It is this grim trend of shortening life expectancy among Americans without college degrees that explains why the U.S.'s mortality rate is a stark outlier among rich nations, far lower than countries such as Japan and Switzerland.... "It is the experience of those without college degrees that accounts for America’s failure."...Case and Deaton note that they've found no precedent for this college divide in modern history except "in the former Communist countries of Eastern Europe after the collapse of the Soviet Union."
There's a graph about two-thirds of the way through the piece that shows how big an outlier this is, the second of two graphs.
12 comments:
I'd be very curious to look at more than just education - smoking and drinking habits based on education, prenatal care (low among those with less than a HS education), likelihood to encounter interpersonal violence (which I suspect is tied to social group more than purely to education). Those are all areas in which the US is a bit of an outlier culturally, and certain sub-cultures that do not encourage post-HS education are even more of outliers compared to the other Developed Nations.
LittleRed1
New World peoples and Africans both have slightly lower life expectancies that seem to be at least partially genetic. Some of this is increased infant mortality, which in America is not true of equally-poor Hispanics. The averages go down must faster if there is more death right after birth than if some groups live to 77 and some to 80 once they have passed forty years old. So the American numbers are not that alarming in that context. I would add obesity/diabetes/hypertension etc to Little Red 1's list. Those seem to be multicausal but most of those causes track with class as well. I agree that education is at least partly a co-occurring rather than causal association. As for violence, Rob Henderson's newsletter covers the class difference in violence just today! https://www.robkhenderson.com/p/luxury-beliefs-have-consequences?r=hjvfh
I don’t have a subscription, so I can’t read far. His opening is pretty astonishing though. I can’t remember the last time I didn’t have “scrapes, bruises, burns, and so on.” I wonder who escapes that! There’s always work that needs doing.
A question - do jobs with college degree requirements have a greater likelihood of including health care coverage as a benefit than non-college jobs; and if so, does this access impact life expectancy?
Maybe related, do people in blue collar jobs, if given the choice between investing in health care or investing in their businesses or their kid's education, opt for the later?
The base numbers are interesting. The cause/effect and what-to-do (if anything) discussion is far more complex.
I'm piggybacking on AVI's comment here. Someone lacking a college degree is also more likely to be obese. Take a look at figure 2 in this CDC link which plots the obesity rate as a function of time according to degree of educational attainment. We have a mechanism explaining how obesity leads to earlier mortality. I'd love to hear the explanation of the mechanism by which a lack of a college degree kills a person.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6650a1.htm#F1_down
One might suppose that it's also harder to avoid obesity at lower incomes, but Figure 1 from the CDC link argues against that, at least for men. The lowest-income men have the lowest rates of obesity.
Obesity probably explains much of the disparity between the US and other countries in figure 2 of the linked MSNBC article. Another factor was also alluded to by AVI: infant mortality. In addition to higher rates among American Blacks and Hispanics*, there are differences in how the US counts infant mortality compared to other countries that boost US rates. For example:
https://www.healthsystemtracker.org/brief/u-s-s-high-infant-mortality-may-be-explained-by-differences-in-data-as-well-as-health/
It seems to me this study (inadvertently?) obfuscates the actual reasons for the disparity between those with a college degree and those without. It does the same for the difference in life expectancy between the US and other developed nations. I didn't read the study, so I'll give the researchers the benefit of the doubt and blame the hack writing at MSNBC.
"It shows that social inequality isn't just leading to diverging quality of life for people in different social strata. It's killing us." Yeesh. I'm not sure if that's stupidly disingenuous or just stupid.
*I wonder if these researchers ever thought to compare life expectancy with the racial homogeneity of a country.
If contact with lithium is a large driver of obesity, as has been recently theorised, then heavy contact would definitely be blue-collar, and the very lowest incomes - the unemployed - would have little contact, just like the rich.
Related:
https://marginalrevolution.com/marginalrevolution/2023/10/on-u-s-life-expectancy-disparities.html
"A question - do jobs with college degree requirements have a greater likelihood of including health care coverage as a benefit than non-college jobs; and if so, does this access impact life expectancy?"
Good question. Union jobs used to come with great benefits, but union jobs (at least in the private sector, where unions belong) are a lot harder to come by than they used to be.
The lithium theory sounds like it could have explanatory value. That would be worthy of study.
I wonder if the fast-food diet is especially embraced by people without college degrees? You can roughly follow the 'food pyramid,' which is heavy-carb at the base, and suggests lower fat consumption and moderate protein, while eating fast food every day. You can't, however, stay lean and healthy while doing so.
It probably is true that a lot of non-college jobs like delivery truck driver keep you on the road so much that drive-through food is what often makes sense. So do some-college jobs like paramedic, though, and the roughness of this metric seems like it should diminish the sharp division. (Unless this is cut off at four-year college "bachelor" type degrees only, so that many community colleges don't count as 'college' for this purpose).
I remember AVI linking to another blog talking about the lithium hypothesis. There was some compelling evidence, but I'd like to see the breakdown in obesity by job type among other data. There's a lot of research potential on the topic. That's not my field of study, so I'll have to leave it to other researchers.
On the other hand, I am going to Japan in a month. Maybe I can convince my wife to spend our time asking a bunch of Japanese people who work with heavy machinery their weight.
Lithium grease, petroleum extraction areas (because what happens to it afterwards is not well tracked and thus likely just goes into the soil and water, and medication. That still seems inadequate to me to explain everything, bhut it might be a big chunk.
Seed oils, especially reheated (chemically changed) seed oils aren't off the table for me either.
Unfortunately, weight loss is still mostly about calories.
I think you're over-reading the data here. The #1 driver of the increased death rate is opioid overdoses; the sharp bend in the curve takes place when fentanyl replaces heroin as the main source of overdoses (2019). These disproportionately affect younger people, with correspondingly larger impacts on the average lifespan. And of course, if a substantial number of the deaths are in adolescents, or in people who started using as adolescents, then the numbers will be disproportionately "non college educated".
I'm not doubting that seed oils, lithium grease, etc. are bad for you, but they aren't resulting in >100,000 deaths per year like fentanyl is.
Janet
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