Lambert here: Everything’s going according to plan.
By Amy Maxmen, public health local editor and correspondent, was a senior reporter at Nature covering health inequities, global health, infectious diseases, and genomics. She’s also written for The New York Times, The Washington Post, Bloomberg Businessweek, National Geographic, and many other outlets. Originally published at KFF Health News.
The life expectancy among Native Americans in the western United States has dropped below 64 years, close to life expectancies in the Democratic Republic of the Congo and Haiti. For many Asian Americans, it’s around 84 — on par with life expectancies in Japan and Switzerland.
Americans’ health has long been unequal, but a new study shows that the disparity between the life expectancies of different populations has nearly doubled since 2000. “This is like comparing very different countries,” said Tom Bollyky, director of the global health program at the Council on Foreign Relations and an author of the study.
Called “Ten Americas,” the analysis published late last year in The Lancet found that “one’s life expectancy varies dramatically depending on where one lives, the economic conditions in that location, and one’s racial and ethnic identity.” The worsening health of specific populations is a key reason the country’s overall life expectancy — at 75 years for men and 80 for women — is the shortest among wealthy nations.
To deliver on pledges from the new Trump administration to make America healthy again, policymakers will need to fix problems undermining life expectancy across all populations.
“As long as we have these really severe disparities, we’re going to have this very low life expectancy,” said Kathleen Harris, a sociologist at the University of North Carolina. “It should not be that way for a country as rich as the U.S.”
Since 2000, the average life expectancy of many American Indians and Alaska Natives has been steadily shrinking. The same has been true since 2014 for Black people in low-income counties in the southeastern U.S.
“Some groups in the United States are facing a health crisis,” Bollyky said, “and we need to respond to that because it’s worsening.”
Heart disease, car fatalities, diabetes, covid-19, and other common causes of death are directly to blame. But research shows that the conditions of people’s lives, their behaviors, and their environments heavily influence why some populations are at higher risk than others.
Native Americans in the West — defined in the “Ten Americas” study as more than a dozen states excluding California, Washington, and Oregon — were among the poorest in the analysis, living in counties where a person’s annual income averages below about $20,000. Economists have shown that people with low incomes generally live shorter lives.
Studies have also linked the stress of poverty, trauma, and discrimination to detrimental coping behaviors like smoking and substance use disorders. And reservations often lack grocery stores and clean, piped water, which makes it hard to buy and cook healthy food.
About 1 in 5 Native Americans in the Southwest don’t have health insurance, according to a KFF report. Although the Indian Health Service provides coverage, the report says the program is weak due to chronic underfunding. This means people may delay or skip treatments for chronic illnesses. Postponed medical care contributed to the outsize toll of covid among Native Americans: About 1 of every 188 Navajo people died of the disease at the peak of the pandemic.
“The combination of limited access to health care and higher health risks has been devastating,” Bollyky said.
At the other end of the spectrum, the study’s category of Asian Americans maintained the longest life expectancies since 2000. As of 2021, it was 84 years.
Education may partly underlie the reasons certain groups live longer. “People with more education are more likely to seek out and adhere to health advice,” said Ali Mokdad, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington, and an author of the paper. Education also offers more opportunities for full-time jobs with health benefits. “Money allows you to take steps to take care of yourself,” Mokdad said.
The group with the highest incomes in most years of the analysis was predominantly composed of white people, followed by the mainly Asian group. The latter, however, maintained the highest rates of college graduation, by far. About half finished college, compared with fewer than a third of other populations.
The study suggests that education partly accounts for differences among white people living in low-income counties, where the individual income averaged less than $32,363. Since 2000, white people in low-income counties in southeastern states — defined as those in Appalachia and the Lower Mississippi Valley — had far lower life expectancies than those in upper midwestern states including Montana, Nebraska, and Iowa. (The authors provide details on how the groups were defined and delineated in their report.)
Opioid use and HIV rates didn’t account for the disparity between these white, low-income groups, Bollyky said. But since 2010, more than 90% of white people in the northern group were high school graduates, compared with around 80% in the southeastern U.S.
The education effect didn’t hold true for Latino groups compared with others. Latinos saw lower rates of high school graduation than white people but lived longer on average. This long-standing trend recently changed among Latinos in the Southwest because of covid. Hispanic or Latino and Black people were nearly twice as likely to die from the disease.
On average, Black people in the U.S. have long experienced worse health than other races and ethnicities in the United States, except for Native Americans. But this analysis reveals a steady improvement in Black people’s life expectancy from 2000 to about 2012. During this period, the gap between Black and white life expectancies shrank.
This is true for all three groups of Black people in the analysis: Those in low-income counties in southeastern states like Mississippi, Louisiana, and Alabama; those in highly segregated and metropolitan counties, such as Queens, New York, and Wayne, Michigan, where many neighborhoods are almost entirely Black or entirely white; and Black people everywhere else.
Better drugs to treat high blood pressure and HIV help account for the improvements for many Americans between 2000 to 2010. And Black people, in particular, saw steep rises in high school graduation and gains in college education in that period.
However, progress stagnated for Black populations by 2016. Disparities in wealth grew. By 2021, Asian and many white Americans had the highest incomes in the study, living in counties with per capita incomes around $50,000. All three groups of Black people in the analysis remained below $30,000.
A wealth gap between Black and white people has historical roots, stretching back to the days of slavery, Jim Crow laws, and policies that prevented Black people from owning property in neighborhoods that are better served by public schools and other services. For Native Americans, a historical wealth gap can be traced to a near annihilation of the population and mass displacement in the 19th and 20th centuries.
Inequality has continued to rise for several reasons, such as a widening pay gap between predominantly white corporate leaders and low-wage workers, who are disproportionately people of color. And reporting from KFF Health News shows that decisions not to expand Medicaid have jeopardized the health of hundreds of thousands of people living in poverty.
Researchers have studied the potential health benefits of reparation payments to address historical injustices that led to racial wealth gaps. One new study estimates that such payments could reduce premature death among Black Americans by 29%.
Less controversial are interventions tailored to communities. Obesity often begins in childhood, for example, so policymakers could invest in after-school programs that give children a place to socialize, be active, and eat healthy food, Harris said. Such programs would need to be free for children whose parents can’t afford them and provide transportation.
But without policy changes that boost low wages, decrease medical costs, put safe housing and strong public education within reach, and ensure access to reproductive health care including abortion, Harris said, the country’s overall life expectancy may grow worse.
“If the federal government is really interested in America’s health,” she said, “they could grade states on their health metrics and give them incentives to improve.”
These sort of disparities were tracked and shown to us by persons working in DEI.
Now this sort of information is considered undesirable and we can expect less of it, thanks to the 47th US president … who rebukes cries for mercy toward anyone other than his victimized self.
Programs to address health inequities or population needs are also on the agenda of #47 … to be found out and, to the extent possible, dismantled or defunded. MAGA, DOGE, and 2025 all the way.
However, if DEI statistics are suppressed, history will cry out. In the end, the true story will be told.
With all due respect, although perhaps helpful (I don’t know), we don’t need DEI statistics. The facts are clear in Census data as well as in previous studies mentioned in the article, this is nothing new. Neither of the two so-called political parties will make any honest effort to ameliorate the situation. Their bribes depend on maintaining the status quo. Congress has had decades, the D party says “single payer is off the table” .
Let the superfluous, surplus population die young, it’s good for business.
You are kidding, right?
The same people screaming about DEI are exactly the ones screaming about us as physicians even discussing obesity with our patients – that is fat-shaming.
I have now had to attend two different equity seminars where I was explicitly told that bringing up obesity is a sign of my own racism. It is a sign that I am so racist that I cannot even help myself. Even when the patient and I are the same race. I was also told that this behavior by a health care worker is a sign of ableism.
If you truly believe what you are saying above, I do wish you the best of luck. Unfortunately, so many of our health care workers have been cowed into submission by this insanity, many of them do not even know how to address these issues scientifically anymore.
https://www.nytimes.com/2024/11/14/well/obesity-epidemic-america.html
November 14, 2024
Three-Quarters of U.S. Adults Are Now Overweight or Obese
A sweeping new paper reveals the dramatic rise of obesity rates nationwide since 1990.
By Nina Agrawal
Nearly three quarters of U.S. adults are overweight or obese, according to a sweeping new study. The findings have wide-reaching implications for the nation’s health and medical costs as it faces a growing burden of weight-related diseases.
The study, * published on Thursday in The Lancet, reveals the striking rise of obesity rates nationwide since 1990 — when just over half of adults were overweight or obese — and shows how more people are becoming overweight or obese at younger ages than in the past. Both conditions can raise the risk of diabetes, high blood pressure and heart disease, and shorten life expectancy.
The study’s authors documented increases in the rates of overweight and obesity across ages. They were particularly alarmed by the steep rise among children, more than one in three of whom are now overweight or obese. Without aggressive intervention, they forecast, the number of overweight and obese people will continue to go up — reaching nearly 260 million people in 2050.
“I would consider it an epidemic,” said Marie Ng, who is an affiliate associate professor at the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine and a co-author of the new paper.
Dr. Ng and her co-authors wrote that existing policies have failed to do enough to address the crisis, adding that “major reform” was needed to prevent it from worsening.
“It’s going to require a lot more attention and a lot more investment than we are currently giving the problem,” said Dr. Sarah Armstrong, a professor of pediatrics and population health sciences at Duke University who was not involved in the study.
The paper defined “overweight” adults as those who were age 25 and over with a body mass index at or over 25, and “obese” adults as those with a B.M.I. at or over 30. The authors acknowledged that B.M.I. is an imperfect measure that may not capture variations in body structure across the population. But from a scientific perspective, experts said, B.M.I. is correlated with other measures of body fat and is a practical tool for studying it at a population level.
The authors found a steady increase in the share of people who are overweight or obese over the past three decades. The rate of obesity in particular rose steeply, doubling in adults between 1990 and 2021 to more than 40 percent — and nearly tripling, to 29 percent, among girls and women aged 15 to 24…
* https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01548-4/fulltext
And the “obesity (and related health problems) crisis” has hit the US military. Also, a basic academic skills crisis. Too fat and too stupid appears to be a big problem.
https://www.airforcetimes.com/news/your-air-force/2023/04/03/fatter-recruits-now-welcome-as-air-force-revises-its-rules/
https://www.stripes.com/branches/army/2023-01-18/army-soldiers-recruiting-requirements-8809987.html
Carnaby Street, Soho, London
1967
https://youtu.be/8Mi4u5hjpes?si=q2cFGrZqfIfuYxya
This is what young and old people looked like, and how they moved, just
58 years ago!
We, obviously, are being poisoned. It is as clear as watching a fruit tree wither, or or your pet dog convulsing in the backyard. Believe your lying eyes!
I find it odd hearing stories like this because in my experience DEI has been much more evidence based and focused on acknowledging and addressing racial inequities like health. I’m not in the US, though.
Yes. The following article is unfortunately behind a paywall. From 2024, last year, in Evie Magazine.
Body Positive Influencers Have Been Dying Really Young Recently—Here’s Why/
Feb 1, 2024These incidents cast a spotlight on the body positivity movement, whose central premise is that you can be healthy at any size, challenging the conventional beliefs about obesity and health.
https://www.eviemagazine.com/post/body-positive-influencers-dying-young-heres-why
And here’s something from the Daily Mail in 2023, not my usual goto source, but US sources seem suddenly very quiet about this.
Tragic deaths of the ‘fat is healthy’ social media stars.
https://mailonline.pressreader.com/article/282419879047703
Yes, society can be very cruel to obese people, particular to obese children. No one doubts that. But the answer to social bullying should not be encouraging people to ignore their personal health, no matter how frustrating it is to confront and deal with, (and it can be enormously frustrating), only in an effort to push back on the bullies. That’s getting people dead much too early. imo.
F the bullies. Take care of your health.
If Ahnold’s bmi in his prime as a body builder seemed off in terms of health, that doesn’t mean your bmi as a semi-sedentary office worker is off in terms of health. / my 2 cents
That’s so awful that I actually lol’d
No one is coming to save people, certainly not the government. Your health, like everything else, is up to the individual and their families. No amount of “education” will change this.
I’m from the government and I’m here to help.
The NYT has admitted that DEI doesn’t work:
https://youtu.be/kh8C2m_V-18?si=4Jot3ONFHuhW_Afd
and the “science” behind it has been debunked:
https://www.dailywire.com/news/new-bombshell-study-shows-dei-programs-increase-hostility
In other words, the oppressor/oppressed distinctions reflected in many modern DEI narratives can actually increase bias, hostility, and attribution of discriminatory beliefs among groups, as opposed to decreasing them. This finding suggests that exposure to ‘antiracist’ narratives decreases people’s ability to view situations rationally; if biased by a preconceived narrative of discrimination, people are more inclined to see discrimination at play in interactions that an unbiased observer might perceive as perfectly fair and reasonable.
Because it is nonsense. Take any one of these disadvantaged people, and put them on a proper diet/exercise regimen, and they will live just as long as a rich white guy on the same regimen.Will they do it? Of course not. It is much easier to whine about what a raw deal you are getting, and depend on someone else to take care of you.
Complete bullshit.
Being poor has a lifespan cost (oh, and being in a highly unequal society exacts a lifespan cost even on the rich). Start with stress. Add much less “access’ to health care. Oh, and areas where housing is cheap is often in polluted areas (see the chemical plants near New Orleans or near big highways, which = more air pollution).
Stress eats away at your body. One reason people tend to over eat and the cheap choices to fill the hunger void aren’t usually healthy.
i blame this on a predatory food system. surely poor educational outcomes are also linked.
garbage in, garbage out.
It’s the food, it’s the food, it’s the food.
It’s the very, very profitable food. Killing people is a path to riches.
I bought some pasta imported from Italy, where grains are not spayed with glyphosate (done in the US) to speed the drying times. Italian pasta is not that much more expensive. On eating a portion of the Italian wheat pasta I found myself full but not sugared out, as they say. Some time later, I cooked some good US brand pasta, a very good brand, and found it much much too sweet, and found myself feeling sugared out after eating the pasta. Not good. Now I’m trying to find a US source for good Italian flour for baking. (Not an Amazon source, hopefully.)
https://www.cornucopia.org/2017/10/glyphosate-used-kill-prepare-crops-harvest/
Stop! You are making me feel hungry!
Can people explain what they mean when they say it’s the food. For example, the Lancet study pointed out that the longevity rates of the United States’ Black population increased and the Black-white disparity decreased up until 2012. What does food consumption have to do with that? I am not arguing that ultra processed food and high caloric/low nutritional food has no impact, but to highlight changes in food consumption as the primary cause of health disparities with little evidence of 1)The actual change in food consumption and 2)It’s impact isn’t helpful.
Industrial food kills people at every level, from farmworkers to meat processors to foul, polluted water supplies poisoning local populations, to fertilizer made of sewage contaminating crops — and people are making lots and lots of money at every stage of this criminal process, from GMO seed to cereal ads. See today’s Links for “Packinghouse Ethics.”
And from the post above “But this analysis reveals a steady improvement in Black people’s life expectancy from 2000 to about 2012.” That’s a blip. It could be an error in the data or not — in any case, it’s an anomaly.
Capitalism kills. And American capitalism kills in particularly violent, ugly and profitable ways. Industrial food is only one of them.
So, let’s blame virtually anything we can dream up, rather than blame people for what they put into their mouths.
How much money people have and what is available to “put in their mouths” matters.
Could the implementation of Obamacare have something to do with the post-2012 inflection point?
Banning all ultraprocessed food should lead to improved health outcomes across the board, but that will never happen, of course. Instead we’ll be lectured endlessly about our “lifestyle choices” and told it’s a matter of personal responsibility. Just like poverty is–if only we would take responsibility to work hard and pull ourselves up by our bootstraps. The plutocrats are really into that personal responsibility excuse for the rest of us.
And Paul Simmons is right here in these comments doing their dirty work.
So, I’m not the only one that have noticed a flood of “dirty work” comments from the named individual.
So what is life expectancy? Is it ¨Life expectancy at birth¨, or some measure of how long people living today could be expected to continue living? If it is the latter, then persons born in 1960 would have a different life expectancy than those born today.
“Money allows you to take steps to take care of yourself,” Mokdad said.
The money quote right there.
“…But without policy changes that boost low wages, decrease medical costs, put safe housing and strong public education within reach, and ensure access to reproductive health care including abortion, Harris said, the country’s overall life expectancy may grow worse…”
Based on the latest news, it looks like programs like Education, Medicaid will be cut, while medical costs continue to rise. What can we expect when all three branches of gov. demonstrate flagrant conflicts of interest and accept bribes?
No, there’s no institutional corruption, the USA is a beacon of democracy and the rule of law doncha know
The USA is becoming more and more like Brazil every day. A well-off bourgeois, with increasing living standards and health, a struggling middle, and a massive and growing under-class of everybody else. This is the fruit of the financialization of the economy and the massive transfer of wealth to the parasitic over class, and commensurate immiseration of the working class. Favela’s in every city, take a walk around.
If you want see real gun control in the US of A, start arming the homeless.
Exactly, which is why millions of people are doing their best to get into the US, rather than Brazil.
I thought you don’t consider those as people.
Brilliant! ‘Roast’ of the day!
https://fred.stlouisfed.org/graph/?g=1p7yP
January 15, 2018
Life Expectancy at Birth for United States, United Kingdom, France, Germany, Italy and Japan, 2017-2022
https://fred.stlouisfed.org/graph/?g=1BP3S
January 30, 2018
Infant Mortality Rate for United States, United Kingdom, France, Germany, Italy and Japan, 2017-2022
And maternal mortality rates in the US are more than DOUBLE other “developed” countries.
https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison
US dwellers pay the highest costs for so-called health care in the world, yet have piss-poor aggregate health outcomes. Talk about an extortion racket.
Big fan of blaming the food but the basic nature of poverty is that you’re in a state of constant financial stress. Overeating used to be the cheapest therapy around but now even that’s becoming unaffordable.
It’s not just the food.
Tree logging has a mortality rate of about 0.1% yearly, and is weighted young, thus pulling down life expectancy.
American Indian opioid overdoses are about 0.15% yearly. Again, trends young.
It’s not just the food.
One could make a simple arguement that increased mortality in correlated to industrial farming and processed foods. https://onlinedegrees.kent.edu/college-of-public-health/community/life-expectancy-and-public-health
I am not making that argument, but to blame processed food for the disparity in life expectancy is simplistic and unscientific.