Widening Gap in U.S. Life Expectancy

My sensitivity to the difference between these terms comes from reading Ray Kurzweil's (and many others') bullshit arguments about how humans will eventually become immortal through technology. He intentionally conflates trends in life expectancy with longevity, as do other charlatans who will sell you a cryogenic chamber or life extending elixir. Having life expectancy increase does not mean that large numbers of humans are going to start living to be older than 100 years. The longevity of humans has been around 80 years and barely changing for thousands of years. The life expectancy of different regions has varied wildly depending on how many people die young.

I'm fairly stunned if you work in this field that you wouldn't have heard of the concept of longevity, or at least maximum lifespan, as something distinct and opposed to life expectancy. It's quite important to rule out accidental causes of death if you want to have any chance of understanding how long humans can possibly live. Being able to make statements about diet and exercise requires being able to factor out all car and sports accidents from the average.

Here's what Wikipedia says: "Longevity, maximum lifespan, and life expectancy are not synonyms. Life expectancy is defined statistically as the mean number of years remaining for an individual or a group of people at a given age. Longevity refers to the characteristics of the relatively long life span of some members of a population. Maximum lifespan is the age at death for the longest-lived individual of a species. Moreover, because life expectancy is an average, a particular person may die many years before or many years after the "expected" survival. The term "maximum life span" has a quite different meaning and is more related to longevity."

https://en.m.wikipedia.org/wiki/Life_expectancy

To be fair, the Longevity entry echoes what you said, that some people use it as a synonym.

My hope was that the NIH would be more careful, because they're scientists working in the field, and they know better than to use vague terms that have easily misunderstood meanings.

> No one dies of old age.

True, but you know exactly what I mean, right? Whatever you want to call it, natural causes? Ideal conditions? What is the correct term for people who grow old and don't die of an accident?

I don't know; that's a good question. As long as most people die old then probably yes. But longevity is more closely related to the maximum, and median doesn't give you information about the maximum. And there have been times in the last millennium when the median would have reflected high infant mortality, and not the age of people who live a long life and then die of "natural causes". Anyway, nobody really reports medians. Life expectancy is an average measure.

You said that the gov't "told generations of kids to eat a pound of bread every day." That seemed clearly a reference to the food pyramid and similar guidelines which recommended relative proportions of carbohydrates, proteins, and fats. Those recommendations were largely reflective of the medical consensus, such as it was--i.e. too much group think and too much reliance on epidemiological methodologies rather than investigatory science.

Yes, the USDA is responsive to the agricultural lobby. So what? At the end of the day it doesn't matter how or why they make their recommendations, but the substance and effect of those recommendations. And my point is that in the long-term the general guidance of the USDA has reflected, more than anything else, the medical consensus. Obviously it doesn't only reflect that, but everything is effected by lobbying, even the medical consensus.

And my larger argument is that if you examine its long-term track record, on the whole it has been positive, at least in the context of nutritional policy. Yes, the USDA's fortification program was largely voluntary. So were its more modern recommendations. Sometimes their recommendations weren't voluntary, like guidelines for federally funded school lunch programs. But the same applies to their fortification programs--those school lunch guidelines also mandate fortified foodstuffs. Also, the fortification programs involved direct and indirect subsidies, which is why most basic foodstuffs (grains, salt) at retail were fortified, at least until the organic craze.

I respond because I'm tired of the narrative that when government does something stupid the answer should just be to remove government from the equation. That's not rational. In every context we should endeavor to make informed and well-reasoned judgments based on a) context, b) facts, and c) some rough assessment of our priorities. Unfortunately we've forgotten how to incorporate those three things into our discourse. We don't understand context because we reframe every issue as some ideological battle about government. We don't understand facts because we're too lazy to root them out, and too lazy to assess their relevance and strength. And we suck at agreeing on priorities because, similar to context, we confuse the means with the end--that is, we seem to think our ultimate goal is to refashion government to fit some conceptual model, rather than to refashion particular laws and agencies to best meet some quantifiable goal, like a lower incidence of diabetes.

This retreat and resort to ideology and abstract modeling is not only a political pathology, but arguably it has been the problem with nutritional science. For example, when I mention "epidemiological methodologies" above I'm implying, among other things, that we committed a category error: too much salt might be "causative" of high blood pressure on a population wide scale, but on an individual scale it doesn't cause anything in most people, and the particular issue in the subset of the population responsive to high salt intake wasn't something you'd expect given the large population studies. The population-wide mechanism was empirically sound (lower average salt consumption, improve average outcomes) but not reflective of the underlying pathologies at the micro-scale and ultimately suboptimal.

IOW, yes, if _everybody_ reduced salt consumption to some common recommended level then population-wide health could improve. But there's a better equilibrium to be found by understanding the details and taking a more nuanced approach, allowing us to improve health even more. Likewise, maybe we might all be better off on average if the USDA disappeared overnight. But perhaps there's a better equilibrium where the USDA still has a role. We can't know without making a careful assessment, and continually re-making that assessment.

Let's stop being lazy. Let's dig into the details. It's difficult and frustrating but there's really no better way. At the end of the day, government will never go away. Somebody will always rebuild the bureaucracy. The only sane long-term strategy is to stay engaged.

Fun was not accounted for because of different preference curves for different people.

There are people who genuinely don't enjoy exercise, despite no indication that they would somehow not benefit from the effects.

Eh, I hear the same arguments against unhealthy lifestyles in the US despite our privatized health insurance system.

Interesting. I went and read the study which does support what the NYT is saying more or less [1].

The main factor as to why this is the case is important though. The longer you live the more costs you incur on the system because you end up getting another sickness which costs a lot more to treat, they specifically quote Alzheimers, than obesity and lung cancer.

One thing they did not take into account though is the lack of productivity i.e. the costs of being disabled (possibly b/c it is a dutch study using dutch data and parameters), in the USA diabetes is a disability and incurs significant other costs on the system which were not taken into account. It would be interesting to see what the comparisons would look like once that is taken into account.

But its certainly the case that smoking is much cheaper overall. It doesn't lead to disabilities and people die younger and incur far less costs.

[1] http://journals.plos.org/plosmedicine/article?id=10.1371/jou...

Yes some people will always try to commit insurance fraud. That's nothing new. Insurers typically guard against that by looking for suspicious data patterns. And most providers won't participate in fraud due to the risk of getting kicked out of insurance networks, or being punished by state licensing authorities.

We already have a 2D scanning appliance which can measure body fat to 1% accuracy, even for weightlifters. It's called a DEXA scan. Currently scans cost about $50 and take several minutes, so not really practical for screening millions of people every year. But I'm sure engineers are working on improving cost and speed.

It's really not. BMI is wildly outdated, and especially doesn't deal well with anybody who has a larger body frame. At the thinnest I've ever been in my life, when you could see every rib hanging out, I was still forty pounds heavier than what BMI charts calculated my weight ought to be.

It's relevant to me.

I don't know for a fact, but I would very much expect the answer to be yes. The relevant metrics to look at would be body fat percentage, cholesterol, triglyceride, and blood sugar levels, resting heart rate and blood pressure, and insulin sensitivity. After correcting for those, weight is just not a risk factor, so far as I know.

> Its also probably true that you don't need as much variation and nutritionists say

Yeah, I've felt the same, and that's why I put it to the test. I can't necessarily extrapolate. All I can say is for the better part of 2.5ish years I've been eating the same thing everyday and my health (according to my yearly checkups) has been stellar.

Of course, you have to hit your macro- and micro-nutrient requirements in your daily regimen.

> I've also lived off of what you suggest and its not that pleasant.

It's a matter of perspective, I guess. I look forward to peanut butter peas or greek yogurt with honey roasted peanuts mixed in or overnight oats made with frozen blueberries and soymilk.

I guess I was just trying to offer up that there is a way to eat healthy, cheaply. Because I certainly didn't know about it until later in life.

Vegetables like peas and broccoli are just as good frozen as they are fresh from a grocery store (but not as good as really fresh vegetables).

They are harvested closer to the ideal time and don't degrade during shipping and so on.

Of course not all vegetables, but there are many that stand up well to freezing. Just don't leave them in an auto defrosting freezer for a long time.

I'm sorry, I should've been more specific. It's $10/day for me because I'm building muscle and eating 3,600 calories a day.

If necessary, like when you're in a maintenance phase, you could get it to $5/day.

I hear you and agree. I think the means testing for food stamps should be looser too. It's funny, I know a couple people on food stamps and I know a few vegans. What you say is true.

I'm not sure this sort of calculus is helpful: Eat less and exercise more, duh!

Also works for saving: earn more and spend less, duh!

Making friends: be nice more and mean less, duh!

Stress: sleep and relax more and worry less, duh!

Marriage: communicate and date more and fight less, duh!

Fat people want to be thinner. There are plenty of negative incentives to being fat. There's something subtler and more complex going on here.

Those are hypothetical causes but they don't actually line up with all the observations. For instances, poor people are fatter than rich people. Shouldn't rich people be fatter since they 1) don't have to work as much manual labor 2) have more access to food.

You can try complicate the explanations to account for this but the fact is that it shows that the 'obvious' reasons most people surmise are not so clear cut and need to be tested like any hypothesis. It's a hard problem to test and there are several other competing hypothesis. The best I can say for my own beliefs is that we need to have more studies that need to be done before I'm convinced of any of them.

Hyper levels of advertising with the primary messages being lack of self discipline is the definition of having fun, and sensible time preference judgment, or application of any judgment at all, is for boring low social status people because cool people live for this instant only and never judge anything ever.

Not too surprising that being immune or actively avoiding that toxic culture, results in both wealth and fitness.

Advertising Kills.

Why not? We're talking about average lifetime medical costs, so who cares if one is preventable and one isn't?

From a public health perspective yes that absolutely matters, but all I'm saying is this narrow claim: You will not save money on medical costs if you get your population to act healthier and they die of unpreventable diseases instead of preventable ones.

> Yet here you are, posting things like this

I posted what I am educated about, and did not post an opinion about what I am not educated about.

> Without any data.

Apologies. I posted a nytimes story that links to a study in another comment in this thread: https://news.ycombinator.com/item?id=14353347