John Burn-Murdoch Profile picture
Mar 31, 2023 24 tweets 7 min read Read on X
NEW: I’m not sure people fully appreciate how dire the US life expectancy / mortality situation has got.

My column:

And some utterly damning charts.

1) at *every* point on the income distribution, Americans live shorter lives than the English. https://t.co/pOoziEK5mZenterprise-sharing.ft.com/redeem/75e5e3d…
Image
2) It’s actually worse than that chart made out, because at most points on the income distribution, Americans earn much more than Brits.

If we plot the same data by actual income instead of percentile, the US deficit is vast.

5 fewer years even among the comfortably-off. Image
Things have deteriorated so much that the average American now has the same healthy life expectancy (years lived in good health) as someone in Blackpool, the town with England’s lowest life expectancy (by far), synonymous with deep-rooted social decline ft.com/blackpool Image
I think that bears repeating. *The average American* has the same chance of a long and healthy life as someone born in the most deprived part of England, a place with the highest rates of relationship breakdown and some of the highest rates of antidepressant prescribing.
So what’s happening?

When people hear about life expectancy they often think about older people, broad-based health problems, but the US problem is quite specific and quite different: it’s young people dying from external causes.
Time for perhaps the most damning stat of all:

One in 25 American five-year-olds today will not make it to their 40th birthday.

No parent should ever have to bury their child, but on average across the US one set of parents from every kindergarten class most likely will. Image
Here’s another way of showing the same thing:

Beyond age 70, US mortality/survival rates are very similar to other rich countries. But between teenage years and early middle age there is a vast gulf. Image
This has an outsized impact on life exp because deaths at early ages erase far more life than even a large number of older folks dying slightly early.

More years of American lives were erased by drugs, guns & road deaths in 2021 alone than from Covid during the whole pandemic.
The result is that the US is the only developed country where even if you strip out all Covid deaths, life expectancy still dropped by a year since 2019 Image
So we have a steady climb in “deaths of despair” and other violent/external deaths, plus the heavy toll exacted by very high rates of diet-related disease (cardiovascular diseases etc).

Why is the US so badly afflicted?
One strong possibility is because the US is the ultimate “individual responsibility” country. Every person for themselves, weaker social safety nets.

So, far more people slip through the cracks and find themselves in situations that make obesity, violence and drugs more likely.
Plus (directly related): huge emphasis on personal freedoms means more guns, more dangerous/unsafe driving, more lethal vehicles than similarly developed countries.

So a perfect storm of 1) more people pushed into bad situations, 2) easier for bad situations to become deadly.
Wider inequalities don’t help.

Look back at the first charts: despite being a richer society on average, the poorest in the US are even poorer than the poorest English.

That’s taking the society-wide US disadvantage and multiplying it. Image
Worse access to healthcare will certainly be playing a part too, but the types and ages of deaths suggest the US’s life expectancy problem is as much (if not more) a social problem than a health problem in terms of the way we should think about it.
To put it another way: it’s certainly true that being unable to access/afford healthcare costs American lives, but the bigger problem is that Americans require so much more healthcare (due to poor diet), and tens of thousands are killed without healthcare even being a factor.
This makes solutions harder, too.

With health challenges — cancer for example — the whole of society is pulling together. Everyone wants to fix this. As a result cancer survival rates have got better and better, and the US does very well on this.
But guns, drugs, obesity, road deaths etc are a) fundamentally caused by social problems not health problems, and b) often involve competing interests.

In the unfortunate reality we live in, fixing them is much harder.
One misconception I also want to address: the dreadful US performance does not disappear if you “adjust for race”.

This is way way overstated.
The pockets of both countries where life expectancy has been falling are overwhelmingly white [working class], and the most diverse parts have seen the biggest increases.

Contrast diverse (and hardly affluent) inner-city London Newham with Middlesbrough, Boston, Lincoln. Image
And here’s a piece I did last year looking at how the US’s life expectancy deficit would look if drugs, guns, road deaths or obesity could be magicked away

enterprise-sharing.ft.com/redeem/39e212e… Image
A belated but important footnote to this thread:

Big thank you to @meepbobeep and @VictimOfMaths for being my actuary/demography/methodology sounding boards for this piece.

Unfortunately it’s been a big few years for journalists thanking actuaries 🙃
Colin @VictimOfMaths has done brilliant work on the same topic here
And Mary Pat @meepbobeep regularly shares invaluable deep-dives like this one

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More from @jburnmurdoch

Aug 8
NEW: Is the internet changing our personalities for the worse?

Conscientiousness and extroversion are down, neuroticism up, with young adults leading the charge.

This is a really consequential shift, and there’s a lot going on here, so let’s get into the weeds 🧵 Image
First up, personality analysis can feel vague, and you might well ask why it even matters?

On the first of those, the finding of distinct personality traits is robust. This field of research has been around for decades and holds up pretty well, even across cultures.
On the second, studies consistently find personality shapes life outcomes.

In fact, personality traits — esp conscientiousness and neuroticism — are stronger predictors of career success, divorce and mortality than someone’s socio-economic background or cognitive abilities.
Read 17 tweets
Jul 18
NEW:

There’s been a lot of discussion lately about rising graduate unemployment.

I dug a little closer and a striking story emerged:

Unemployment is climbing among young graduate *men*, but college-educated young women are generally doing okay. Image
In fact, young men with a college degree now have the same unemployment rate as young men who didn’t go to college, completely erasing the graduate employment premium.

Whereas a healthy premium remains for young women. Image
What’s going on?

At first glance, this looks like a case of the growing masses of male computer science graduates being uniquely exposed to the rapid adoption of generative AI in the tech sector, and finding jobs harder to come by than earlier cohorts.
Read 14 tweets
May 15
NEW with @KuperSimon

The prevailing narrative around increased injuries and player workload in elite football is wrong.

Players don’t play more football than in the past. What has changed is a sharp rise in intensity of play.

Not more minutes, but each minute exerts more load. Image
Of course, that doesn’t mean a reduction in playing time wouldn’t help. But if one wants to solve the problem, it helps to know the cause.

Fixture schedules are barely busier than in the past, and squad sizes have grown to mean no rise in minutes per player regardless...
...But the recent evolution of much faster-paced gameplay both with and without the ball comes with elevated risk of soft-tissue injuries.

Here’s the full article: ft.com/content/36ebc9…
Read 5 tweets
Apr 11
NEW 🧵

The number of people travelling from Europe to the US in recent weeks has plummeted by as much as 35%, as travellers have cancelled plans in response to Trump’s policies and rhetoric, and horror stories from the border. Image
Denmark saw one of the steepest declines, in an indication that anger over Trump’s hostility towards Greenland may be contributing to the steep drop-off in visitor numbers. Image
Corporate quotes are usually pretty dry, but the co-founder of major travel website Kayak wasn’t mincing his words: Image
Read 5 tweets
Apr 4
NEW 🧵

A quick thread of charts showing how Trump’s economic agenda is going so far:

1) Trump has had the same impact on economic uncertainty as a global pandemic. Image
2) That was just the US version.

What’s particularly impressive is that he’s managed this on a global scale.

Starting to get the feeling that “Trump” annotation is going to be the chart equivalent of a layer of volcanic ash in the fossil record. Image
3) US consumers are reacting very very negatively.

These are the worst ratings for any US government’s economic policy since records began. Image
Read 11 tweets
Mar 14
NEW 🧵: Is human intelligence starting to decline?

Recent results from major international tests show that the average person’s capacity to process information, use reasoning and solve novel problems has been falling since around the mid 2010s.

What should we make of this? Image
Nobody would argue that the fundamental biology of the human brain has changed in that time span. People’s underlying intellectual capacity is surely undimmed.

But there is growing evidence that the extent to which people can practically apply that capacity has been diminishing.
For such an important topic, there’s remarkably little long-term data on attention spans, focus etc.

But one source that has consistently tracked this is the Monitoring The Future survey, which finds a steep rise in the % of people struggling to concentrate or learn new things. Image
Read 15 tweets

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