Why Are Americans’ Life Expectancies Shorter than Those of People in Other Advanced Economies?

Yves here. The high social cost of inequality – the fact that it shortens the lives of people at the top of the pecking order along with the lower orders – has long been excluded from discussion in polite company in the US. Michael Prowse took note of the lifespan cost of income inequality in the Financial Times in 2007, and this information wasn’t new in public health circles even then:

Those who would deny a link between health and inequality must first grapple with the following paradox. There is a strong relationship between income and health within countries. In any nation you will find that people on high incomes tend to live longer and have fewer chronic illnesses than people on low incomes.

Yet, if you look for differences between countries, the relationship between income and health largely disintegrates. Rich Americans, for instance, are healthier on average than poor Americans, as measured by life expectancy. But, although the US is a much richer country than, say, Greece, Americans on average have a lower life expectancy than Greeks. More income, it seems, gives you a health advantage with respect to your fellow citizens, but not with respect to people living in other countries….

Once a floor standard of living is attained, people tend to be healthier when three conditions hold: they are valued and respected by others; they feel ‘in control’ in their work and home lives; and they enjoy a dense network of social contacts. Economically unequal societies tend to do poorly in all three respects: they tend to be characterised by big status differences, by big differences in people’s sense of control and by low levels of civic participation….

Unequal societies, in other words, will remain unhealthy societies – and also unhappy societies – no matter how wealthy they become. Their advocates – those who see no reason whatever to curb ever-widening income differentials – have a lot of explaining to do.

Sam Pizzigati puts a renewed focus on his post on America’s lagging life expectancy. He makes an argument that some readers may question, namely, that Americans generally lived unhealthier lives in the 1950s than now. I’m not sure I agree. I grew up in the 1960s, and standard work weeks were shorter and kids were much more active (walking to and from school, having much more unstructured play time). Labor saving devices in the home also became more prevalent in the 1950s, which reduced the physical effort associated with being a stay-at-home wife (try beating eggs with a whisk). There were fewer pollutants (some scientists contend that many chemicals interact in the human body, and so much lower doses may have adverse effects in combination than they do when they are tested in isolation). Phthalaes, for instance, are endocrine disruptors and were commonly used in building materials and in furniture cushions, starting in the 1950s. They’ve been linked to childhood obesity. Similarly, when I was young, a soda with all its high fructose corn syrup, was a treat, not a staple. And don’t get me started on our large portion sizes, or how much processed food is in the typical American diet. So while inequality is clearly a big culprit in American’s relatively decline in life expectancy, I’m not so certain I’d write off other lifestyle factors so quickly.

By Sam Pizzigati, editor of the online weekly Too Much, and an associate fellow at the Institute for Policy Studies. Cross posted from Too Much

Let’s talk life expectancy.

The stats first. They tell a clear story: Americans now live shorter lives than men and women in most of the rest of the developed world. And that gap is growing.

Back in 1990, shouts a new study published last week in the prestigious Journal of the American Medical Association, the United States ranked just 20th on life expectancy among the world’s 34 industrial nations. The United States now ranks 27th — despite spending much more on health care than any other nation.

Americans, notes an editorial the journal ran to accompany the study, are losing ground globally “by every” health measure.

Why such poor performance? Media reports on last week’s new State of U.S. Health study hit all the usual suspects: poor diet, poor access to affordable health care, poor personal health habits, and just plain poverty.

In the Wall Street Journal, for instance, a chief wellness officer in Ohio opined that if Americans exercised more and ate and smoked less, the United States would surely start moving up in the global health rankings.

But many epidemiologists — scientists who study health outcomes — have their doubts. They point out that the United States ranked as one of the world’s healthiest nations in the 1950s, a time when Americans smoked heavily, ate a diet that would horrify any 21st-century nutritionist, and hardly ever exercised.

Poor Americans, then as now, had chronic problems accessing health care. But poverty, epidemiologists note, can’t explain why fully insured middle-income Americans today have significantly worse health outcomes than middle-income people in other rich nations.

The University of Washington’s Dr. Stephen Bezruchka has been tracking these outcomes since the 1990s. The new research published in the Journal of the American Medical Association, Bezruchka told Too Much last week, should worry Americans at all income levels.

“Even if we are rich, college-educated, white-skinned, and practice all the right health behaviors,” he notes, “similar people in other rich nations will live longer.”

A dozen years ago, Bezruchka published in Newsweek the first mass-media commentary, at least in the United States, to challenge the conventional take on poor U.S. global health rankings.

To really understand America’s poor health standing globally, epidemiologists like Bezruchka posit, we need to look at “the social determinants of health,” those social and economic realities that define our daily lives.

None of these determinants matter more, these researchers contend, than the level of a society’s economic inequality, the divide between the affluent and everyone else. Over 170 studies worldwide have so far linked income inequality to health outcomes. The more unequal a society, the studies show, the more unhealthy most everyone in it — and not the poor alone.

Just how does inequality translate into unhealthy outcomes? Growing numbers of researchers place the blame on stress. The more inequality in a society, the more stress on a daily level. Chronic stress, over time, wears down our immune systems and leaves us more vulnerable to disease.

This same stress drives people to seek relief in unhealthy habits. They may do drugs or smoke — or eat more “comfort foods” packed with sugar and fat.

Inequality has an equally potent impact on policy decisions around health.

“A substantial proportion of our adult health,” as Stephen Bezruchka explained last week, gets programmed in the early years of a child’s life. Given this reality, guaranteeing every child the best possible supports in the early years ought to be priority number one for any society committed to better health for all.

But unequal nations do precious little of this guaranteeing. The nations with the highest ranking for child well-being turn out to be the nations with the most equal distributions of income.

Can the United States change course on health? Will Americans in the future be able to look forward to living lives as long as people in other developed nations?

Japan may offer the most encouraging precedent. In the middle of the 20th century, Japan ranked as a deeply unequal and unhealthy nation. But since the 1950s Japan has become a much more equal society, one of the world’s most equal, and, on life expectancy, Japan now ranks number one globally.

The United States, over the same span of time, has gone in the exact opposite direction. We have become the world’s most unequal major nation, with health outcomes among the developed world’s worst.

So how do we start a turnaround? Most Americans, Stephen Bezruchka notes, already understand the concept of “vital signs.”

“We can sense these vital signs tell us something significant about our individual health,” he notes, “every time we step on a scale at the doctor’s office or feel a blood pressure cuff tighten.”

But societies have “vital signs,” too, with none more important to health than our level of inequality. We need to start recognizing these broader “vital signs.” If we do, Bezruchka believes, we can make a difference.

“Dying so much younger than we should,” he sums up, “can be changed.”

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  1. fatmoron

    To me, the terrible state of American healthcare is directly related to the illness at the core of American society — namely a systemic root of narcissism in practically everything we do. I may be a bit biased on this point (I work in a hospital), but it seems to me that the great mass of doctors and healthcare professionals are in the business entirely for the check and the esteem of others, with patient care being prioritized far, far later down the line. All too often, I see very sick patients get all of two minutes with a doctor, who then moves on to the next guy and does the same.

    Medicine was never intended to be an assembly line operation.

    But I think, in a more general sense, America’s narcissism is its most crippling attribute. The great mass of Americans want whatever they can grab of the old American dream, but they want it on THEIR terms. Why deal with neighbors and parking when you can build a house out in the country? Why suffer the lack of services that decision would normally entail when you can drive to work/school/city/anywhere else? At some point it seems to me that we’ve decided that we can isolate ourselves from the consequences of our actions — that we can either sidestep the problems or pass the buck so far down the line that it doesn’t matter. Worst still, we’ve collectively convinced ourselves we’re not being short-sighted assholes while we’re doing it!

    So, in turn we keep destroying our natural environment, whilst replacing it with a built environment that does nothing to instill any sort of pride or sense of community within its members. We accept a Wal-Mart twenty miles away to replace the downtown that was gutted eight blocks away. All the while, we wonder how we’ve become so unhappy and unfulfilled.

    No wonder we get start getting sick.

    1. Roberta Paulson

      I work in healthcare as well both and in various settings from the hospital, outpatient, and to the home.

      A major part here being overlooked are generational problems. There are many elderly who are out living their offspring generation and each succesive generation seems to get unheathier.

      My grandmothers generation was never in debt and many never had a credit card. She was financially self disciplined as well as with her eating and daily activities (things in moderation).

      What is scary are people half her age taking twice as many pills, twice her weight, have a ton of credit cards and debt having kids that are having learning these poor habits.

      It upsets me to go into Walmart seeing a young man or woman riding a scooter because they are overweight and stocking up on fried food, junk food, and diapers. Excessive and a seemingly lack of self respect.

      Meanwhile you have an old lady with a hip replacement who pushes her own cart proud to be independant.

      As values for independance sink with each successive generation sinks, so will the age.

      In essessence in America, the young are dieing younger, and the old are dieing older. It’s a generational gap of values both in health and wealth.

    2. Banger

      Narcissism is not inevitable and was not inevitable in American society. I suggest that it was deliberately engineered by the power elite, not in a meeting where all agreed, but in a series of meetings and writings of large business concerns and department stores focused on trying not just selling individual products but in engineering consumer culture–this occurred starting about a century ago and has been an ongoing operation that has spread to all parts of society including churches.

      Consumer culture is narcissistic and it requires narcissism. This culture, combined with the idea that you can “have it all” without reference to your community or its standards, without reference to your family and its real needs and with simple minded bliss echoed in most movies, advertisements and marketing campaigns has become deeply toxic. These tendencies go against what our brain/nervous system and our endocrine systems want. Basically, we can say that consumerism hijacks our brains.

      We want to belong–we want to feel love and concern from our fellows as a matter of course and not something to be earned or sought. Instead we seek the symbols of acceptance because we have been taught from our media and educational system that this is the only way to live and this way of life we accept and embrace every time we shop for crap we don’t need and, even worse, every time we go into the voting booth and cast votes for assholes who pledge to make being an asshole the ultimate goal of life.

      That we aren’t more unhealthy and more murderous is, in a way, a kind of miracle a testament to the positive nature of human beings.

      What I have just said is all backed up by historical analysis, social science and neuro-science. We have, as a society, rejected what our scientific culture has established–we have rejected all this due to the mind-control of PR/advertising/propaganda that comes from all parts of the mass media. Our medical profession ignores real studies and is, rather, mesmerized by the drug industry and its glittering prizes, our educational professionals ignore the science of learning and often do exactly the opposite of what developments psychology suggests. We are now at the point when our deeply fragmented scientific and intellectual culture (divided artificially in university departments) has virtually no systemic connection to policy-makers. For example, drug addiction is still treated as a moral crime not a disease stemming from profound trauma in childhood on the one hand and, after addiction sets in, profound changes in brain chemistry on the other. Instead, drug addiction is used as a way to incarcerate those parts of our population most poor, most traumatized and most in pain out of, frankly, a combination of sadism, generalized fear of the “other”, and the naked greed of policians and prison professionals and corporations.

      In short, we claim to be a “Western” country but are in fact something rather new that future sociologists, should human kind survive in any number, will be able to classify.

      Human beings are deeply compassionate by nature unless driven to madness so I trust we will evolve out of this and begin to understand that what we view as the American Dream is a cruel fraud, a con, designed by criminals who, at this point, largely run our society. Each of us has the obligation to try, despite continued failure and overwhelming opposition of society as a whole, to live out a different and more human life focused on connection rather than separation.

      1. Adam Noel

        “Consumer culture is narcissistic and it requires narcissism. This culture, combined with the idea that you can “have it all” without reference to your community or its standards, without reference to your family and its real needs and with simple minded bliss echoed in most movies, advertisements and marketing campaigns has become deeply toxic. These tendencies go against what our brain/nervous system and our endocrine systems want. Basically, we can say that consumerism hijacks our brains.”

        Basically, consumerism is an evolutionary novel substrate and our brains are unable to cope. Through darwinian forces the most pathological of social institutions based on market forces win out. The focus on profit over everything else ensures products that best exploit evolutionary novel substrates will win.

        Look at the food industry. Most food is designed through a simple darwinian process (Food which overrides satiety mechanisms will increase profit therefore will be more plentiful in the future)and due to pursuit of profit margins the food that is most destructive will win out. Some people will say this is intentional (parts are, parts are not) but the sheer efficacy of darwinian selection forces in choosing substrates that override our brains is remarkable.

        Look anywhere in society and you will see the same thing. The mind control is established not through any sort of intentional planning but exploitation of our psychological weaknnesses in pursuit of profit maximization. Those who deviate from being a part of a consumer society are marginalized and labeled as outcasts. Social selection after psychological selection further seals the deal.

        If the primary motivation driving our society was not profit the deck would not be as stacked against us. Anyone who supports profit maximization in any form continues the survival of the system. That is to all of the left who talk about sustainable growth or what have you.

    3. harry


      I am struck by your observation. I think you have probably hit the nail on the head. Now for your next trick, what precisely caused that surplus of narcissism?

      1. fatmoron

        That’s a tough question. If I had to pick one thing, it was that we won the Cold War. There was an entire generation of Americans that grew up hearing about how great American institutions, freedoms, and way of life were — especially compared to the Evil Empire. In addition, there were countless ads that built up the “mystique” of American consumer living — the car gets you the girl, the cigarettes make you fit in, the Levittown homes make you the perfect parent… it all builds toward this idea that “they” are bad and “you” are good.

        So this dynamic of relentless ads and American exceptionalism continue for almost fifty years, and then the unthinkable happens. America wins! It’s a shocking vindication of everything that people have been saying for decades! Surely this must be proof that those who said looking out for your fellow man were fools. America is the nation of the individual, and the individual just triumphed over the common mass of Soviets.

        I truly believe that winning the Cold War kind of ended up being a disaster for us. So many people had their fundamental belief about who they are and what they stood for tied up in that relationship. So many identities were defined, not so much by believing in X or Y, but by defining themselves as NOT Soviet. And then, when the Soviet dropped from the scene, they were suddenly rudderless. I think America lost its victory at that moment when it failed to redirect any of the energy towards defining itself for this new Soviet-free future. Instead, there was nothing, and left to its own devices the identity crisis metastasized into this narcissistic, “I can do nothing wrong” culture that we have today.

        At least, that’s my take on things. It’s a question that deserves far more analysis than this arm-chair historian can give.

  2. Newtownian

    The thesis feels reasonable.

    However an oversight is discussion of the impacts of two World Wars and the Great Depression.

    The US mainland wasn’t affected in contrast to Japan and Europe in terms of the proportion of war wounded and deprived populations.

    A more interesting comparison which might solve this would be with Canada and Australia which were not invaded either have comparable social situations but more socialised health systems.

  3. Ed

    “Why Are Americans’ Life Expectancies Shorter than Those of People in Other Advanced Economies?”

    Because “America” isn’t an advanced economy.

    Sometimes you have to start with the simplest answer.

      1. Capo Regime

        A lot has changed since 1969. Maybe the whole moon thing was shot in a studio in colorado. Be that as it may—things NOW for americans looking bleak. And advanced economy–maybe but advanced polity–no way maybe a cut above Pakistan.

        1. icliks

          The year was 1970, when franken-wheat was finally cobbled together in the lab … and lived! Now 99.9% of the “wheat” consumed worldwide is this dwarf variety. You can grow a lot per acre, but it’s poison! Check it out.


          1. neo-realist

            So the Shredded Wheat I’ve been eating for years is slowly killing me:(? The Wicked Wheat?

          2. LucyLulu

            While I can’t vouch for wheat consumption, and I know much of the global wheat is home grown, I linked last night (last post) to an article where the EU has banned the growth of all GM crops except one variety of maize. France, Germany, and Italy have in addition banned that variety of maize. Most of the other advanced economies are found within the EU, where longer lifespans are found.

            I’m not proposing there is a single factor at work, with GM crops being the sole or even primary culprit. No doubt it’s more complex with multiple causes. But it does point to a different culture in the EU that places a higher priority on health, even if profits might suffer, lending further support to the thesis of the article (and the consumerism/quick gratification argument above).

      2. Mickey Marzick in Akron, Ohio

        Dare I say that in 1969 the United States was both the most advanced and largest economy in the world. And the level of inequality was probably much less than it is now – at least among the Caucasian population.

        Now the United States is merely the largest economy – not the most advanced. And certainly the gap in inequality between Caucasians in this country has widened considerably by most measures. This transition from TREX to flabby Brontosaurus began to become apparent around 1990 as Japanese prowess in manufacturing took the world by storm. Of course, by then we were into the throes of the transition from manufacturing to the “knowledge economy” and financialization.

        The rest of world caught up and now some countries are both more advanced and more equal than US.

        For some reason I always equated more advanced with more equal! Scandinavia comes to mind. But that’s just me…

        Funny thing though, beginning to wonder if there is a correlation between increasing inequality and economic stagnation/regression. Maybe we should ask ourselves how more equality of outcomes fosters innovation and economic advance rather than how it retards it. Heaven forbid the adherents of mainstream economics, especially the neoliberal libertarians, got it wrong! Likewise, is innovation more likely to occur in a culture of fear or one in which there is a modicum of security? Think Maslow’s hierarchy of needs – not the narcissist preoccupation with self articulated by Christopher Lasch!

        Even your moniker ‘FATMORON’ appears as a bit of an oxymoron to me. Back when I was growing up, there were FAT kids but they were in the minority and by no means were they MORONS. Nor were they objects of ridicule and scorn like they are today. Of course, I suspect the emergence of “fast – JUNK – food” and the sedentary solitary life of the Internet and computers in general have something to do with OBESITY. Then too “exercise” was something we got playing sports or combat traipsing through the woods, fighting Injuns’ or Germans. Working on the shop floor WAS exercise. Wringer washers and hanging diapers on the clothes’ line WAS exercise for many women and their figures attested to such exercise well into middle age. Just an observation – not an endorsement of the male dominated patriarchy in which it occurred. Nor am I advocating that we return to the good old days because they weren’t all good – for working men, women, or children – fat and skinny alike.

        But the idea that more egalitarian societies enjoy better health and longevity should surprise no one. That it does testifies to the effective propaganda and junk ideology of economic libertarianism inculcated into the hearts and minds of most Americans by the MSM for two generations. War is peace, ignorance is strength, and love is hate to which I would add, MORE is better. After all, so long as I have the latter, I will likely live healthier and longer. That’s all that matters, right? ME! And so long as this attitude prevails, most of us will die sooner as life becomes “solitary, brutish, and all too short.” [Thomas Hobbes]

      3. ScottS

        And the Nazi scientists who got us there were Americans? Perhaps by the time Operation Paperclip got them out of Germany and back to the US, they might have become Americans.

        And aside from Tang and Velcro, couldn’t we have found better things to do with that money than showing up the Russians?

  4. Janal

    There is a common consensus among myself and my baby boomer friends. We do not want to live long lives because we cannot afford to do so. Most all of us face the nightmare of outliving our money with few or no benefits.

    1. LucyLulu

      Yep. You can include me in your list of baby boomers who worries about living too long. 70 sounds about right.

  5. Bob

    It’s all about the southern poor; as a group they skew those numbers dramatically southward.

    1. Capo Regime

      North, South, East and West, Urban, Rural, White or Black or Hispanic all Americans no?

      1. Bob

        Totally agree. The point is that lists like the one cited are difficult to derive meaning from, specifically as it relates to policy, when there are such significant outiers. Where we are on that list just does not tell us much other than demographically we are not Sweeden.

        1. Klassy!

          A commenter turned me on to The Status Syndrome by David Marmot who helped to conduct the Whitehall Studies which did about as good a job controlling for all sorts of variables as any study could that looked at health disparities deriving from relative wealth and power inequality. http://en.wikipedia.org/wiki/Whitehall_Study

      2. Inverness

        While living in the US, I’ve known people without health insurance, who would come up with plans “just in case” of an attack of appendicitis, etc. And those cobra plans cost hundreds of dollars a month.

        Anyone, from the poor to the near-rich, can go broke from one serious illness. Health is wealth, indeed.

        It also means that other conditions that are not recognized as immediately dangerous go untreated altogether. Just live with your acid reflux and depression, even though over time, you avoid treating such conditions at your own peril. Forget preventative care.

        Another phenomenon: you have people who don’t engage in healthy sports like cycling because they cannot afford an accident.

        Of course, even having health insurance doesn’t guarantee it will cover all of your costs. That’s another story.

  6. middle seaman

    The only solid result in the above collection of mentioned works is that US life expectancy ranks almost the lowest among about 30 developed countries.

    Inequality’s contribution locally is clear. But, what do we mean by inequality? If the couple A makes $200,000 a year and the couple B makes $50,000, you talk about unequal incomes. A’s life is way easier than B’s life (everything else assumed similar). Typically, however, by inequality we mean the outrage that a CEO makes a day what his workers make in 2-4 years. None of the mentioned sources is quoted as having an opinion on that.

    Our health care system is terrible, but that touches almost everyone. What really matters, in my opinion, seems to be vacations (way shorter in the US), work hours (way higher in the US), no paid maternity leave (the Swedes have a year), management/employee relationship that is absolutely degrading, pressure causing and anti-productive. Our safety net is minimal. In Europe, many counties have no time limit to unemployment support, universal health care (not the Rombama joke we are getting into), better day care services. Even way more amenities such as live theater, opera and concerts are expensive in the US. Opera in DC will cost you up to several hundred dollars in NYC and DC, while in Berlin you can frequently get a couple of tickets for about 50€.

  7. judabomber

    Always comes back to the same arguments…fat people are fat because they consume too many calories and don’t exercise enough…the question in my mind that I think people fail to answer is a calorie is not a calorie, at least in terms of how it is metabolized by your body.

    Nutritional policy in the U.S. over the last thirty plus years has been based on bad statistical analysis by Ancel Keys. Some people have become self aware by reading websites like Marks Daily Apple or Mercola.

    Simple changes can help a tremendous amount, but the changes in many cases are not cheap to make, especially if one wants to improve his or her diet

  8. Lambert Strether

    Frederick Pohl, The Space Merchants (1952):

    I’d been paid again, and my debt had increased by eight dollars. I tormented myself by wondering where the money went, but I knew. I came off shift dehydrated, as they wanted me to be. I got a squirt of Popsie from the fountain by punching my combination — twenty five cents checked off my payroll. The squirt wasn’t quite enough so I had another — fifty cents. Dinner was drab as usual; I couldn’t face more than a bite or two of Chicken Little. Later I was hungry and there was the canteen where I got Crunchies on easy credit. The Crunchies kicked off withdrawal symptoms that could be quelled only by another two squirts of Popsie from the fountain. And Popsie kicked off withdrawal symptoms that could only be quelled by smoking Starr Cigarettes, which made you hungry for Crunchies. Had Fowler Schocken thought of it in these terms when he organized Starrzelius Verily, the first spherical trust? Popsie to Crunchies to Starrs to Popsie?

    And you paid 6 per cent interest on the money advanced you.

    It had to be soon. If I didn’t get out soon I never would. I could feel my initiative, the thing that made me me dying, cell by cell, within me. The minute dosages of alkaloid were sapping my will, but most of all it was a hopeless, trapped feeling that things were this way, that they always would be this way….


  9. BilboBaggins

    Because who cares? You? Me? Anyone? Since when?

    The social engineers of human economic capital – the tax base – certainly don’t care more than any of the above. They see the American working population for what it is: a capital asset that depreciates over an average period of approximately 45 years of a productive, working life; and about the time it takes to extract from them the investment (tax) needed to keep them alive for the remaining 15 years of their life – if they must.

    So feed them shitty food; let them live in a shitty environment and sell them a shitty education that gives them the illusion of generational progress and advancement. Then support these lifestyle choices with healthcare costs that ensure they never live long enough to reap the benefits of any mediocre success that they might have eek from this combination of optimism through adversity – “lifing themselves by their own bootstraps”.

    And, what happens after that asset is fully depreciated is neither here or there. If it drops dead, so what? They will have already spent that assets lifetime investing in, and account for a suitable replacement and saved money on keeping a retired asset alive – it’s a win-win. So, drop dead at 65 (please)! What moral difference does it make to the return on investment to the capitalist? None.

    You think capitalists care whether the replacement human capital resource is Chinese, Indian East European, Mexican, or African in origin. There’s a billion plus Indians and Chinese just waiting in line for a place in Ameriku! As long as they sign up for the same ‘Corporate USA’ terms and conditions as the old resource, the capitals and rentiers will change the immigration laws, engineer societal norms and cultures and , if necessary, even change the constitution – all to provide a false sense of security, a future and a sense earned entitlement (the American Dream).

    As Chicagoan retirees are about to find out, they are expendable. Fucking “idiots” had better die sooner rather than later, and make room for new human capital to learn the hard way

    1. Capo Regime

      Biblo B,

      Just brilliant. Really great. Hope you don’t mind saving your comment.

    2. rps

      So true. Yet, your optimism about the “average period of approximately 45 years of a productive, working life..” doesn’t exist if your first full-time employment begins at 21yrs of age making 66 the retirement age. I’d say since Ronnie Raygun, the average age of enforced retirement was 59; then in the 1990’s it was 55yrs. And now, I would say that age 45 is the new 55 to boot “At-will” employees out of the company. In fact, job security is 20th century passe’ for anyone over 21. The problem with this last go-around, many fired or as the media likes to call “laid off” baby boomers are screwed waiting around for twelve years to collect SS.

  10. Thor's Hammer

    World Health Organization ranking of health systems by country:



    —Represented by the US media as a cesspool of narco traffickers and humble peasant coffee growers.
    —The location of the longest running civil war in the Americas, stretching back to the Violencia starting in the 1960’s.
    —And by the way, Colombia’s health care system is entirely privatized.


    —Highest per capita expenditure in the world by a large margin
    —Per capita expenditures ten times as high as countries with similar rankings
    —Countries with similar rankings: # 40, Cuba with per capita incomes in the $100 per month range, and #36, Dominica, a tiny and poor island in the Caribbean.

    Can the failure of monopolized greed and politicized malfeasance be any more obvious?

  11. LAS

    The whole world is now becoming fatter, more obese and subject to exposure to endocrine disrupting chemicals and tobacco. Dec 15, 2013 The Economist had a 14-page report on it. Based on ecological type reasoning, it may not be obesity and personal behavior factors that cause Americans to experience worse health outcomes. Again, based on ecological type reasoning, of all nations America has the least socialism in its spectrum of political representation and I believe this is meaningful. Here, too much of the Kabuki theater performed in the name of health care is for profit. (Even the non-profit health care endeavors in this country are increasingly wedded to and influenced by for profit corporations through cause marketing relationships.) For profit interests select high margin procedures rather than cost effective, evidence based ones. Our health system is riddled with this bias from top to bottom.

    1. Dave

      Ah yes! Another problem to blame on inequality. From what I have been reading lately, women now also seem to be dying earlier relative to men. But they are more equal now than they have ever been! I submit that it may be another “E” word that is responsible for this problem.

      Consider the possibility that the other “E” word may be exercise. Women did not go to the gym in the 1950s nearly as much as they do now. Neither did men. All this emphasis on fitness may just be a plot to save Social Security. People who had physically demanding jobs in the 1950s wore out their bodies by doing their work. Now folks pay various fitness clubs large sums of money for the privilege of going cardio. Hence the affluent are experiencing shorter life spans also.

      The more the body is used, the faster it wears out, and this includes the heart. Might it not be that there could be a morbidly fit as well as a morbidly inactive?

      To my mind at least, this explains the cause of the problem. Even though common workers were much more equal to captains of industry back in the old days than they are now, this exercise theory makes much more sense.

      1. Yves Smith Post author


        If you mean this as a joke, the effort at irony isn’t coming across.

        I go to a gym. The gym rats who overexercise are few and far between. And I live in the Upper East Side, where you have people who have the money and motivation to be fit (in sales positions, in investment or private banking, where being fit is a plus, or wives desperately trying to maintain youthful bodies to hang on to their well off hubbies).

        I don’t see any evidence of overexercising on a macro level. Americans are way fatter than they were in the 1980s. We also have a diabetes epidemic which is going to create large health costs and reduce life spans further. And you can seriously post over exercise as a real risk? Do you know how hard it is to exercise enough to constitute “over exercise”? It’s more than an hour a day of intense cardiovascular exercise. We aren’t talking about people who jog, even long distances. The only population I can identify that is harmed by overexercise are competitive marathoners (not the type who plods the distance), tri-athletes, and competitive long distance bikers. Basically you need to do hard cardio for more than an hour, regularly.

        My father did a genealogy. All of his ancestors in the 1700s in the US (each and every one, this is supported by church birth and death records and tombstones) lived to be over 80. Basically, if you lived in Coastal Maine and survived childhood diseases and accidents, you lived a long time. And this is also BEFORE people understood the importance of hygiene, of cleaning wounds well and cleaning one’s hands well before dealing with infections.

        Men and women in the 1700s did hard physical labor. Women churned butter and beat eggs by hand. They’d have to haul water from a well to clean and cook, so they were constantly lifting fairly heavy weights. Twice a year, they’d beat out rugs and clean the house from top to bottom. They’s also scrub clothes and wring them out by hand. And in the northeast, men would be at sea fishing for 4-8 weeks at a stretch, depending on the configuration of the ship, so they’d also have to do all the manly tasks around the house too.

        Men who were farmers would till fields and operate a plow (even with horses, since oxen weren’t used in the northeast, the plowman still did a fair bit of work), harvesting (as in picking and hauling crops).

        Without electricity and internal combustion engines, our predecessors did VASTLY more hard physical labor than gym rats do today, clearly in terms of hours spent during a week doing physical labor and except for hard core body-builders, in intensity.

        And all the studies show that being stronger is highly correlated with lower biological age. People in their 80s who start weight lifting 3x a week show big reductions in their biological age. My great uncle, who hauled lobster traps without a winch for half a day into his late eighties (which is REALLY hard), looked absolutely spectacular: alert, straight posture, moved freely, and would be mistaken for a man in his late fifties.

        1. Dave

          Thanks for the information Yves, but I am completely serious. There are indeed strong genetic factors in long life, and apparently your family is blessed with these. Regular movement is excellent for good health and physical condition. It maintains flexibility and blood circulation.

          Asians generally live long lives. Have you ever observed typical exercise sessions as are commonly done in China? They certainly do not increase the heart beat to the level of many found in our culture. Those I have observed are mainly fairly slow movement with some stretching. Basically on the same level as walking. According to my european wife, europeans do much more walking or just riding, not racing, a bike. They move more than we do on a regular basis. Apparently they live longer too.

          There is a big difference between regular movement and intense heart stressing exercise at intervals. Also much of our culture engages in exercise that places a lot of stress on the joints, particularly the ankles and knees. EVERY individual that I personally know who has done long sessions of jogging on a regular basis over a period of years has had knee surgery. Many have needed new hip joints. Also, one of our astronauts (I’ve forgotten his name.) maintained that we are born with only a certain number of heartbeats. So this has led me to use my heart beats mostly on those activities that are fun! :-)

          As is the case in most activities or lack thereof, moderation is best. I see our society as quite the opposite in many cases.

          1. Yves Smith Post author

            This is so non-empirical I don’t know where to begin.

            First, there is a lot of research supporting the importance of elevating one’s heart rate. The heart is a muscle. If you don’t work it sufficiently it gets to be weak. And people are subject to suddenly taxing it (running to get a bus or catch a plane, shoveling snow, etc). So if you don’t stress it sufficiently to deal with unexpectedly and suddenly engaging in vigorous activity, you are asking for a heart attack.

            Second, the fact that a lot of people exercise badly does not say exercise is bad, it says exercising badly is a bad idea. Most people jog rather than run. Jogging puts more load on your joints than running or sprinting, where more of your energy goes into your forward motion than back into your joints. On top of that, the overwhelming majority of people jog on hard surfaces (roads or pavements) which worsens the joint stress. And a lot don’t wear well enough cushioned shoes (you need to replace them often and most people don’t). And if you jog when overweight, you are asking for even more trouble. You get a lot more cardio benefit with much less joint wear doing anything other than jogging: interval sprinting (training intervals in general is the best way to train your heart, balls to the wall exertion for 30 seconds with a rest period of 5-6x that followed by another max sprint), or on a rowing machine or a versa climber. Or swim. I personally can’t stand swimming, it takes too long (showering before and after) but it gets you a cardio and resistance workout without loading your joints.

            The discussion above is not helped by the fact that there are a lot of incompetent trainers and misguided to dangerous training fads. A lot of certifications require “trainers” to learn info and techniques that are actually bad or at least not helpful. And hardly any trainers know the basics of exercise physiology. One of my pet peeves has been the long-standing fad of having people do complicated balance exercises while using weights. These movements are never functional (as in ones you’d do in normal life or a sport). They are at best a waste of time (you are not doing the weight training part efficiently) and for people with overly lax joints, risking injury.

            Third, orthopedists push knee surgeries way way beyond what is indicated. Knee surgeries have a low success rate except for medial meniscus and ACL tears. I happen to have crappy joints genetically (I was seeing orthopedists as soon as I could walk) and poor biomechanics. I’m nevertheless pretty fit and have pretty much resolved what looked like a chronic knee condition by virtue of finally finding someone who could rehab me properly (he rehabs elite athletes and has a masters in an advanced form of physical therapy, although he does not bother practicing as a PT). Many knee problems are not knee problems (save cartilage and ligament tears, as indicated earlier), they result from biomechanical issues (either long standing, in my case, or adaptations resulting from injuries of OTHER joints). But knee guys look at knees in isolation, they won’t look to see if your knee symptom results from how you walk (in all my years of seeing orthopedists in NYC, I had only one look at my gait), hips, back, etc. You can fix those without surgery if you know how to address them.

            1. LucyLulu

              Or HOW you stand. Standing with your knees back and locked pretty much guarantees future surgery. And I agree about needing not to look at any joint in isolation, as often the problem stems from poor mechanics either above or below the injury.

              Yet, on an anecdotal level, I can also see Dave’s point as regards to Europeans. They are generally more active, use cars less, walk more, ride bikes, less likely to have elevators, less tools of convenience, etc. Gym memberships don’t have nearly the popularity here. More vigorous exercise is likely to involve participation in some type of recreational sport instead. Those who have the space have gardens (I think it’s the law there).

            2. optimader

              Swim, cycle (spin), stretch, drink only good beer and don’t eat food that is from a bag or box. That’s it.

  12. Brick

    Its more noticeable in America because workers rights and the security net have been more eroded here.Life expectancy for Americans is not always worse than in other developed countries though. Its a generalisation which may be true but needs clarifying. For instance in Calton in Scotland life expectancy is 54.
    While many will point to bad lifestyle choices ,Yves quite rightly points out that bad lifestyle choices are intricately linked with low income because the choices are not always available and conditions make bad life style choices harder to resist. In addition job security seems to play an increasing part in life expectancy.
    Life stress especially at an early age also plays a considerable role in life expectancy.
    This clearly confirms to me there is deep inequality in life expectancy across income groups. Work and money stress along with reduced freedoms and limited life style choices stack the deck against poor.This is a transfer of wealth from the poor to the rich on a massive scale.In addition is the thorny issue of whether retirement ages affect life expectancy. The jury seems to be out on this one based on past data.
    My guess is that in 10 years the projected gains in life expectancy forecast will not materialise(backward looking statistics), due to a combination of reduced job protection, stress , the casual part time nature of jobs and later retirement. Its likely to affect white collar workers through stress, job security and later retirement and blue collar workers through physical elements, depression, poor life style choices and being unable to afford to retire.

  13. Paul Tioxon

    Considering how xenophobic we are, the reason why Americans die before everyone else in the world does, is because we WANT to. Hah cha cha, I got a million of them. Take my wife for instance, please take my wife. Hah cha cha.

  14. Mista B

    Horrendous diet, which causes many Americans to be fat, fat, fat. Eating a healthy diet alleves the vast majority of health issues. Exercising on top of it is a bonus, but the main issue is diet. Poor people aren’t fat and unhealthy due to wealth inequality. They’re fat and unhealthy because they eat extremely poor diets.

    1. Binky Bear

      And they eat bad diets because that’s what poor people can afford to eat. They live in cheap housing with mold, lead, and chemical-oozing construction materials and furnishings made of particle board, gypsum board and oriented strand board. They might be lucky and not be able to see the trailer hitch on it, or the wheels.
      When poor people get some extra money, they can then afford the worst restaurant foods-fast foods, pizza, pre-fab frozen meals from WalMart. These are also likely places for them to work such that they are exposed to workplace hazards and injuries, have their wages stolen, or get treated to financial advice that starts with having a second or third job.

      And the beat goes on.

  15. rps

    Economic stressors have always been a major contributor to human life-spans. However, in the past 40 years, USA salaried employment demands employees to forgo vacations, work when sick, work more than 40 hours per week no matter if you’re a corporate-owned farmer, teacher, bricklayer, factory worker, construction, sales, or even the coked-up casino gamblers on Wall St. Comp time is a joke particularly since the advent of beepers, cellphones, email, skype, etc… are today’s stressors.
    Then there’s other stressors including: job hazards, food supply, allergies, physical ailments, home-life, and Mother Nature: floods, tornados, hurricanes, snow storms, etc.. Most of these are not a new phenomenon for civilizations. But there’s one Major Exception: FOOD SUPPLY.

    Lets do a quick review of our corporate friendly food producers who control our foodstuffs/seeds such as: Monsanto. Monsanto = GMOs = genetically modified organisms. Anyone notice how obesity increased with the advent of GMOs??? Let us count the ways one GMO vegetable – Corn is ingested on a daily basis: Cereal, cornstarch, corn flour, snacks, chips, crackers, cookies, cakes, soda pop/drinks, baby formula, baby powder, sweetners and Meat. Corn products are fed to livestock and chickens. Cows also produce milk products such as butter, ice cream and milk byproducts listed in the fine print on those convenient ready made products in the grocery aisles. Do you eat Eggs?, Hens ingest corn.

    Oh yes, lets not forget artificially injected animal hormones to increase milk and egg production too. Antibiotics?, Sorry kids, that’s another bedtime story. You thought Grimm’s fairytales were scary, how about a bedtime story about the plastic wrap and containers we drink, eat and microwave from that are made with BPA/estrogen and other chemicals that leach into our food. Yes, the bygone days of recyclable glass containers that are human and planet friendly but corporate condemed profit unfriendly.

    And to cap our Schoolhouse Rock infomericial lesson, lets singalong with the final song: P-e-s-t-i-c-i-d-e-s and h-e-r-b-i-c-d-e-s!!!

    1. Yves Smith Post author

      Chronic sleep depravation is another issue, due partly to work stress and partly to electronic device addiction. People really do need 8 hours of sleep a night for adequate tissue repair (your growth hormone levels spike right after you turn in) and brain function. There are some people who are genetic freaks who can get away with less on a permanent basis and when you are young, you can push your body hard for a long time with no ill effects, but we have way way too many people claiming to need only 6 hours of sleep on an ongoing basis than can possibly exist in the population

  16. rps

    Oops, guess I forgot to mention, GMOs have never been safety tested. Rather, Americans are the guinea pigs. Many countries banned GMO products from port entry. What does that tell us…..

    From Occupy.com: Eight national governments in the European Union have banned Monsanto’s MON810 maize and other forms of GMO cultivation in their countries: Austria, Bulgaria, France, Germany, Greece, Hungary, Luxembourg and Poland. In Poland, Amflora potatoes and MON810 were banned in January of this year, with the Ministry of Agriculture citing danger to bees in justifying its decision. Violation of the bans are sanctioned with fines of 200 percent of the value of GM seeds, with government ordinance to destroy any GMO fields.

  17. neo-realist

    Many upper and middle income people find the idea of having National Health Care or something similar to it unacceptable because they don’t like the idea of their tax dollars going to pay for the health care of people they deem to be undeserving/unworthy, e.g., The AA baby momma with 4 kids, or just make that poor people of dark skin perceived to be ripping off the government for welfare and other social services.

  18. Andrea

    I probably shouldn’t post this because I don’t have a link. It was a scholarly paper in some med journal a few years back, and it was not freely available on the net (I checked to bookmark it.) So it’s an anecdote, or an idea to explore.

    The authors compared the health of recent immigrants to the US – children and adults – who nevertheless had been in the US for 5 years or more (I forget the exact time span.) with the health of 3rd gen. (or more) Americans.

    They controlled for economic level, so their results were not due to ‘wealth’ or income. I know they separated into Black and White (dodgy categories..) but don’t remember if other groups (Carribean, Asian, Hispanic) were sorted. They found a huge advantage for the recent immigrants, for all groups, and most strongly for the poorest.

    They tentatively explained the results by: better diet, more communal family eating (my ex: beans and rice and an apple eaten in common is better than eating alone in a fast food joint); stronger family ties, solidarity with a community of immigrants; more social contacts; and possibly, less smoking and drinking and drugs (they did not test for that.) They also wrote about optimism and a more ‘resilient’ attitude to life, this again was from their hat.
    Sorry to be so vague, ignore it if not considered factual enough.

    If one turns to the importance of the inequality of a society, it would seem to imply that the steep inequality takes time to seep in, take hold, and the effects of more equality endures at least for some time.

    As for the general argument, a for-profit health care system will encourage both sickness and treatment simultaneously. A not-for-profit system can afford the time and space to think about what is best for ppl, that might be better screening, cheaper drugs, less useless operations, more support at home for chronic patients, more hygiene in hospitals, better school lunches, and on and on….or whatever, depending on the state of affairs, the culture of the country, the available resources, etc.

  19. nobody

    I don’t want to detract from the point that inequality “shortens the lives the people at the top of the pecking order along with the lower orders,” or the impact of “other lifestyle factors,” but I would like to stress just how bad things are for many of those on the lower rungs.

    There was a piece in the New York Times last year about research that has found a rapid collapse of life expectancy, by nearly half a decade, among American “whites” who don’t have high school diplomas. When you stop and think about it, that probably means that there are some in this category who are living out their fully allotted years, and quite a few others who are avoidably dying DECADES prematurely.


    Here is a glimpse, via Joe Bageant, of the sort of human situations underlying such statistics:

    “[W]hen it comes to heart and feeling, the best in town is a woman named Dottie. Dot is 59 years old, weighs almost 300 pounds and sings Patsy Cline nearly as well as Patsy sang Patsy. Dot can sing ‘Crazy’ and any other Patsy song ever recorded and a few that went unrecorded. Dot knows Patsy’s unrecorded songs because she knew Patsy personally, as did lots of other people still living in Winchester. We know things such as the way she was treated by the town’s establishment, called a drunken whore and worse, and snubbed and reviled during her life at every opportunity, and is still today sniffed at by the town’s business and political class. But Patsy, who took shit off no one, knew cuss words that would make a Comanche blush, and well, she was one of us. Tough and profane. (As you may have noticed, cussing is a form of punctuation to us.) Patsy grew up on our side of the tracks and suffered all the insults life still inflicts upon working people here. Hers was a hard life.

    “The fat lady sings, then drops dead. Dot’s life has been every bit as hard as Patsy’s. Harder because she has lived twice as long as Patsy Cline managed to. By the time my people hit 60 they look like a bunch of hypertensive red faced toads in a phlegm coughing contest. Fact is, we are even unhealthier than we look. Doctors tell us that we have blood in our cholesterol and the cops tell us there is alcohol in that blood. True to our class, Dottie is disabled by heart trouble, diabetes and several other diseases. Her blood pressure is so high the doctor at first thought the pressure device was broken. Insurance costs her as much as rent. Her old man makes $8.00 an hour washing cars at a dealership, and if everything goes just right they have about $55 a week for groceries, gas and everything else. But if an extra expense as small as $30 comes in, they compensate by not filling one of Dot’s prescriptions — or two or three of them — in which case she gets sicker and sicker until they can afford the copay to refill the prescriptions again. At 59, these repeated lapses into vessel popping high blood pressure and diabetic surges pretty much guarantee that she won’t collect Social Security for long after she reaches 63. If she reaches 63. One of these days it will truly be over when the fat lady sings.

    “Dot started working at 13. Married at 15. (Which is no big deal. Throw in ‘learned to pick a guitar at age six’ and you would be describing half the Southerners in my social class and generation.) She has cleaned houses and waited tables and paid into Social Security all her life. But for the last three years Dottie has been unable to work because of her health. (Did I mention that she is slowly going blind to boot?) Dot’s congestive heart problems are such she will barely get through two songs tonight before nearly passing out.

    “Yet the local Social Security administrators, cold Southern Calvinist hardasses who treat federal dollars as if they were entirely their own — being responsible with the taxpayers’ money — have said repeatedly that Dot is capable of fulltime work. To which Dot once replied, ‘Work? Lady, I cain’t walk nor half see. I cain’t even get enough breath to sing a song. What the hell kinda work you think I can do? Be a tire stop in a parkin’ lot?’ Not one to be cowed by mere human misery, the administrator had Dot bawling her eyes out before she left that office.”


  20. Andrea

    Yves wrote: “So while inequality is clearly a big culprit in American’s relatively decline in life expectancy, I’m not so certain I’d write off other lifestyle factors so quickly.”

    She mentions diet/eating habits, pollutants, family life-style, working hours, and moving about (exercise). Absolutely, these are primary causes.

    Perhaps the main ones, as comparisons concerning ‘equality’ are very supra-ordinate level and correlate with a bunch of stuff on the ground – so it is a bit of a tautology.

    From friendly free-preschool with a good lunch to bike paths (etc. Scandinavia) to not fearing bankruptcy for med. reasons (UK, Canada, France), to free or almost contraception and sex health for teens (Switz.) to de-criminalizing drugs (Portugal), to affordable and efficient private health insurance (Colombia), etc. – the countries that enact these measures are more ‘equal’ than the US, that is why the measures come to being.

    The changes Yves speaks about are all somehow due to predatory competition and corp. and other lobbying. (Some call it capitalism but I’m not arguing that here.) The fructose and working hours and working pay are prime examples.

  21. Daniel From Paris

    Thanks for this great post.

    Of course, that’s a pity to hear that the health of the US citizen is so bad.

    Many factors in the loop. I accept that inequality may be a significant one. But, sure do not underestimate diet, diet, diet, diet, diet again.

    As one of those lazy French people working 35 hours a week when not on holidays (that happens), I wonder whether the hyper-competitive society that US has developed into, both at work and outside, is not unbearably stressful.

    Stress does not help when it comes to diet. Rats and human beings alike…

    Read Tocqueville about about the way US used to be – religion-family-and-community-driven.

    I wonder whether the sense of the community has of course disappeared even more than here in Europe. I’d be glad to hear about the obesity rates in oldish rural America should there be any left. Is it as bad?

  22. Banger

    Although medical professionals don’t want to talk about it the main cause of disease lies in the nature of the word itself, i.e., not being at ease. In other words the main cause of disease is stress. That is why healing touch and other alternative modalities work–that is why the placebo effect works, that is why being loved and being part of a bonded community or family works. That is why more vacation and shorter working hours works and why living in a culture with less income inequality works because few people stress about how they will keep their houses heated.

    Americans, in my experience, are the most gullible people in the world who will, like Linus, try to kick the football that Lucy is holding every time. This is why we never learn that all wars since Korea (and even then, who knows?) have been cons perpetrated by people who profit from them. This is why poor people accept Limbaugh and all those, like him, who believe if you make the rich richer and more powerful the poor will benefit–they don’t have to explain how that magic happens, it just does and 100 million people accept this fiction. Or they believe that the U.S. health care system is the best in the world when that is as sensible a statement as pigs can fly.

    This gullibility is the direct result of the spectacular and ongoing failure of the educational system in this country. It is like fielding an army of men on horseback in full armor equipped with lances as swords against a modern army with tanks and helicopter-gunships. The mind-control regime that has been steadily built up and fortified for the past century uses all the most modern techniques discovered by social science and neuro-science to carefully and thoughtfully control the minds of the public. And the public invites these modern wizards into their homes to ply their trade to control minds from infancy without having a clue from professionals at any level, who know better, what they are inviting in. The fact we are not far worse off than we are is a testament to the resiliency and ingenuity of the human spirit.

    It is this unnatural mind-control system that makes us ill by making us feel stress just because we breathe and do not meet the standards of super-stardon in every way. Even the rich are never good enough so they always want more. I’ve seen it. I worked for a guy, nice fellow, who had a rather nice boat, one of the biggest in his marina, but he wasn’t happy–he wanted a much bigger boat and said, after a few drinks, that he was determined to get it. Why? Why? In many ways his attitude destroyed his marriage–but he didn’t care about that or his child–he wanted to really succeed. Even his success was stressful on him–but he couldn’t see it and despite being smart and relatively cultured he couldn’t see what he was doing–he was still young I suppose.

    These sorts of decision are multiplied millions of times all around the country. Those who fall by the wayside struggle everyday with the label of failure even if they aren’t starving or homeless and hope for the lottery and fantasizing of what they will do with all that money. If they only knew what it was like to be rich they wouldn’t be so anxious to be rich–sure they do better–but it’s never quite enough and their wealth surrounds them with flatterers and con-artists–but that’s another story.

  23. anon y'mouse

    I was not alive during the 1950s, and my only familiarity with it comes through the testimony of my grandmother, who was a rare “working woman” and later, family breadwinner. so forgive me if I labor under a lot of misapprehensions, but I think that one of the significant differences is:

    no one is at home doing the valuable “social service” that necessarily accompanies all of our lives. women were doing housework, yes, but they were also cooking, tending the social network of neighbors which allowed more info-sharing and communal control over the safety of children. children could play in the streets relatively worry-free because other neighbors would be watching from the kitchen window. they were also active in other social groups, like churches and women’s associations which organized to do things like take food to the sick and help out the financially hit.

    time crunch of both parenting figures heavily plays into that “early education” issue. if the only quality time you get with your kid is the mad-dash to drive them to school (another thing about not knowing your neighbors or believing you share common cause with them means that the “Stranger Danger” is everywhere) it’s hard to have much of an impact on their moral or other development.

    mom and dad both work, and are stressed out from it such that planning meals, shopping wisely and preparing food from scratch become just another chore. it might be a pleasurable one, but after commuting, dashing to the grocery and scrambling over everyone else doing the same thing at the same time to bring back the goods, one is pretty well too exhausted to do much other than throw a box in the microwave. meanwhile, “after school” means your kids play -safely- inside with video games instead of outside with friends, and make themselves pizza rolls when they get hungry.

    i’m not saying that it has to be women who stay at home, or even that one party should give up working entirely. I just think that the time crunch from the work-commute-struggle to live daily needs to be minimized. the social network needs to be tended and expanded. the family home has become a bunker where one collapses in exhaustion from the struggle and worries of everyday life, instead of merely a safe, familiar place within a safe, familiar community.

  24. Yancey Ward

    It is is difficult to take seriously any essay that writes:

    But many epidemiologists — scientists who study health outcomes — have their doubts. They point out that the United States ranked as one of the world’s healthiest nations in the 1950s, a time when Americans smoked heavily, ate a diet that would horrify any 21st-century nutritionist, and hardly ever exercised.

    Seriously, this explicitly suggests that Americans are physically more active today than in the 1950s, that they have a better diet today than they did then (an unsupported assertion, and one that is highly doubtful on its face). The entire essay reeks of ergo prompter hoc fallacies stacked one on the other.

    And, does it really need pointing out that comparing the US in the 1950s to other countries in the 1950s (Greece or Japan for example), then redoing the comparison today doesn’t demonstrate much more than that in the 1950s the US was relatively more wealthy by comparison in the 1950s than is the case today? The real question you need to ask is, what would the life expectancy of an American be if he/she had the diet and physical activity of the Japanese, for example? I think a good guess that it would be a year or two higher than it is now, but then we are only then controlling for one of thousands of confounding factors.

  25. Min

    What about childhood mortality? That really drags down life expectancy. And surely inequality would have an effect on childhood mortality, as the children of the poor are most vulnerable.

    1. kevinearick

      Just keep adding arbitrary layers of increasing complexity just as their pedecessors blow up…figuratively, or actually if necessary…

      Delano, Delano….

  26. Waking Up

    According to Forbes, there are now 1,426 Billionaires in the world with a record net worth of $5.4 TRILLION.

    Think about the enormous amount of power granted to 1,426 people based solely upon their personal wealth in a world with over 9 billion people. And…what a sad commentary that the wealthiest man in the world, Carlos Slim Helu, lives in Mexico. If an individual hoarding wealth to the extreme was something of real value to society, then Mexico would be the best place on earth to live, after all, the wealthiest man in the world lives there.

    Do even a simple majority of Americans feel “valued”, “in control” or have a dense network of social contacts? In a country where fear and narcissism prevail, inequality is an expected outcome.

    1. Capo Regime

      As a dad of 6 kids one of the culprits (yes I am 73 years old so bear with me) of lousy health outcomes for kids and adults–breastfeeding. U.S has low rates and crappy maternal leave policies. So soon enough after 2 or 4 weeks kid is at daycare drinking down corn heavy formula. Meanwhile my cousins in Madrid took 6 months off (paid) and kids are commonly breastfed in all communities not just rich yuppies like the U.S. Women have to return to the grind early after child birth and thereby cannot breastfeed and thus child is nutritionally affected. Been going on since the 1970’s. unintended down side of women’s ability to enter the workforce combined with the mores of a country where the portrait of justice had her breasts covered by an attorney general–in the 21st century I should add.

  27. MLS

    I’m with you, Yves, it’s hard to dismiss the impact of lifestyle choices regarding diet, exercise, etc. Plus there is the lack of concern about these choices since a many people figure “I’ll just get a pill to fix that high cholesterol” and are willing to medicate the slightest ailment. I’d be interested to know if the studies include the impact of deaths from unnatural causes, since Amreicans seem to shoot each other more than in other countries as well.

  28. Johnny Indiana

    Maybe – gasp! – the US isn’t an advanced economy?

    The US dollar is hyper-over valued – the most overvalued currency in human history, with the largest trade deficits in human history.

    Once the USD collapses, it will turn out that US nominal GDP per capita will match the backwardness of the US economy.

  29. PJ

    Growing numbers of researchers place the blame on stress
    “Stress” is becoming what witchcraft was in the 12th century it causes everything.

  30. Bagehot by-the-Bay

    Actually, Yves, sodas with high fructose corn syrup didn’t exist when (either of us) were young. Coca-Cola and Pepsi switched to HFCS in the U.S. in 1984.

    1. Yves Smith Post author

      Oh, wow, thanks for that info!

      It seems to be the worst of all possible worlds. It has a glycemic index not much lower than that of sugar AND increased triglycerides in anything other than small doses (the sort you’d get in fruit, as opposed to soda). The more forward-thinking cardiologists are looking at triglyceride and homocysteine levels as a likely better predictor of cardiovascular problems than cholesterol.


      I see that HFCS is in a lot of mass market candies. Do you have the foggiest idea when that started becoming common?

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