“America’s fatalities per kilometer driven are very average, but we drive a lot more than anyone else, including residents of Canada and Australia, countries that are more sparsely populated and that don’t have any cities as dense or transit-rich as New York.”
The statement about Canadians and Australian driving less despite being more sparsely populated is misguided. Both countries have vast territories that are almost uninhabited. Canadians are generally clustered within 100 miles of the US border. Australians live along their coast. Population-weighted density is what matters and is quite likely much higher than the US, which has a much more highly populated rural interior.
Also, it is far from true that Canada has no dense, transit-rich metropolises like New York. Have you been to Canada’s cities? The two largest cities - Toronto and Montreal - have extensively used, world-class transit systems that compare favorably to the best transit systems in the US or abroad. Not to mention, both cities are in fact of comparable size to New York relative to the population of their respective countries. Toronto is actually quite a bit bigger.
That the US find and cures more cancer isn't necessarily a good thing, by vigorous screening one also ends up treating many people who never would have had any negative effects from the cancer. These people will pad the survival statistics. They are also at risk of side effects from the unnecessary treatment. https://fivethirtyeight.com/features/the-case-against-early-cancer-detection/
To get back on *my* bullshit, I look forward to the day when policy writers stop using obesity as a stand in for unhealthy behaviors. Not all unhealthy behaviors make your body bigger and, significantly, adopting healthy behaviors like regular exercise often don't make your body smaller. But regular exercise is really, really good for you even if you don't get skinny! When you focus on obesity you start recommending interventions like weird diets, pharmaceuticals and surgeries that do not make people healthier. When you focus on healthy lifestyles, you keep your focus where it belongs: walkable cities, expanding access to whole fruits and vegetables, and creating community spaces to support neighborhood-level social ties. Matt is recommending many of those interventions above, which again, should be pursued even if they don't make people skinny—because they for sure do make people healthier.
I carefully specified with and southwest. California is neither. That there exist healthcare deserts cannot seriously be disputed. Seems like not-picking to me.
Someone on twitter suggested that Matthew Yglesias has a personality disorder regarding this article, but clearly what ought to be problematized is the large number of people who, when confronted with an observation that does not conform to the narrative, lose all reading comprehension and collapse into attributing various fantastic motives to the author
How do you price a sugar/sweeteners tax, is it on the initial sale of raw material, after it is processed into a form of sweetener, or after as an additive ingredient for some selection of processed foods? Guess more of a question of implementation who collects it from whom, idea of a sugar VAT seems dumb but idk.
Incarcerating people appears to reduce their mortality rates, per a study with a convincing control group and an explanation for why previous work on this topic found opposite results.
Thanks for mentioning alcohol. I'm convinced that alcohol is a key factor in firearm and opioid-related death, as well as drunk driving death (also sexual violence).
"The broader question, that I think is harder to answer, is about the impact the American healthcare system has on non-acute health care."
What sort of non-acute healthcare? The US seems to at least do more routine screenings than other places, that's not exactly acute (though it could lead to acute care).
Question from Canada - when you see warnings like "consult a physician before beginning an exercise program", is that a thing people do in the states? I have never heard of anyone here asking their doctor if they should start jogging.
I don’t know if anyone else has mentioned this but Sweden has a very low level of cigarette use. It may be the lowest in Europe and their lung cancer rate is really low too. How did they do that? They got people to switch from cigarettes to Snus which is a type of chewing tobacco. It probably doesn’t raise the risk of heart disease by much, and doesn’t rise the risk of lung cancer.
It’s still a nicotine delivery product and it’s made of tobacco so it can hardly be considered safe, but it’s less dangerous than cigarettes. Encouraging smokers who are not going to quit nicotine to vaping may lower some of the heart disease and cancer rates.
Meanwhile it seems like the FDA is doing the opposite and trying to treat vaping as though it's as bad or worse than cigarettes, which is only driving vapers back to more harmful products
Yeah, I've notices a lot of moral panic around vaping. Doctors telling patients that they need to stop smoking and switching to vaping doesn't count. So of course, the patients try to quit, many can't quit and are still cigarette smokers instead of vapers. The other thing I keep hearing is that we need to ban vaping because kids will start vaping and their brains are still developing. I just don't see why that means we need to ban vaping entirely instead of just for people under 18 or 21. And kids are still better off vaping instead of smoking.
Are people better off if they're not addicted to nicotine? Absolutely. But tobacco products kill people because of the non-nicotine stuff in them. That's why it's so important to get people to stop using tobacco, not because people just shouldn't be addicted to nicotine.
Definitely something that I think goes underdiscussed, especially in progressive circles, is how much taxation in the US focuses on income taxes as opposed to consumption taxes. The "tax the rich" crowd want those taxes to be in the form of payroll taxes and income tax and a higher capital gains tax, not consumption taxes on products seen as luxury. I wonder if part of that is because they don't want to tax things like alcohol and gas that are used by the poor even as they are used more by the rich on the off chance that those taxes are seen as "regressive", despite actually being progressive
I’m curious about the life expectancy gap between richer Americans and Europeans. Drug overdoses and murders seem less likely to be the primary driver there. Could increased stress/less exercise from longer working hours be a factor?
“America’s fatalities per kilometer driven are very average, but we drive a lot more than anyone else, including residents of Canada and Australia, countries that are more sparsely populated and that don’t have any cities as dense or transit-rich as New York.”
The statement about Canadians and Australian driving less despite being more sparsely populated is misguided. Both countries have vast territories that are almost uninhabited. Canadians are generally clustered within 100 miles of the US border. Australians live along their coast. Population-weighted density is what matters and is quite likely much higher than the US, which has a much more highly populated rural interior.
Also, it is far from true that Canada has no dense, transit-rich metropolises like New York. Have you been to Canada’s cities? The two largest cities - Toronto and Montreal - have extensively used, world-class transit systems that compare favorably to the best transit systems in the US or abroad. Not to mention, both cities are in fact of comparable size to New York relative to the population of their respective countries. Toronto is actually quite a bit bigger.
That the US find and cures more cancer isn't necessarily a good thing, by vigorous screening one also ends up treating many people who never would have had any negative effects from the cancer. These people will pad the survival statistics. They are also at risk of side effects from the unnecessary treatment. https://fivethirtyeight.com/features/the-case-against-early-cancer-detection/
To get back on *my* bullshit, I look forward to the day when policy writers stop using obesity as a stand in for unhealthy behaviors. Not all unhealthy behaviors make your body bigger and, significantly, adopting healthy behaviors like regular exercise often don't make your body smaller. But regular exercise is really, really good for you even if you don't get skinny! When you focus on obesity you start recommending interventions like weird diets, pharmaceuticals and surgeries that do not make people healthier. When you focus on healthy lifestyles, you keep your focus where it belongs: walkable cities, expanding access to whole fruits and vegetables, and creating community spaces to support neighborhood-level social ties. Matt is recommending many of those interventions above, which again, should be pursued even if they don't make people skinny—because they for sure do make people healthier.
"Dying is bad."
That's the kind of insight I'm paying cash money for.
One Billion Americans thought it should too.
I carefully specified with and southwest. California is neither. That there exist healthcare deserts cannot seriously be disputed. Seems like not-picking to me.
Someone on twitter suggested that Matthew Yglesias has a personality disorder regarding this article, but clearly what ought to be problematized is the large number of people who, when confronted with an observation that does not conform to the narrative, lose all reading comprehension and collapse into attributing various fantastic motives to the author
How do you price a sugar/sweeteners tax, is it on the initial sale of raw material, after it is processed into a form of sweetener, or after as an additive ingredient for some selection of processed foods? Guess more of a question of implementation who collects it from whom, idea of a sugar VAT seems dumb but idk.
Incarcerating people appears to reduce their mortality rates, per a study with a convincing control group and an explanation for why previous work on this topic found opposite results.
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3644719
Most of the effect comes from reducing overdoses and homicides.
Thanks for mentioning alcohol. I'm convinced that alcohol is a key factor in firearm and opioid-related death, as well as drunk driving death (also sexual violence).
Carrie Nation wasn’t all wrong, just a bit misguided in her methods.
"The broader question, that I think is harder to answer, is about the impact the American healthcare system has on non-acute health care."
What sort of non-acute healthcare? The US seems to at least do more routine screenings than other places, that's not exactly acute (though it could lead to acute care).
Question from Canada - when you see warnings like "consult a physician before beginning an exercise program", is that a thing people do in the states? I have never heard of anyone here asking their doctor if they should start jogging.
I don’t know if anyone else has mentioned this but Sweden has a very low level of cigarette use. It may be the lowest in Europe and their lung cancer rate is really low too. How did they do that? They got people to switch from cigarettes to Snus which is a type of chewing tobacco. It probably doesn’t raise the risk of heart disease by much, and doesn’t rise the risk of lung cancer.
It’s still a nicotine delivery product and it’s made of tobacco so it can hardly be considered safe, but it’s less dangerous than cigarettes. Encouraging smokers who are not going to quit nicotine to vaping may lower some of the heart disease and cancer rates.
How's their oral cancer rates?
Meanwhile it seems like the FDA is doing the opposite and trying to treat vaping as though it's as bad or worse than cigarettes, which is only driving vapers back to more harmful products
Yeah, I've notices a lot of moral panic around vaping. Doctors telling patients that they need to stop smoking and switching to vaping doesn't count. So of course, the patients try to quit, many can't quit and are still cigarette smokers instead of vapers. The other thing I keep hearing is that we need to ban vaping because kids will start vaping and their brains are still developing. I just don't see why that means we need to ban vaping entirely instead of just for people under 18 or 21. And kids are still better off vaping instead of smoking.
Are people better off if they're not addicted to nicotine? Absolutely. But tobacco products kill people because of the non-nicotine stuff in them. That's why it's so important to get people to stop using tobacco, not because people just shouldn't be addicted to nicotine.
Definitely something that I think goes underdiscussed, especially in progressive circles, is how much taxation in the US focuses on income taxes as opposed to consumption taxes. The "tax the rich" crowd want those taxes to be in the form of payroll taxes and income tax and a higher capital gains tax, not consumption taxes on products seen as luxury. I wonder if part of that is because they don't want to tax things like alcohol and gas that are used by the poor even as they are used more by the rich on the off chance that those taxes are seen as "regressive", despite actually being progressive
I don't see any mention in this piece about the higher rates of smoking in Europe, which makes the mortality gap look even worse.
And Japan is one of the most smoke-friendly countries on the planet
"Dying is bad"
That's my $80/year take right there. Take the rest of the year off, Matt!!!
I’m curious about the life expectancy gap between richer Americans and Europeans. Drug overdoses and murders seem less likely to be the primary driver there. Could increased stress/less exercise from longer working hours be a factor?