4 ms·

>The news is perhaps not shocking given the relatively poor quality of health care in the US. I'm not sure I agree with that? I'd think intuitively the delta b

>The news is perhaps not shocking given the relatively poor quality of health care in the US. I'm not sure I agree with that? I'd think intuitively the delta between years lived and "health span" would be largest in countries with good health care. The end of the article does allude to this. >While the US presented the most extreme example, the researchers note that the global trends seem to present a "disease paradox whereby reduced acute mortality exposes survivors to an increased burden of chronic disease."

LinuxBender 2y ago
I am not an expert but I think it may be more nuanced in my opinion. Fast food started in the US in the 70's. Other nations followed after some time and I do recall seeing a funny chart ... not sure if I can find it tonight but it is an overlay of when people started eating fast food and when there was a dramatic increase of type 2 diabetes. One graph followed the other perfectly. There is a time window offset and I think that's why people have a hard time grasping the cause and effect. Other countries have similar graphs and they have the same time window offset but the graphs map onto each other perfectly with that same time windows offset. It's only gotten worse since then. A bored journalist at Ars should try to find those graphs.
- listenallyall 2y ago
  Lots of people want to vilify fast food and blame it for any unhealthy trends. But the timing of fast food's emergence correlates with all kinds of other possible triggers - massive increase in availability of snack foods (cookies, Domino's, potato chips) in the home, far more sedentary lives and careers, introduction of plastic 2-liter soda bottles, increased use of seed oils, more sugar-based breakfast food, etc. So it is lazy and biased when you look at a few charts and assume it's all McDonald's fault.
  - _heimdall 2y ago
    Once you consider seed oils (many people still vilify saturated fats) the fast food timing gets even murkier. Fast food restaurants originally cooked in beef tallow where as its all seed oils today. If the oil type makes a difference and it wasn't necessarily the design of a fast food restaurant, the clock would have to start when chains got rid of tallow.
    - trealira 2y ago
      Why are seed oils unhealthy, though? I can't find anything that's bad about them in particular. I've only seen people commenting online saying to avoid them.
      - _heimdall 2y ago
        There's too much there for me to give a great answer here, but I can recommend Dr Michael Eades as a starting point. He wrote a couple books over the years on heart health and has been writing a newsletter for the last few years where he discusses various related topics in detail. At a super high level, it has to do with how seed oils ("vegetable" oils, etc) are produced and how oxidative they are in the body.
- marinmania 2y ago
  Fast food causing people to eat badly reflects poorly on US society as a whole, but not sure if it reflects badly on the US healthcare system. Especially if the stats show that the US is good at keeping these people alive.
rayiner 2y ago
It’s like people just say this stuff as a meme. Is healthcare in the U.S. bad? Asian Americans in the U.S. live 84.5 years on average, longer than Singapore, an Asian country with universal healthcare. As far as I can tell Asian Americans have the same healthcare system as at least white Americans. So is the problem the healthcare system? In Utah, LDS males have a life expectancy of 77.3 versus 70 for non-LDS males. (LDS have higher income but only slightly.) I don’t think there’s any special Mormon healthcare system!
- dangus 2y ago
  It is objectively bad based on value, and it’s objectively bad on the equality of the care. US healthcare is great if you’re in the top 50% of earners who have employer-sponsored healthcare and you can keep your job while you go through major care events. People like knowledge workers tend to fit this bill. Doesn’t hurt that they aren’t messing up their back doing construction or something. Obviously the USA has a ton of excellent care available including some of the top technology, doctors, and hospitals in the world. It’s not so great if you’re one of the double digit millions of people who have no health insurance at all. It’s not so great if you can’t afford anything except the yearly check-up. Did you know that over 40% or people who get cancer in America lose their life savings within two years?
  - rayiner 2y ago
    Don’t forget the additional 20% of people on Medicare. What percentage of people who get cancer have to leave their jobs as a result? What’s the corresponding statistic in other countries?
    - rayiner 2y ago
      Sorry I meant medicaid
  - bigfatkitten 2y ago
    > It’s not so great if you can’t afford anything except the yearly check-up. The people in your second demographic don't even get that. They finally take unpaid time off work to see the doctor when they start pooping blood, and the doctor tells them to get their affairs in order in the few months they have left.
refurb 2y ago
Precisely. Average lifespan is a terrible metric for quality of healthcare. There are dozens of confounding factors that can reduce lifespan even in the presence of high quality healthcare.
- scary-size 2y ago
  A recent podcast I listened to highlighted the US‘ child mortality rate as an indicator for the quality of their health care system.
  - refurb 2y ago
    A podcast you say! Child mortality is even worse. Not all countries count neonatal deaths the same. In many countries premature babies that die are "stillborn" and not counted. In the US, very, very premature babies are resuscitated and if they pass away, are averaging "zero" into the stats. So in fact, aggressive medical care in neonates can actually make mortality measures worse. https://pmc.ncbi.nlm.nih.gov/articles/PMC4560894/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4560894/ The popularity of the infant mortality indicator notwithstanding, international variations in birth registration laws and practices have the potential to bias comparisons of infant mortality. Problems can arise from differential registration of live births and stillbirths, especially births occurring at the borderline of viability (e.g., gestational age <22 weeks or a birth weight <500 grams, who typically do not survive the neonatal period), and/or their classification as stillbirths versus live births
    - scary-size 2y ago
      Thanks for pointers. I was actually curious about this. Didn’t want to imply that child mortality is a better metric.

LinuxBender 2y ago

I am not an expert but I think it may be more nuanced in my opinion. Fast food started in the US in the 70's. Other nations followed after some time and I do recall seeing a funny chart ... not sure if I can find it tonight but it is an overlay of when people started eating fast food and when there was a dramatic increase of type 2 diabetes. One graph followed the other perfectly. There is a time window offset and I think that's why people have a hard time grasping the cause and effect. Other countries have similar graphs and they have the same time window offset but the graphs map onto each other perfectly with that same time windows offset. It's only gotten worse since then. A bored journalist at Ars should try to find those graphs.

listenallyall 2y ago
Lots of people want to vilify fast food and blame it for any unhealthy trends. But the timing of fast food's emergence correlates with all kinds of other possible triggers - massive increase in availability of snack foods (cookies, Domino's, potato chips) in the home, far more sedentary lives and careers, introduction of plastic 2-liter soda bottles, increased use of seed oils, more sugar-based breakfast food, etc. So it is lazy and biased when you look at a few charts and assume it's all McDonald's fault.
- _heimdall 2y ago
  Once you consider seed oils (many people still vilify saturated fats) the fast food timing gets even murkier. Fast food restaurants originally cooked in beef tallow where as its all seed oils today. If the oil type makes a difference and it wasn't necessarily the design of a fast food restaurant, the clock would have to start when chains got rid of tallow.
  - trealira 2y ago
    Why are seed oils unhealthy, though? I can't find anything that's bad about them in particular. I've only seen people commenting online saying to avoid them.
    - _heimdall 2y ago
      There's too much there for me to give a great answer here, but I can recommend Dr Michael Eades as a starting point. He wrote a couple books over the years on heart health and has been writing a newsletter for the last few years where he discusses various related topics in detail. At a super high level, it has to do with how seed oils ("vegetable" oils, etc) are produced and how oxidative they are in the body.
marinmania 2y ago
Fast food causing people to eat badly reflects poorly on US society as a whole, but not sure if it reflects badly on the US healthcare system. Especially if the stats show that the US is good at keeping these people alive.

rayiner 2y ago

It’s like people just say this stuff as a meme. Is healthcare in the U.S. bad? Asian Americans in the U.S. live 84.5 years on average, longer than Singapore, an Asian country with universal healthcare. As far as I can tell Asian Americans have the same healthcare system as at least white Americans. So is the problem the healthcare system? In Utah, LDS males have a life expectancy of 77.3 versus 70 for non-LDS males. (LDS have higher income but only slightly.) I don’t think there’s any special Mormon healthcare system!

dangus 2y ago
It is objectively bad based on value, and it’s objectively bad on the equality of the care. US healthcare is great if you’re in the top 50% of earners who have employer-sponsored healthcare and you can keep your job while you go through major care events. People like knowledge workers tend to fit this bill. Doesn’t hurt that they aren’t messing up their back doing construction or something. Obviously the USA has a ton of excellent care available including some of the top technology, doctors, and hospitals in the world. It’s not so great if you’re one of the double digit millions of people who have no health insurance at all. It’s not so great if you can’t afford anything except the yearly check-up. Did you know that over 40% or people who get cancer in America lose their life savings within two years?
- rayiner 2y ago
  Don’t forget the additional 20% of people on Medicare. What percentage of people who get cancer have to leave their jobs as a result? What’s the corresponding statistic in other countries?
  - rayiner 2y ago
    Sorry I meant medicaid
- bigfatkitten 2y ago
  > It’s not so great if you can’t afford anything except the yearly check-up. The people in your second demographic don't even get that. They finally take unpaid time off work to see the doctor when they start pooping blood, and the doctor tells them to get their affairs in order in the few months they have left.

refurb 2y ago

Precisely. Average lifespan is a terrible metric for quality of healthcare. There are dozens of confounding factors that can reduce lifespan even in the presence of high quality healthcare.

scary-size 2y ago
A recent podcast I listened to highlighted the US‘ child mortality rate as an indicator for the quality of their health care system.
- refurb 2y ago
  A podcast you say! Child mortality is even worse. Not all countries count neonatal deaths the same. In many countries premature babies that die are "stillborn" and not counted. In the US, very, very premature babies are resuscitated and if they pass away, are averaging "zero" into the stats. So in fact, aggressive medical care in neonates can actually make mortality measures worse. https://pmc.ncbi.nlm.nih.gov/articles/PMC4560894/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4560894/ The popularity of the infant mortality indicator notwithstanding, international variations in birth registration laws and practices have the potential to bias comparisons of infant mortality. Problems can arise from differential registration of live births and stillbirths, especially births occurring at the borderline of viability (e.g., gestational age <22 weeks or a birth weight <500 grams, who typically do not survive the neonatal period), and/or their classification as stillbirths versus live births
  - scary-size 2y ago
    Thanks for pointers. I was actually curious about this. Didn’t want to imply that child mortality is a better metric.