Guns, Germs, and Drugs Are Largely Responsible for the Decline in U.S. Life Expectancy

Link: https://reason.com/2024/01/08/guns-germs-and-drugs-are-largely-responsible-for-the-decline-in-u-s-life-expectancy/

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The Post reported that some politicians pointed to the rising death toll from “lethal drug overdoses” as a significant factor in declining U.S. life expectancy. The Post did, however, acknowledge that drug deaths “are not solely responsible for the decline in life expectancy.” It is worth noting that opioid overdose deaths began truly soaring after 2010 when users turned to illicit heroin and fentanyl after the introduction of Food and Drug Administration–approved abuse-deterrent formulations.

So how much do drug overdose deaths contribute to the recent decline in U.S. life expectancy? A 2021 comprehensive review of factors affecting mortality trends in the U.S. between 1999 and 2018 found that average life expectancy would “have been 0.3 years greater were it not for increases in unintentional drug poisoning.” In a 2023 preprint article, two Johns Hopkins University researchers calculated that opioid overdose deaths between 2019 and 2021 reduced U.S. life expectancy by 0.65 years. If politicians and policy makers really want to make increasing life expectancy a priority, one huge step would be to actually end the war on drugs. A cease-fire in the drug war would likely reduce gun deaths too.

Author(s): Ronald Bailey

Publication Date: 8 Jan 2024

Publication Site: Reason

Obesity in Asia

Link: https://www.genre.com/knowledge/publications/2023/april/ri23-1-en

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Figure 2 shows the incidence of cardiovascular disease and stroke in the male population.

This was derived from Gen Re’s Dread Disease experience study covering the period 2012–2015 and 2015–2019 for Hong Kong, Singapore and Malaysia. As per the analysis from the leading insurance companies of the respective market, 43% of men in Singapore, 40% of men in Malaysia and 26% of men in Hong Kong had critical illness claims due to cardiovascular disease and stroke between 2015 and 2019. When compared with the 2012–2015 analysis, it was noted that there is an increase in claims by 3% in Singapore, 10% in Malaysia and 1% points in Hong Kong, which may be associated with overweight and obesity or simply an older portfolio.

Due to increases in body weight and medical complications, insurance companies may be confronted with increasing claims which will impact their profitability. To mitigate this cost, insurance companies may have to increase the premium so as to commensurate with this rising claim cost. This increase in price will impact on the healthy population.

Health insurance premium has doubled in the past 10 years, but it is unclear how much of this premium is sufficient to cover the financial burden of the obesity pandemic. The evaluation of existing and developing new health coverages related to obesity-related conditions is an important consideration for the profitability of the health insurance providers.14

Author(s): Bharath UP

Publication Date: 12 April 2023

Publication Site: Gen Re

U.S. Has Far Higher Covid Death Rate Than Other Wealthy Countries

Link:https://www.nytimes.com/interactive/2022/02/01/science/covid-deaths-united-states.html

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“We’ve finally started getting to a stage where most of the population has been exposed either to a vaccine or the virus multiple times by now,” said Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Referring to American and European death rates, he continued, “I think we’re now likely to start seeing things be more synchronized going forward.”

Still, the United States faces certain steep disadvantages, ones that experts worry could cause problems during future Covid waves, and even the next pandemic. Many Americans have health problems like obesity and diabetes that increase the risk of severe Covid.

Author(s): Benjamin Mueller and Eleanor Lutz

Publication Date: 1 Feb 2022

Publication Site: NYT

Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK

Link: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30288-2/fulltext

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3 632 674 people were included in the full study population; the following results are from the analysis of never-smokers, which comprised 1 969 648 people and 188 057 deaths. BMI had a J-shaped association with overall mortality; the estimated hazard ratio per 5 kg/m2 increase in BMI was 0·81 (95% CI 0·80–0·82) below 25 kg/m2 and 1·21 (1·20–1·22) above this point. BMI was associated with all cause of death categories except for transport-related accidents, but the shape of the association varied. Most causes, including cancer, cardiovascular diseases, and respiratory diseases, had a J-shaped association with BMI, with lowest risk occurring in the range 21–25 kg/m2. For mental and behavioural, neurological, and accidental (non-transport-related) causes, BMI was inversely associated with mortality up to 24–27 kg/m2, with little association at higher BMIs; for deaths from self-harm or interpersonal violence, an inverse linear association was observed. Associations between BMI and mortality were stronger at younger ages than at older ages, and the BMI associated with lowest mortality risk was higher in older individuals than in younger individuals. Compared with individuals of healthy weight (BMI 18·5–24·9 kg/m2), life expectancy from age 40 years was 4·2 years shorter in obese (BMI ≥30·0 kg/m2) men and 3·5 years shorter in obese women, and 4·3 years shorter in underweight (BMI <18·5 kg/m2) men and 4·5 years shorter in underweight women. When smokers were included in analyses, results for most causes of death were broadly similar, although marginally stronger associations were seen among people with lower BMI, suggesting slight residual confounding by smoking.

Author(s):

Krishnan Bhaskaran, PhD
Prof Isabel dos-Santos-Silva, PhD
Prof David A Leon, PhD
Ian J Douglas, PhD
Prof Liam Smeeth, PhD

Publication Date: 1 December 2018

Publication Site: The Lancet

Why do Americans die earlier than Europeans?

Link: https://www.theguardian.com/commentisfree/2021/may/04/why-do-americans-die-earlier-than-europeans

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A 30-year-old American is three times more likely to die at that age than his or her European peers. In fact, Americans do worse at just about every age. To make matters more grim, the American disadvantage is growing over time.

In 2017, for example, higher American mortality translated into roughly 401,000 excess deaths – deaths that would not have occurred if the US had Europe’s lower age-specific death rates. Pre-pandemic, that 401,000 is about 12% of all American deaths. The percentage is even higher below age 85, where one in four Americans die simply because they do not live in Europe.

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There have been many efforts to account for the US mortality disadvantage. There is no single answer, but three factors stand out. First, death rates from drug overdose are much higher in the US than in Europe and have risen sharply in the 21st century. Second is the rapid rise in the proportion of American adults who are obese. In 2016, 40% of American adults were obese, a larger proportion than in Europe. Higher levels of obesity in the US may account for 55% of its shortfall in life expectancy relative to other rich countries. Third, the US stands out among wealthy countries for not offering universal healthcare insurance. One analysis suggests that the absence of universal healthcare resulted in 45,000 excess deaths at ages 18-64 in 2005. That number represents about a quarter of excess deaths in that age range.

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Above age 65, healthcare insurance coverage is nearly universal via Medicare. An international review of medical practice by the National Academy of Sciences suggested that the US does comparatively well in identifying and treating cardiovascular diseases and many cancers. But the prevalence of these diseases, the principal killers in wealthy countries, is unusually high in the US. Heart disease, a type of cardiovascular disease and America’s number one cause of death for decades, is strongly linked to lifestyle factors such as obesity. Although the connection between obesity and health risks is well known, consumer preferences for unhealthy food are strong. Not just because humans are biologically vulnerable to sweets and fats, but because major food producers and distributors are incentivized to turn this weakness into profit.

Author(s): Samuel Preston, Yana Vierboom

Publication Date: 4 May 2021

Publication Site: The Guardian UK