Changes in midlife death rates across racial and ethnic groups in the US • Hacker News Board

Re: Changes in midlife death rates across racial and ethnic groups in the US

#21

Post by prepend » Thu, Aug 16, 2018, 1:41 PM UTC

lighthazard wrote: post #7

sigfubar wrote: post #6

Earlier quoted context omitted.

Addiction progresses like a disease, but begins as a moral failing. If I were to begin using heroin today, it would be by conscious choice, not because there's something wrong with my body.

Except for 12 year old Travis whose mom introduced him to heroin and now he can't stop. Travis has morally failed because he is doing drugs and it's all his fault.

It’s important to not drive logic using analogy. For every “Travis” there’s lots of others with different circumstances.

There are many social determinants that affect behavioral risk factors.

We need to work to address risk factors as well as provide appropriate treatment.

The US has some data, but there are more gaps that need to be filled. [0]

[0] https://www.cdc.gov/brfss/index.html

Re: Changes in midlife death rates across racial and ethnic groups in the US

#22

Post by davemp » Thu, Aug 16, 2018, 1:42 PM UTC

WhompingWindows wrote: post #3

"Drug overdoses were the leading cause of increased mortality in midlife in each population, but mortality also increased for alcohol related conditions, suicides, and organ diseases involving multiple body systems." Perhaps we can start treating addiction like a disease and not a moral failing?

I would just like to see more education about addiction. Society definitely doesn't handle addiction properly, but it's not a disease and it's not a clear cut moral failing (though it takes strong morals to overcome). The roots of addiction go deep and many people don't properly understand that the roots have to treated lest the addiction sprout again in some form.

Re: Changes in midlife death rates across racial and ethnic groups in the US

#23

Post by bilbo0s » Thu, Aug 16, 2018, 1:44 PM UTC

Sounds like Americans have had a marked decrease in mental and physical health over the time period analyzed. (1999-2016).

I think maybe easier access to healthcare, mental and physical, could help?

Also a lot of this might be signs of an overworked populace? (How many jobs are people working to make ends meet? Do the ends meet after all the jobs are worked? etc). So we should probably look at that as well.

But I think one of the biggest things we should take a long hard look at is our lifestyle. (I know that work hours are a part of that, but I broke that out on its own because it's at least a bit easier). What are we doing during our days? (A lot more screen time these days than there were pre 1999. How many hours do people spend checking reddit/facebook/TinderInstaChat? What impact does that have on physical and mental health?)

What are we eating and drinking? (This might have something to do with it?)

Are there any environmental factors that have arisen as a result in subtle lifestyle changes during the indicated time period?

Etc etc etc.

I guess, in short, I think a comprehensive trend such as the one outlined in the study likely requires a comprehensive look at possible causes.

Re: Changes in midlife death rates across racial and ethnic groups in the US

#24

Post by st26 » Thu, Aug 16, 2018, 1:45 PM UTC

Alex3917 wrote: post #15

It’s gotten to the point where doctors are no longer strongly pushing meeting all the RDIs for eating healthy and exercising if you’d otherwise be working, since (absent other risk factors) how much earning power you have at 35 is a better predictor of your total life expectancy than whatever amount of permanent damage you’d do to your body before then.

That sounds very anecdotal.

Re: Changes in midlife death rates across racial and ethnic groups in the US

#25

Post by st26 » Thu, Aug 16, 2018, 1:46 PM UTC

dominotw wrote: post #18

WhompingWindows wrote: post #3

"Drug overdoses were the leading cause of increased mortality in midlife in each population, but mortality also increased for alcohol related conditions, suicides, and organ diseases involving multiple body systems." Perhaps we can start treating addiction like a disease and not a moral failing?

> Perhaps we can start treating addiction like a disease and not a moral failing? Curious. What advantages would that change of mindset bring?

The idea (I'm not particularly for or against) is that a victim of a disease can seek help & compassion; a morally bankrupt individual can find only scorn. Then it just comes down to whether you think help & compassion helps people right their ways more than admonishment & ostracism.

Re: Changes in midlife death rates across racial and ethnic groups in the US

#26

Post by WhompingWindows » Thu, Aug 16, 2018, 1:47 PM UTC

dominotw wrote: post #18

WhompingWindows wrote: post #3

"Drug overdoses were the leading cause of increased mortality in midlife in each population, but mortality also increased for alcohol related conditions, suicides, and organ diseases involving multiple body systems." Perhaps we can start treating addiction like a disease and not a moral failing?

> Perhaps we can start treating addiction like a disease and not a moral failing? Curious. What advantages would that change of mindset bring?

If people are not deemed to be bad/evil/degenerates because their brain chemistry demands they seek out a certain drug, then we as a society can re-organize our efforts to helping them be safe and recover more quickly. We can provide clean needles and addiction treatments, rather than jail cells and criminal records.

Re: Changes in midlife death rates across racial and ethnic groups in the US

#27

Post by dominotw » Thu, Aug 16, 2018, 1:51 PM UTC

WhompingWindows wrote: post #26

dominotw wrote: post #18

Earlier quoted context omitted.

> Perhaps we can start treating addiction like a disease and not a moral failing? Curious. What advantages would that change of mindset bring?

If people are not deemed to be bad/evil/degenerates because their brain chemistry demands they seek out a certain drug, then we as a society can re-organize our efforts to helping them be safe and recover more quickly. We can provide clean needles and addiction treatments, rather than jail cells and criminal records.

> We can provide clean needles and addiction treatments

1. how do clean needles prevent overdose?

2. https://americanaddictioncenters.org/rehab-guide/state-funde...

We already have state funded addiction centers free of cost. I am not sure how well funded they are though.

Re: Changes in midlife death rates across racial and ethnic groups in the US

#28

Post by sturgill » Thu, Aug 16, 2018, 1:52 PM UTC

vanderZwan wrote: post #20

sturgill wrote: post #13

Earlier quoted context omitted.

Addiction is a disease. And I also think it can be a moral failing to play around with addictive substances. I say this as one who has a long family history of addiction and who has struggled with his own addictions: I was wrong to get involved with certain things. When I reached out to my parents my (normally quiet and ultra-supportive) mom’s first words were, “I thought you were smarter than that.” And her next sen…

Your description is very different from treating it as something to punish people for, which is what usually is meant with "moral failing" in this context.

Even that I'm on the fence about. It can be perfectly appropriate to punish people for making poor choices while at the same time helping them overcome some of the natural consequences of those choices.

I don't know where I stand on the issue of incarcerating people for drug use. But on its face I am not opposed to putting people in jail for selling highly addictive substances to young kids. This is one issue I have with the pro-legalization theory. Alcohol absolutely destroys lives (my grandmother drank herself to death when my mom was 13 in order to have some mental escape from the physical abuse of my alcoholic grandfather). Prohibition didn't seem to work very well, but general acceptance also seems to be failing.

It's a complicated issue, and I don't know where I stand on every aspect of it. But on its face I don't think punishment and help are mutually exclusive. And the fear of punishment _can_ be an effective deterrent. (Education being, in my opinion, the best deterrent. I've never had a drop of alcohol both because of my religious beliefs and the growing understanding that I'm very likely a drunk trapped in a sober body.)

Re: Changes in midlife death rates across racial and ethnic groups in the US

#29

Post by ronnier » Thu, Aug 16, 2018, 1:52 PM UTC

bilbo0s wrote: post #23

Sounds like Americans have had a marked decrease in mental and physical health over the time period analyzed. (1999-2016). I think maybe easier access to healthcare, mental and physical, could help? Also a lot of this might be signs of an overworked populace? (How many jobs are people working to make ends meet? Do the ends meet after all the jobs are worked? etc). So we should probably look at that as well. But I thi…

I wish it called out the difference between males and females. Is the trend mostly with males?

Re: Changes in midlife death rates across racial and ethnic groups in the US

#30

Post by hyperpape » Thu, Aug 16, 2018, 1:52 PM UTC

WhompingWindows wrote: post #4

hyperpape wrote: post #2

I read through the methods, and didn't see any attempt to correct for changes in the age composition of the population ranges. From my minimal familiarity with it, it doesn't sound like it invalidates the results, but it does tend to complicate them. http://andrewgelman.com/2015/11/06/correcting-rising-morbidi... http://andrewgelman.com/2015/11/06/age-adjustment-mortality-...

Did you read the methods, though? This is the first sentence: Methods We examined age adjusted mortality rates based on the 2000 US standard population for 1999-2016 using the Underlying Cause of Death Detailed Mortality database in the Center for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) platform.27 The agency’s methods for age adjustment are described elsewher…

Yes, I read this sentence.

This is a problem with common ways of doing age adjustments.

The issue is somewhat subtle: if you partition people into age bands (45-56), at different times in history, the average person who is in that age group may be older or younger, because different years had higher or lower birth rates. This was a particularly strong effect when the baby boomers were in the 45-56 age range.

My initial comment was that this paper didn't make clear whether they addressed the issue. Having now followed through to the CDC link they have, it looks like it also uses somewhat coarse age bands.