting and heavy industry.


Need some error bars on that data.


[deleted]


Maybe we should have a war on drugs, then. I'm sure that would work.

Getting guns out of our communities is probably easier than getting drugs out of them, not to mention mental conditions that lead to suicide.


Far fewer people are dying from gun violence than from drug use according to those charts.


"progress stopped in the mid 1990s" maybe i am missing something but it seems like the mortality rate would be a lagging indicator progress hence progress would have "stopped" earlier?

Not that I necessarily would say it stopped at all...


If whomever contributed to the code on this is around, could you give us some insight into building this app, or do a writeup? I'd be super interested to see how you designed/architected such a smooth and experience.


Pretty incredible user experience on mobile, haven't seen graphs that look that good in a mobile web browser (and interactive no less).


I don't care much about the topic, but I thought this is a great way to present data !


Surprised how nice the visualization looks, given how ugly the Bloomberg terminal is


Any reason why the 75-84 group was out living the 85+ group until recently?


Well if the average age steadily increases, then if your life expectancy used to be 75 and climbed to 85, the people that would previously die at 75 now die at 85. As the chart states, average life expectancy is increasing.


I couldn't figure out any way to navigate without using the mouse.


The left/right cursor keys didn't work for you?


That's neat, but it's very hard to tell the colors apart.


[deleted]


I wonder is the drop in car accident death caused by; 1) Cash for clunkers taking old dangerous cars off the road so the fleet consists of more newer safer cars or; 2) People driving less since the recession and the gas price increases


I would bet it would be more likely related to '1'.

I know insurance rates went down across the board 1-2 years back. It's hard to get a car without traction control and ABS now, which makes a huge difference.

According to this study, vehicle stability control really does decrease crashes.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217442/


I don't know about cash for clunkers but america's car fleet turnover is 14 years. So from the invention of a new safety measure, to its broad introduction across all new cars, to cars with the feature being predominant, is ~20 years.


Everyone knows that the most Americans actually die in terrorist attacks. How else can you justify such emphasis on fighting it? Hmmmmmmmm.


Terrorists driving cars, apparently.




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