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Comment by barry-cotter | Hacker News Reader

How shocking that a massively multi-ethnic country that contains 5% of the human population has very large gaps in life expectancy if you measure by county.

If you look at European countries, a much coarser level of measurement the gap is 83-71, 12 years.

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

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It is shocking because we don't officially acknowledge the existence of social classes in the USA.

All men are created equal here. It's counter to our national narrative to think of communities and areas where your life is fucked just because you're born in the wrong spot.

Or fucked because you were born to poor uneducated parents in the right spot...

It's pretty shocking, because I don't think most Americans would suspect there is that much regional variation within the country. The US is frequently regarded as basically monolithic, with people moving from one place to another for jobs, family, cost-of-living reasons, basically assuming that life in one part will be largely similar to life in another part. This assumption is not backed up by data.

(That said, I would be interested in an analysis of whether or not your life expectancy varies with where you live, or where you are born. I.e. if I am from Boston but move to Mobile, do I end up with a Bostonian's life expectancy or a Mobilian's? How long does it take for the shorter life expectancy of someone from Mobile to override the longer life expectancy of someone from Boston? Or does it never do that? All would be interesting questions for research.)

So roughly half as much for a continent with over twice the population and 44 sovereign countries? The difference between areas in South Dakota and Colorado is bigger than that between Luxembourg and Moldova

Going by state in the US the difference is 6.3. If you go by all US states and territories it’ll go up to 7.9. The smaller your unit of measurement the greater the range will be. Counties are already prettt ridiculous given that some have populations in the millions and some I’m sure are in the hundreds.

If you want to compare European life expectancies you might be able to do it by Eurostat statistical region but none will have populations in the single digit thousands.

The extreme range in the US is specifically driven by a few counties are either all, or mostly, Native American Reservations with very specific issues around unemployment, alcoholism, etc.

> Native American Reservations with very specific issues around unemployment, alcoholism, etc.

Native Americans typically receive their healthcare from the IHS, which is known for being an absolute disaster. It's not surprising (or news) that life expectancy is much lower for a population which receives its healthcare exclusively through a system which has a track record of neglecting its patients or using them as test subjects without their consent.

Healthcare is an issue, but its just one of the many issues on reservations.

Indian reservations have issues with poverty, unemployment, alcoholism, substandard housing, violence, and suicide.

Fair enough. Nonetheless I don't think the point of the article is to compare the US to Europe but simply to reflect on the wide range that exists within the US.

You'd need to also do the exact same thing in Europe and look at what kind of spreads exist inside of Europe as well.

Let's see the worst life expectancy areas of Russia for example. You're nearly dipping into the 50s for life expectancy in that case, and you're going to see a 30+ year gap from top to bottom across peak Europe vs the lowest areas. This has recently come to the fore with the Russian Government's move to push the retirement age so low that it nearly clips the average man off of it.

"A stroll around the Zapadnoye Cemetery reveals how few Novgorod men actually make it to old age. It’s easy to find graves of young men who died in accidents, wars or gangster feuds—many with epitaphs such as “came to a tragic end.” For the rest, the typical age of death is around 62. Graves of men who lived beyond 70, however, are pretty hard to find."

https://www.bloomberg.com/news/features/2018-08-27/putin-s-m...

Because the problems that are correlated with lower life expectancy are highly localized.

You can't compare France (83) to Ukraine (71), you're talking 15x gdp (and just being there would show you how wildly different they are).

There are still places in the US where electricity isn't used, the primary languages aren't European, and the gdp per person is that of a third world country. If it's fair to compare those places to New York or San Francisco, France vs Ukraine doesn't seem terribly far-fetched.

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