"Life Expectancy" Doesn't Measure How Long You're Expected To Live • Hacker News Board

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#31

Post by manifold » Tue, Sep 11, 2012, 6:45 PM UTC

barrkel wrote: post #19

tptacek wrote: post #4

This is a great post. Because I'm a nerd, I'm compelled to make an orthogonal point: Life expectancy is not entirely medical and is not a particularly good way to compare countries. Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles) and suicide, both of which are anomalously high in the US. Consider also that if you go to the top US cause of death (heart disease, clea…

You'll tend to see similar effects for other medical issues, particularly cancer, in which the US notoriously outperforms many of the European countries that outrank it on life expectancy. FWIW, I looked into this using the tables on http://www.worldlifeexpectancy.com/cause-of-death/all-cancer... - not just the all cancers table, but also the separate tables for different types of cancer. The implication of what you…

The other thing to consider is how the causes of death interact, and who it is that's contributing to mortality/survival rates. For example, perhaps people in France have higher cancer mortality rates because they are not dying from heart disease at a younger age. Perhaps the US has better survival rates for cancer because the incidence rates are higher among lower age groups, and people's general health is better at those ages, and so on.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#32

Post by tptacek » Tue, Sep 11, 2012, 6:47 PM UTC

Retric wrote: post #29

tptacek wrote: post #13

Earlier quoted context omitted.

Not sure how we get to the word "dwarfed" in that analysis, since despite ranking below Europe on life expectancy, the US does significantly better on heart disease and cancer mortality. Point being: something's going on here that confounds life expectancy comparisons.

Your statistics are simply wrong. Which is why they numbers don't seem to add up correctly. US has a mixed heath-care system with some people reviving enough treatment that it actually lowers there chances of survival and others getting little to no treatment. PS: It's hard to get good data. Japan has twice the US suicide rate and a longer life expectancy. However, some of their numbers are off due to people not repo…

Is there data to back up your argument? What you're saying seems to amount to this:

If you're wealthy, the US health care system is so good that not only does it outdo Europe's system at handling heart disease and cancer, but it does so much better than Europe's that the effect is evident from mortality statistics even though 75MM people in the US make less than $22,000/yr. At the same time, you're saying that regardless of the fact that US hospitals are required by law to treat indigent patients regardless of cost, enough people receive so little care that they bias the mortality statistics.

This seems like an extraordinary claim.

I am not an apologist for the US health care system, as a cursory look at HNSearch will show you. But I don't think the problem is that people don't get care in the US; it is, as policy wonks will tell you, better (from a health care perspective) to be homeless in 2012 than it was to be President in 1955. The problem is that the US health care system routinely bankrupts patients.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#33

Post by tatsuke95 » Tue, Sep 11, 2012, 6:54 PM UTC

tptacek wrote: post #4

This is a great post. Because I'm a nerd, I'm compelled to make an orthogonal point: Life expectancy is not entirely medical and is not a particularly good way to compare countries. Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles) and suicide, both of which are anomalously high in the US. Consider also that if you go to the top US cause of death (heart disease, clea…

>" Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles)"

If I have a higher-than-average chance of dying in an automobile accident in a specific country, that's good information to have. In fact, I want to know all the particularly common ways I could die somewhere, be it via car or mortar attack. I think that's a great way to compare countries and life expectancy. Maybe I miss your point?

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#34

Post by grecy » Tue, Sep 11, 2012, 6:55 PM UTC

tptacek wrote: post #25

grecy wrote: post #23

Earlier quoted context omitted.

Some other factors to think about: Road quality in the United states is low compared to other OPEC countries Seatbelts and motorbike helmets are still not mandatory in all US states Car quality and safety in the United States is lower than other OPEC countries EDIT: I meant OECD, not OPEC.

In only one state in the US are seatbelts not mandatory for adults (New Hampshire). Otherwise, the only differences are between states in which you can be pulled over for being observed not wearing a seatbelt (the "primary enforcement" states) and those in which you can only be issued a seatbelt ticket after being pulled over for some other reason. I also think the road and car quality questions are up for debate.

Aren't there a lot of states where back seat passengers don't have to wear seat belts, and people can ride in the back of pick-ups etc.

Obviously road and car quality are up for debate, but once you spend some time driving around Europe in European cars, you'll see what I mean.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#35

Post by grecy » Tue, Sep 11, 2012, 6:56 PM UTC

baltcode wrote: post #28

grecy wrote: post #23

Earlier quoted context omitted.

Some other factors to think about: Road quality in the United states is low compared to other OPEC countries Seatbelts and motorbike helmets are still not mandatory in all US states Car quality and safety in the United States is lower than other OPEC countries EDIT: I meant OECD, not OPEC.

I thought OPEC was the oil producers club, and that the US isn't a member. Did I miss something?

Sorry, confused my acronyms.

OECD

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#36

Post by tptacek » Tue, Sep 11, 2012, 6:59 PM UTC

tatsuke95 wrote: post #33

tptacek wrote: post #4

This is a great post. Because I'm a nerd, I'm compelled to make an orthogonal point: Life expectancy is not entirely medical and is not a particularly good way to compare countries. Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles) and suicide, both of which are anomalously high in the US. Consider also that if you go to the top US cause of death (heart disease, clea…

> " Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles)" If I have a higher-than-average chance of dying in an automobile accident in a specific country, that's good information to have. In fact, I want to know all the particularly common ways I could die somewhere, be it via car or mortar attack. I think that's a great way to compare countries and life expectancy. May…

I'm not saying life expectancy tells you nothing, just that it doesn't tell you what a lot of people seem to think it tells you. If you got sick and had to pick a country to be treated in solely based on your health outcome, you'd be making a mistake to choose based on life expectancy. In the same vein: if you were picking countries based on quality of public transit nationwide, sure, life expectancy could be a counterintuitive and convoluted way to arrive at the right conclusion. But a look at an Amtrak schedule would tell you pretty much the same thing without the tea leaf reading. Everyone knows that Europe and Japan have denser public transit than the US.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#37

Post by onetimeuse001 » Tue, Sep 11, 2012, 7:05 PM UTC

tptacek wrote: post #4

This is a great post. Because I'm a nerd, I'm compelled to make an orthogonal point: Life expectancy is not entirely medical and is not a particularly good way to compare countries. Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles) and suicide, both of which are anomalously high in the US. Consider also that if you go to the top US cause of death (heart disease, clea…

Life expectancy is not entirely medical and is not a particularly good way to compare countries. Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles) and suicide, both of which are anomalously high in the US.

Maybe I am getting it wrong but does it matter how you die? Generally speaking (averaged out,) if you live in US and do what the average person does, you will get in accidents and deal with the pressures that push some to suicides (around 10 to 22 per 100,000 http://www.bloomberg.com/news/2011-04-14/suicide-rates-rise-... .) Even if you are careful, the recently licensed teenager, to stereotype, can ram his car into yours.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#38

Post by tptacek » Tue, Sep 11, 2012, 7:08 PM UTC

grecy wrote: post #34

tptacek wrote: post #25

Earlier quoted context omitted.

In only one state in the US are seatbelts not mandatory for adults (New Hampshire). Otherwise, the only differences are between states in which you can be pulled over for being observed not wearing a seatbelt (the "primary enforcement" states) and those in which you can only be issued a seatbelt ticket after being pulled over for some other reason. I also think the road and car quality questions are up for debate.

Aren't there a lot of states where back seat passengers don't have to wear seat belts, and people can ride in the back of pick-ups etc. Obviously road and car quality are up for debate, but once you spend some time driving around Europe in European cars, you'll see what I mean.

For every 1 passenger killed in the US, almost 3 drivers are killed. Given that the mean occupancy per car in the US is something between 1.3 and 1.7, it seems very unlikely that back seat restraints are a significant contributor to these statistics.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#39

Post by barrkel » Tue, Sep 11, 2012, 7:09 PM UTC

tptacek wrote: post #26

barrkel wrote: post #19

Earlier quoted context omitted.

You'll tend to see similar effects for other medical issues, particularly cancer, in which the US notoriously outperforms many of the European countries that outrank it on life expectancy. FWIW, I looked into this using the tables on http://www.worldlifeexpectancy.com/cause-of-death/all-cancer... - not just the all cancers table, but also the separate tables for different types of cancer. The implication of what you…

The United States ranks #56 (higher numbers are better), ahead of basically the entire EU, on colorectal cancer mortality. The United States ranks #41, ahead of much of the EU but behind Germany and France, on ovarian cancer. The United States ranks #61, again ahead of almost all of the EU, on breast cancer. Here I might point out that to come in much higher than the US in these numbers, ie, to be Gabon, you have to…

But even by what you write, it's not convincing, though, is it? Behind some major countries on a number of common cancers, but in the lead on others. I mean, it's clear that the US is not lagging. But it's not a convincing lead either. And you need to look at the variances. From looking at the per 100K deaths, many of the US leads are in the region of 10%, but the variances between different European countries is much larger than that.

But the US is definitely in the lead on breast cancer. No doubt about that.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#40

Post by tptacek » Tue, Sep 11, 2012, 7:10 PM UTC

grecy wrote: post #35

baltcode wrote: post #28

Earlier quoted context omitted.

I thought OPEC was the oil producers club, and that the US isn't a member. Did I miss something?

Sorry, confused my acronyms. OECD

[WARNING: Egregiously incorrect comment follows]

In other words, you think car quality in the US is lower than that of countries like Tajikistan, Swaziland, Kazakhstan, and Ecuador. When you say "OECD", you might as well say "the entire world". I officially doubt your statistics.