Is this not just because Covid killed off many of the weakest individuals? I suspect we just traded deaths in 2021 for deaths in 2025, making this latest data look better, without fundamental improvement. Not to say with confidence that _no_ improvement has been made, but that I think the stats for _this one year_ are probably not very meaningful. Maybe I misunderstood something though?
> It's the result of not only the dissipation of the COVID-19 pandemicopens in a new tab or window, but also waning death rates from all the nation's top killers, including heart disease, cancer, and drug overdoses.
I think it would depend on how the “weakest groups” are decided. If the weakest 10% of 2021 all died, then the weakest 10% of 2022 will be people who were stronger than 2021’s weakest 10%. All the groups would propagate up to be stronger than in previous years. Now i don’t know how these groups are drawn, percentiles is just what makes intuitive sense to me.
The linked quotes don’t seem to support your argument, unless I misunderstand? If the weakest people die, then the remaining people are expected to be more resilient to heart disease and cancer.
I think decreases in drug overdose and suicide are probably the most isolated from this effect, so I have higher confidence that those decreases are “real”. But I can imagine ways that even they might interact.
Obesity drugs are in the top 25 for 2025, but don't make up the largest plurality. That goes to oncology drugs at ~1/3rd. Obesity drugs are at ~14%.
I want to mention here that these oncology drugs are mostly antibody methods. Which, what the hell? We're making antibody drugs at scale now?! And that's like some of the highest selling drugs out there?
For comparison, though not in the linked article here, Acetaminophen (Tylenol) only comes in at ~$4.3B, which would put it way down in 13th place, out of the top 10.
Granted, this is sales numbers, and in the US, that's practically taking the savings of very sick people and turning it into stocks. Something that elicits no small reaction here on HN or just about anywhere.
Still, to the point of the main article, yes, we live in an age of medical miracles, and it arrived quite suddenly, only in the last 7 years or so, and we have a lot of gas in this tank.
If you exclude obese individuals US life expectancy is quite high. Health is the ultimate marginal good so exorbitant expenditure is relatively logical. You can't take the money with you so it often makes sense to spend on health even assuming extreme diminishing returns.
US obesity rates are around 40% of population.
Australia, Canada, UK, it is around 30% of population.
Canadian life expectancy is 3-4 years higher on average.
UK around 3 years higher on average.
Australia around 4-5 years higher
Does the gap in obesity rates fully explain the difference in life expectancy? Or are there other factors at play?
I don't think it actually does, because UK has lower obesity rates than Australia (26-29% versus 32%), yet also lower life expectancy (Australia is 81.1 male, 85.1 female; UK is 78.8 male, 82.8 female)
I don't know how well this is represented in your stats, but qualitatively US obesity is incomparable to anything you see in Europe. I don't think 40% vs 30% does it justice.
Yes, if you exclude about half of the U.S. population (40% of Americans are obese) [1] then the U.S. has life expectancy that is on par with the rest of the developed world.
What role does access to health care have I wonder. Canada and Australia (well, ALL other developed nations) have universal healthcare. I know that in the states past 65 they do, but not getting proper health care before then surely puts people at risk of dying earlier. Also, what is the venn diagram of people who are obese and don't have affordable access to healthcare - double whammy.
The American demographic with the highest rate of being uninsured, Hispanics, have life expectancies comparable to the UK average. So access to healthcare probably plays some role, but it seems like there are lots of other confounding factors.
It also doesn’t seem to vary that much by state level healthcare differences. States vary quite a bit by geography, but states that didn’t do Medicaid expansion, like Wisconsin and Wyoming, seem to have similar rates to neighboring states that did.
The obesity rate in the US is 40%. The just-overweight rate is 33%. So unless we really ramp up on tackling obesity, the life expectancy is going be dragged down.
Universal access to GLP1s would almost certainly effectively end the obesity problem.
SubQ pen injections are something even most people afraid of needles can get used to quite quickly, so even if the pill forms never get to the same efficacy there's really no reason that they couldn't solve it for most everyone once they go generic and become affordable, or become otherwise subsidized. China already produces the APIs in huge quantities for insanely cheap for sale on the black market, so we know that they can be produced for extremely low costs.
And the US has no plans to do it, probably because the cost doesn't even out until 15+ years, outside the timeframe for congressional budget estimates.
The US doesn't have to. Rybelsus already costs less than a thousand dollars per month, some of which is offset by reduced spending on groceries/restaurants/coffee/alcohol.
This is the even more effective pill that is about to hit the market:
>LLilly recently announced an agreement with the U.S. government to expand access to its obesity medicines and reduce patient costs. Upon FDA approval, self-pay patients living with obesity will be able to access orforglipron through LillyDirect's self-pay pharmacy channel with the lowest dose starting at $149 with additional doses up to $399.
Those numbers are extremely expensive for people on a fixed income (Medicare patients) and the people who are must vulnerable to the shitty US food system (Medicaid). It needs to be free.
It’s not clear that healthcare has much to do with life expectancy. The group with the lowest access to healthcare and highest rate of lacking insurance, hispanics, also have the second highest life expectancy.
Lifestyle seems to play a huge role in life expectancy. Mormons live 10 years longer than white Americans generally: https://www.deseret.com/2010/4/13/20375744/ucla-study-proves.... That’s a huge difference—it dwarfs the 2.5 years difference between men in the U.S. and men in the UK.
>White people in the US have comparable rates to Europe.
No it's not. White non Hispanic population in the U.S. has a life expectancy of 77.5, which is lower than the U.S. average life expectancy and comparable to Eastern Europe, but not Europe as a whole (life expectancy of 81.4).
That needs clear causal evidence that race somehow causes health outcomes, otherwise there's nothing distinguishing it from the old racial prejudice - now including blaming the victim:
There is a lot of evidence of a causal relationship between being non-white and having less access to healthcare, nutrition, and other things that affect health outcomes, and that evidence aligns well with being targets of racial discrimination.
When we just repeat baseless claims about race, we risk perpetuating it.
I've never seen evidence of a racial difference in accessing health care that is accessible. It's hard to believe skin color would affect that, while it's easy to believe (and witness) that it affects what you have access to.
You shouldn’t make an assumption in either direction. There’s clearly a racial aspect to life expectancy—east asian countries tend to have higher life expectancy than other countries with similar GDP per capita: https://ourworldindata.org/grapher/life-expectancy-un-vs-gdp....
Your argument about access to healthcare based on race doesn’t make sense either. Hispanics in the U.S. live longer than white people, despite having the highest rate of lacking health insurance.
> You shouldn’t make an assumption in either direction.
The null hypothesis is usually that there is no effect. Otherwise we'd say 'do life forms from the Andromeda galaxy affect climate change? We have no data, so shouldn't make an assumption either way.'
Correlations aren't perfect, but you'd need data correlating it with race. East Asia has many other differences such as diet. Why the drive to find an intellectual basis for discrimination based on race? It generally has only reflected biases and has had very bad consequences.
We already know the null hypothesis (that there will be no change) is false. So the question here is about finding the cause of why the null hypothesis is false. Ruling out one category of explanations, and, in practice, assuming a different category of explanations, is bad science.
It’s also harmful. We know, for example, that south asians develop cardiac problems at lower BMIs than other groups. We know biology is a dominant factor in longevity: https://www.nytimes.com/2026/01/29/health/longevity-lifespan.... We need to follow these leads so we can give people the best medical advice. The possibility of bias isn’t an excuse. Doctors have an obligation to address medical differences that are real and exist while not succumbing to bias. You gotta walk and chew gum at the same time.
The current admin is doing everything they can to stop this trend, but by making life worse in the island, as they don't want to do anything about the health of US citizens.
As my comment implies, nearly everything else in Cuba is dysfunctional.
In one sense the Cuban healthcare system is mediocre, since it suffers from the shortages that plague the entire nation.
But that's like saying Cuban auto mechanics, who also suffer from shortages, are mediocre, despite their ability to keep the island's 70 year old American cars and Yugos in pristine condition.
What good is “healthcare” is you don’t have basics like antibiotics and wound dressings? The idea that Cuba healthcare is anything but terrible is a myth. Any stats coming from the Cuban government about health outcomes shouldn’t be taken seriously, they don’t allow any independent investigation and medical professionals can’t freely publish research.
That may well be true. While I have heard people praise the healthcare system, I neither am a doctor myself nor someone with first-hand experience of Cuban healthcare.
I personally knew someone growing up who goes there every year and did free eye procedures, and his commentary was that basic procedures were unavailable there and doctors lacked proper training. I know some other doctors who have interacted with them in Central America and expressed surprise at their lack of familiarity with basic procedures. You can’t learn those procedures without supplies.
The embargo doesn’t cover medical supplies and Cuban buys what medicine and medical supplies it has mainly from the US. The embargo also doesn’t cover food.
Cuba also does a lot of trade with China and Spain but has relatively little to actually sell because the state controlled industries are so unproductive. Cuba also has the least productive agricultural sector in the Caribbean, despite being the most productive before the revolution.
The embargo is no excuse it doesn’t cover other countries, and Cuba has always had European trade partners. In fact they received free oil, agricultural equipment, and technical support from the USSR, and later free oil from Venezuela until a few weeks ago.
Maybe, except for the tens of thousands who were eating US-supplied lead.
> The third, and perhaps most disastrous of our failures, was the decision to give stature and support to one of the most bloody and repressive dictatorships in the long history of Latin American repression. Fulgencio Batista murdered 20,000 Cubans in seven years - a greater proportion of the Cuban population than the proportion of Americans who died in both World Wars, and he turned Democratic Cuba into a complete police state - destroying every individual liberty.
- Remarks of Senator John F. Kennedy at Democratic Dinner, Cincinnati, Ohio, October 6, 1960 [1]
The Cubans absolutely deserve a representative government, and the US will never lift a finger to give it to them. Not then, and as we can see demonstrated in Venezuela today (the US regime is happy to prop up Maduro's cohort and doesn't care about conducting fair elections), not now. The US would prefer a ruthless dictatorship ruling Cuba that sends all the country's wealth to the US over a representative government that doesn't.
The Cuban economy today is a shadow of what it was before the USSR fell apart, which makes it a moot point to claim they are dysfunctional despite foreign support. The Soviets successfully managed to keep Cuba afloat. Not that that constitutes a ringing endorsement for the Cuban system.
That’s part of my point. They were a basket case with a ton of free support, and still are while trading with China and Europe. It’s just ridiculous to blame the embargo as ridiculous as the embargo is.
If you read what the Soviets had to say about the Cuban government it’s pretty damning.
My disagreement is that, as far as I know, the reputation of Cuba's healthcare system is great, and that, as someone else pointed out, the US embargo has real impact.
I certainly agree the Cuban system, excepting a few areas like healthcare and regardless of the embargo's impact, does not work.
No, but losing the wealthiest nation on the planet as a potential trading partner does mean that you are going to be selling your goods for less than you might be able to otherwise.
Being permanently locked out of the most lucrative deals obviously is going to have an economic impact.
Additionally, the US embargo limits third parties from trading freely with Cuba in certain ways, and prohibits most Americans from traveling to Cuba. Cuba was a popular destination for American tourists prior to the Revolution.
And I'm not sure I'll continue to reply to this thread. Somehow I find myself repeatedly defending the Cuban system, of which I am not a fan!
Why defend them? They have for decades exported repression, stoked civil wars, and held their own population captive.
And again the embargo doesn’t stop most countries from trading with them. They could host tourists from Europe and do, but almost no one wants to go there. I know people who go regularly for various reasons and they have to bring food with them because there’s so little on the island due to their insane agricultural practices.
The Cuban state firms don’t produce anything of value. They’re a net recipient of food aid, their tourism industry is anemic and the largest source of dollars and euros. Their medical exports have been called slave labor by the UN.
What could they possibly sell to the US? Even with endless Soviet support in the form of fuel, tractors, and agricultural experts they never produced as much food as the island did before the revolution.
The fact is that what little the government earns from trade they’ve always spent on exporting revolution. Cuban intelligence for example was helping run Venezuela’s SEBIN and secret prisons.
I’m shocked that people on hacker news defend a place that bans the internet, and locks up people for reading banned books.
You understand that all of this is a feedback loop, right? They've been under embargo for more than half a century. Do you not understand how that can cripple an economy? How it can prevent an economy from growing and developing?
You're confusing defending with pointing out objective fact. I don't have to like Cuba, it's current regime, or really anything about it to point out that acting like the state of it's economy and industry isn't massively shaped by the embargo is silly.
Hell, if it wasn't, then we could say the embargo is pointless and not having it's intended impact. We're not embargoing them just to go "Well, we at the United States of America think you guys suck." We're explicitly doing it to make them feel economic pain for their policies. It's a very strange conversation we're having where I am pointing out the embargo has worked and you're providing ethical justification for why we should embargo them but also ignoring the actual (desired!) outcome of the embargo.
They had near total subsidy from the USSR from about 1960 until 1990, and in that time they developed precisely no industry and no agricultural output. The Cuban government in the first few decades was primarily focused on exporting revolution, and not on economic development. Despite their ties to the USSR they never even produced anything that could be traded back to the Soviet block, unlike their Eastern European counterparts who also didn't trade with the west. Other communist countries outside of the Soviet orbit like Vietnam also developed local industry and the ability export some agricultural products despite also not trading with the West for a long time, but Cuba's government couldn't muster the focus or ideological flexibility to do so. When most of the communist regimes reformed agriculture and small scale industry int he 1980s, Cuba refused and continued on its ruinous course. They only slightly limited the size of state run farms in the mid 1990s, but it still didn't yield sufficient results to feed the island.
In the 2000s China was buying hundreds of tons of sugar from Cuba but stopped because the Cuban government mismanaged production and couldn't meet agreed upon deliverables. There was also a steep decline in Chinese investment from 2017 to 2022 because euphemistically Cuba couldn't protect Chinese investment, or read another way the Cuban government kept stealing from the Chinese.
These failures are NOT BECAUSE OF THE EMBARGO.
> pointing out objective fact
It's not objective fact though. You're falling for Cuban propaganda.
To be clear I'd end the embargo tomorrow if I could, but it's crazy to think that it's what held Cuba back. I won't be lectured by someone who doesn't know anything about this topic.
> They had near total subsidy from the USSR from about 1960 until 1990, and in that time they developed precisely no industry and no agricultural output. The Cuban government in the first few decades was primarily focused on exporting revolution, and not on economic development. Despite their ties to the USSR they never even produced anything that could be traded back to the Soviet block, unlike their Eastern European counterparts who also didn't trade with the west.
You mean a small island nation didn't develop a massive trade relationship with a country on the other side of the planet when their closest neighbor embargoed them? Color me shocked. What did Cuba have to trade with Russia and co that would make it worth the cost to ship to the other side of the globe? Cigars? Produce that would no longer be fresh by the time it arrived?
> Other communist countries outside of the Soviet orbit like Vietnam also developed local industry and the ability export some agricultural products despite also not trading with the West for a long time, but Cuba's government couldn't muster the focus or ideological flexibility to do so. When most of the communist regimes reformed agriculture and small scale industry int he 1980s, Cuba refused and continued on its ruinous course. They only slightly limited the size of state run farms in the mid 1990s, but it still didn't yield sufficient results to feed the island.
You mean countries geographically located near ideological partners traded more heavily with those ideological partners than a country that wasn't? Also, nice to leave out the fact that their farming during the subsidy period was made possible by the USSR providing them with fertilizer - something that they could not produce locally and obviously makes a huge impact on farming efficiency and crop yields. So no, it's not surprising that their post-USSR attempts to improve farming struggled when lacking something as basic as fertilizer, much less all of the high technology innovations that have been pouring into farming since the 70s.
> These failures are NOT BECAUSE OF THE EMBARGO.
You continue to act like all of these happen without the context of decades of embargo and being cut off from their closest potential trading partner - that also happens to be the wealthiest nation in the world.
> To be clear I'd end the embargo tomorrow if I could, but it's crazy to think that it's what held Cuba back. I won't be lectured by someone who doesn't know anything about this topic.
You're posting on a public forum. You can ignore me, but as long as I'm following the rules, I can reply to your messages. So, uh, enjoy continuing to get "lectured," whatever you seem to think that actually means in this context.
Cuba can both be a shitty place with it's own issues and also be severely impacted by being embargoed for half a century. The UN estimates over 100b in economic damages. The US State Department in 1960 explicitly said the purpose of the embargo is to 'make the greatest inroads in denying money and supplies to Cuba, to decrease monetary and real wages, to bring about hunger, desperation and overthrow of government.
If you think that Cuba would not be significantly better off from an economic perspective today without the embargo you're nuts. They can still be in a subpar position because of their own corruption issues, the fact that communism doesn't seem to actually work particularly well, etc. etc. - yet also be getting completely fucked by the fact that they can't trade with the US, that ships docking in the country can't dock in the US for 6 months after, etc.
Cuba would be much better off if it wasn't for crippling sanctions imposed by the US.
Genocide by denial for decades.
To give Trump credit, at least he's open about his intentions. Much like a certain Austrian painter from the 1930s; he too was open about his plans, and no one took him seriously until it was too late.
The embargo doesn’t cover food or medical supplies, and Cuba trades with Europe and China. Cuba sucks because its government is terrible. If they could trade with the US they’d have almost nothing to trade. You don’t seenBYD electric vehicles from China there for a reason.
Statistics like these often overlay with demographic maps. In all of these states, there are swaths of geography that fall along color and income lines. If we want to change the numbers, taxing prosperous states to benefit these poorer ones would be beneficial.
>taxing prosperous states to benefit these poorer ones would be beneficial.
So red states don't want state income tax in their states. Yet when it comes to taxing somebody else for the benefit of the red states, the red states are all for it. It is just such typical conservative position that wealth redistribution is a bad thing, until the conservatives are the beneficiaries, and then they are all for it.
In this specific case what would be the point of additional money given that the state is actively suppressing reproductive healthcare?
>Shouldn’t the progressive position be to offer help from the states with higher incomes?
that is exactly what blue states have been doing by pushing for better social net, for medicaid expansion (all these things are de-facto financed by the blue states (net "givers") not the red states (net "takers")), yet the red states governments have been either blocking directly or obstructing that help to the poor and minorities by various things like onerous "work requirements", by suppressing reproductive care, etc.
> Comparing these statistics across countries is useless without demographic adjustment.
Why is it useless? Any aggregate number can be broken down different ways into different groupings - region, age, education, income, wealth, smoking/not, weight, smartphone use, exercise, sleep, etc etc. By your argument, any aggregate number is useless because, no matter what the researcher chooses, it could be broken down differently.
So why choose race? I think the fact that so many in this discussion repeat the partisan trope - long used to oppose taxpayer-funded services such as healthcare, education, housing, food, etc. - of dividing people by race, is very telling.
Statistics show there is a huge difference in life expectancy based on recency of immigration. Most hispanics in the U.S. are immigrants or children of immigrants. They have the second highest life expectancy despite having the lowest access to healthcare. That’s plausibly explained by the fact that immigrants are more likely to be healthier than the average person in their country.
> immigrants are more likely to be healthier than the average person in their country.
That makes sense to me. Unhealthy people are less likely to make the (often) physically gruelling trip and take on the potentially gruelling lifestyle, and all the uncertainty. The same, I expect, applies to motivation - people thoughtlessly call immigrants 'lazy', but the lazy people don't give up their familiar lives and move - many crossing jungles and risking criminals - someplace where they have nothing, not even legal status, often not even the language, and start from scratch - with the goal that after a lifetime of hard work, your children will be comfortable.
I think you have a stereotype in your head that applies to only a subset of immigrants. You're thinking of the H1B that busts his ass to get here. But you're overlooking the nephew who comes over years later under family reunification and is happy to live on subsidized housing and welfare benefits. Because of the way both the US and Canada treat family reunification, what happens is that a highly motivated initial wave of immigrants over time leads to waves of less motivated, less skilled immigrants. I've seen this in my own diaspora community (Bangladeshis)--especially over the last 10 years as migration hubs like NYC have become very generous with welfare benefits for immigrants. (Canada has always been that way. My cousin grew up in subsidized housing. While he was highly motivated and became a professional, tons of people around him were content to live on the welfare benefits.)
I'm not talking about skills at all and wasn't thinking of H1B. I'm talking about low-skilled people who come here with nothing and to build a life. They don't have much to cover indigent nephews, especially if they are undocumented.
I have no reason to think nephews are any different. The 'welfare queen' narrative has long been used by those opposing public benefits (one source dates it to 1974 and says Ronald Reagan used it) but they never substantiate it. IMHO it's blaming the victim - is there any data saying poverty is caused by laziness? The data I remember atm says, 1) (from decades ago) people move in and out of the welfare system; they don't tend to stay in it, and 2) (much more recently) the leading cause of homelessness is medical bills.
> NYC ... Canada
Some of the most economicly dynamic places on earth. New Yorkers credit immigrants for a lot of that, as has much of America (until very recently).
In places like New York, immigrants get lots of public support: https://empirejustice.org/wp-content/uploads/Public-Benefits.... I found out recently that lots of Bangladeshis are in on the program where the city pays you to take care of your elderly immigrant parents.
> I have no reason to think nephews are any different.
They are different. It’s self-selection. It’s much easier to immigrate through family reunification in both the U.S. and Canada. Again, it seems like you have a stereotype in your mind that’s based on the folks who face rigorous selection processes or significant adversity in immigrating. But go wander around Little Bangladesh in Queens or the high rise subsidized housing in Toronto where my aunt and uncle live. More than half of Bangladeshis in America receive government welfare. There is no logical reason why this should be the case, since the only meaningful pathway from there to here is H1B (or these days O visas). It’s not like the U.S. has a land border with Bangladesh and there’s a large influx of illegal immigrants from there.
The family reunification immigrants do not face the same selection pressures. Once there’s an ethnic network already in place in a city and government benefits, it’s very attractive for typical people to immigrate and take advantage of that. And these are typical people from countries that are deeply dysfunctional.
> NYC ... Canada
Some of the most economicly dynamic places on earth.
> New Yorkers credit immigrants for a lot of that
That’s a mythology that was developed to integrate the Ellis Island immigrants. But what’s the foundation of New York’s economy? It’s Wall Street, which dates back to 1703. London, which developed on a parallel course to New York, had few immigrants until the late 20th century. It was finance that powered the economic dynamism, not immigration. And note that there was a huge self-selection effect back then that doesn’t exist today. There was no welfare. Within 5 years. 30-50% of italian immigrants to America went back home: https://www.loc.gov/classroom-materials/immigration/italian/....
> In places like New York, immigrants get lots of public support: https://empirejustice.org/wp-content/uploads/Public-Benefits.... I found out recently that lots of Bangladeshis are in on the program where the city pays you to take care of your elderly immigrant parents.
That's great. I want to support people and I believe in them - it's a great investment in the economy and for humanity - and also giving these elderly people care from their own families, rather than being institutionalized or worse, is a fantastic solution. It's also applied more widely other places, not restricted to immigrants (if that restriction exists in NYC). Biden planned to cover home care more generally with Medicare. If you've seen or heard about the institutions, they are often warehouses for death and treatment can be awful.
> That’s a mythology that was developed to integrate the Ellis Island immigrants.
That 'myth' extends back to 1776 and before: 'All are created equal' is the foundation of America.
The mythology is in your comments: most of what you say has no basis - as I said, the welfare queen narratives are unsubstantiated (afaik) - but the old mythology of race, including its rationalizations based on (questionable) facts. That mythology is what keeps people poor.
As a prominent example, redlining was (and is to an extent) based on the mythology: The myth that black people were unworthy credit risks (along with outright hate) resulted in people being unable to get a loan, and therefore unable to buy a house or to do major repairs or upgrades if they did somehow get a home. Also, the government refused to insure loans in neighborhoods with even one black homeowner (or maybe resident), which motivated white homeowners to resist any black families moving into their neighborhood, and 'restrictive covenants' among real estate agents to not sell to black people. As a result, these people couldn't get credit and even with financing, couldn't find homes to buy, and even then couldn't upgrade or repair them. Then white people would look down on their lack of assets and care for their homes.
Similarly, Wall Street long excluded almost all but white males; to say that success was because of their race (and gender) is obviously absurd. Wall Street also caused the Great Depression, etc.; is that due to white males? World wars? Genocides? Starvation and disease? (Also, NY's economy has been the center of many industries, including trade - not just finance.)
So much is invested in racism, which has produced some of the worst results in human history and the worst in the US, when we could be figuring out solutions to make a better world.
I've always found the numbers in https://en.wikipedia.org/wiki/List_of_countries_by_life_expe... rather interesting, because of how different the cultures and living conditions are even among the top countries. Hong Kong and Japan are always around the top, but so are Switzerland and Australia.
* food standards for shops and franchises .. McDonalds here has better salads that in the US,
* sport and activity as a fundemental part of most lives,
* good health care for all, even for "bottom tier" unemployed, with hybrid public/private health insurance and literal walk in, fall over, free heart surgery and follow up (for those that cannot pay).
Stats wise, higher life expectancy and better cancer survival rates*
* Yes, better, but not by much .. just cheaper and across the demographics.
We have a huge amount of data around physical size being inversely correlated with lifespan. The bigger you are, no matter what drives it - height, muscle mass, body fat, etc. - the lower your life expectancy is.
Obviously lots of other factors, but it does help explain part of why we see much of the most developed portions of Asia at the top of the list.
Switzerland is an interesting counterpoint, though - average height there is taller than most of Europe - though their obesity rates are about half of that of the European average.
It's still correct, but like most things related to human health, there are many different factors at play. The practical consideration for most people is not just getting too much, or having high levels of both muscle and fat, increasing your total body size more than just being one or the other.
Higher muscle mass tends to mean better insulin sensitivity, a higher general level of physical fitness, etc. etc. etc. These are all larger beneficial improvements than the problem with just being a larger person.
But if you look at two people of different heights, the same FFMI, etc., the larger person will have lower life expectancy, and it's not because their head is a few inches higher in the air, and despite having a similar body composition and more total muscle mass. (Obviously controlling for all other variables)
We know that blood flow demand increases put additional strain on the heart. We know this is one of the causes of things like LVH and other negative cardiac remodeling. We know that at rest, muscle and fat mass have essentially identical blood flow requirements. Even natural powerlifters when having their heart scans have found increased septum and posterior wall thickness without the increase in chamber size that endurance athletes have that keeps function optimal - they have diastolic function loss. In fact, in many of the negative imaging results, they found minimal difference between natural powerlifters and enhanced - https://pubmed.ncbi.nlm.nih.gov/4079743/
People get obstructive sleep apnea from too much muscle mass, even at low levels of body fat.
On the enhanced side, we see better health outcomes from people that both drop the AAS usage alongside letting them size go down vs. those that just come off the gear. (You can keep very significant portions of your enhanced gains while at physiological levels, as long as you maintain strict training, protein intake, etc. It's one of the reasons that many people argue that the 7-10 year bans in natural powerlifting federations is not actually effective.)
It's a u shaped curve. At some point all of the health benefits of muscle can't make up for the increased cardiovascular strain. The majority of people have more risk from their less-muscular body composition so building more will almost certainly benefit them, but that's not the same as the idea that body size, from any cause, doesn't have a negative correlation with longevity.
> “There are still critical problems in the U.S. public health profile. It should not be big news when the life expectancy rises, which happens every year in every other developed country,” Cohen says
Wow, that’s a really biting criticism of US public health — and rightly so
The significance is obvious: People in the US are getting healthier, by a significant metric. That doesn't matter? The US is a relativley well-defined group, sharing many inputs and consuming many of the same resources, including the same national health care resources for research, care, regulation, etc.
> There are many different populations in the USA.
Are you saying only your 'population' matters to you?
What do you mean by it exactly? There are lots of populations everywhere, and every population can be broken down into more populations. Any aggregate number won't describe you as an individual, even if it's a number for your own family.
no, i think you're imagining a lot of things. i'm just saying it is very coarse metric by which to understand anything at all. But, I'm not in any way educated in this metric so i'm open to anyone telling me how it is useful, like I asked initially.
Functional years are a big concern. A lot of people, especially self inflicted diabetics, spend the last 20ish years of their lives at home doing nothing because their self inflicted disease makes it hard.
Same with most diet or stress caused illnesses, like cardiovascular diseases or lung diseases.
Everyone wants to shit on this news but I think it’s amazing. You can’t go back and change the past but if you’re doing better than you’ve ever done before there’s reason to celebrate even if it would have been nicer if it happened in 2016.
Yeah, that seems curious. But nowadays, you can just ask. So I asked ChatGPT and it listed a wide variety of factors.
> Researchers generally group explanations into (1) cause-of-death differences, (2) exposure/behavior differences, (3) healthcare-use differences, and (4) biological differences.
>That 5 years difference between men and women keeps being biologically weird
The implication is that the "biological" expectation would be that men and women have the same life expectancy, absent medical intervention and societal standards and whatnot.
But it is possible that, due to having different biologies, men and women simply have different life expectancies. Similar to how men and women have different muscle mass and bone densities and height and yada yada.
Obviously, external factors could also be a factor, but my point is "internal" factors are also in play.
Ironically, the above link is a good discussion on biological differences in morbidity, which was the parent comment’s point, and not what I was trying to show.
I'm ignorant on the matter, but "vastly" seems a bit too much, given that a good chunk of medicine applies to both.
They are different, no doubt, but not the difference between a human and a crab.
5 years life expectancy difference is a lot. As a man, it is frustrating and I want to make sure I get the most out of my life (which I enjoy)
"A lot" is arbitrary, as would be the expectation that men and women would have the same longevity (absent medical intervention).
It seems evident that the taller you are, the less life expectancy you have from the simple fact that the heart has to work harder.
Hence, since men are usually taller than women, it might also be expected for men to die younger.
I am making the following scenario up, but what if a difference in men and women's bodies causes men to process cholesterol differently, and increases the probability of atherosclerosis and/or arteriosclerosis. Perhaps it happens simply because men eat more than women, and this compounds over decades of life, eventually resulting in the difference in average age at death.
Yeah, I personally believe women's longer lifespan mostly stems from a lower caloric intake. Studies have long suggested that reducing caloric intake can be one of the best things you can do for health and extending lifespan. And this has been shown true across many species including: yeast, worms, flies, mice, monkeys, fish, and others.
We also observe that larger animals tend to live longer than smaller animals, but intra-species it tends to be the opposite (e.g. small dogs tend to live slightly longer than large dogs). It also makes some sense biologically speaking, as we now know that most genetic mutations and errors happen during cellular reproduction when DNA is copied, and cellular reproduction rates correlate with nutrient uptake, alongside mutations with age.
Of course too much caloric restriction can be detrimental, but seems to me this could explain much of the difference in life expectancy between men and women. That and perhaps the genetic advantages from having two X chromosomes.
I wonder how much this might change in the coming years purely from GLP-1s. Articles like this[0] (which yes, Betteridge's law applies) talk about how it’s pretty likely they’ll be able to be used by everyone. But even now, taking people with cardiovascular high probabilities and dropping that risk way down purely by giving them the feeling that they’re more full more frequently is crazy to think about. Not sure opinions here but I’m at the point of telling my parents they should both be on these right now in their upper 60s.
Some people shrug it off or claim that they’re higher status because they lost weight via diet and exercise, but I map that to people who think they’re better programmers because they don’t use llms for coding, when the real result is what matters. Similar to people thinking AI slop, there are news articles about what happens if you stop GLP-1s and gain the weight back. But the stories of people who either continue to microdose, or also learn the feelings of their body and how it differs have long term success. Similar to those who know how to work with llms get good results, but the news is about how smarter people don’t use it.
All very interesting subjects. What a world we’re in.
Then why the fuck hasn't the US just added it to Medicare / Medicaid coverage? It makes no sense. These healthcare schemes are costly, and covering this medication would make it... less costly.
What does "less muscle-mass" mean in terms of mortality statistics?
We already know women live longer than men on average, and also have less muscle-mass than men on average, so clearly it's not having too much of an impact on women.
Without looking into actual statistics here, Japan is known for having a high life expectancy, and stereotypically Japan's population is both relatively thin, and has relatively little muscle, so that also seems to defy that expectation.
And specifically GLP-1 usage is associated with significant loss of lean mass:
https://pubmed.ncbi.nlm.nih.gov/38937282/
In some studies, reductions in lean mass range between 40% and 60% as a proportion of total weight lost ...
This might be a good start. There is quite a bit of material here and as might be expected much of it is fairly recent and gets a lot of this kind of skinny equals long life feedback that isn't strongly supported by clinical data.
A person who does it naturally is still higher status. Staying thin naturally, especially if also fit, indicates a level of will, health focus, and self respect that I appreciate. I wouldn't like to start dating a woman and learn that she has a "thinness subscription". That's a lot of money being spent to avoid discipline, and lack of discipline also is just unattractive. I would consider GLP1 use in a potential partner equivalent to him/her ordering food all the time; it wastes money and indicates that he/she may be lazy or struggling with executive function.
I don't think this is necessarily a good thing. The world would be a demonstrably better place if the average life expectancy had remained around 70, like it was the year I was born.
Every new generation deals with growing populations to one degree or a other. World population has doubled in my lifetime for example. But human society just isn't made to have so many long lived people hoarding wealth and power decades beyond what they historically have.
GenX finally outnumbers the Boomers, but that should have happened a decade ago. The damage they've inflicted on the younger generations is really incalculable.
I think as time goes by, we may have to decide that people over a certain age are to be legally treated the same as those under 18.
Yeah this is bad news from an environmental standpoint.
We can't stop our status symbol consumption and travel lifestyles. This is just more people to feed, which in our current broken system means more consumption and waste at insane scales.
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