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.
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
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.
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.
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
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.
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.
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
NEW: my column this week is about the coming vibe shift, from Boomers vs Millennials to huge wealth inequality *between* Millennials.
Current discourse centres on how the average Millennial is worse-off than the average Boomer was, but the richest millennials are loaded 💸🚀
That data was for the UK, but it’s a similar story in the US. The gap between the richest and poorest Millennials is far wider than it was for Boomers. More debt at the bottom, and much more wealth at the top.
In both countries, inequality is overwhelmingly *within* generations, not between them.
And how have the richest millennials got so rich?
Mainly this: enormous wealth transfers from their parents, typically to help with buying their first home.
In the UK, among those who get parental help, the top 10% got *£170,000* towards their house (the average Millennial got zero).
American politics is in the midst of a racial realignment.
I think this is simultaneously one of the most important social trends in the US today, and one of the most poorly understood.
Last week, an NYT poll showed Biden leading Trump by less than 10 points among non-white Americans, a group he won by almost 50 points in 2020.
Averaging all recent polls (thnx @admcrlsn), the Democrats are losing more ground with non-white voters than any other demographic.
People often respond to these figures with accusations of polling error, but this isn’t just one rogue result.
High quality, long-running surveys like this from Gallup have been showing a steepening decline in Black and Latino voters identifying as Democrats for several years.
The politics of America’s housing issues in one chart:
• People and politicians in blue states say they care deeply about the housing crisis and homelessness but keep blocking housing so both get worse
• Red states simply permit loads of new homes and have no housing crisis
And if you were wondering where London fits into this...
It builds even less than San Francisco, and its house prices have risen even faster.
That cities like London & SF (and the people who run them) are considered progressive while overseeing these situations is ... something
Those charts are from my latest column, in which I argue that we need to stop talking about the housing crisis, and start talking about the planning/permitting crisis, because it’s all downstream from that ft.com/content/de34df…
NEW: we often talk about an age divide in politics, with young people much less conservative than the old.
But this is much more a British phenomenon than a global one.
40% of young Americans voted Trump in 2020. But only 10% of UK under-30s support the Conservatives. Why?
One factor is that another narrative often framed as universal turns out to be much worse in the UK: the sense that young generations are getting screwed.
Young people are struggling to get onto the housing ladder in many countries, but the crisis is especially deep in Britain:
It’s a similar story for incomes, where Millennials in the UK have not made any progress on Gen X, while young Americans are soaring to record highs.
Young Brits have had a much more visceral experience of failing to make economic progress.