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  #1   ^
Old Fri, Feb-09-18, 08:51
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 10,318
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
Progress: 96%
Location: NC
Default Failing Health of the United States

MedPage reports BMJ publishes editorial with headline, "Failing Health of the United States."

Failing Health of the United States

Steven H Woolf, director1, Laudan Aron, senior fellow2

The role of challenging life conditions and the policies behind them

Life expectancy in the US has fallen for the second year in a row.1 This is alarming because life expectancy has risen for much of the past century in developed countries, including the US. The decline in US health relative to other countries, however, is not new; it has been unfolding for decades (fig 1). In 1960, Americans had the highest life expectancy, 2.4 years higher than the average for countries in the Organisation for Economic Cooperation and Development (OECD). But the US started losing ground in the 1980s. US life expectancy fell below the OECD average in 1998, plateaued in 2012, and is now 1.5 years lower than the OECD average.2

[Article has charts, citations, best to read at link.]

A joint panel of the National Research Council and Institute of Medicine investigated the US health disadvantage in 2013.3 It found that Americans had poorer health in many domains, including birth outcomes, injuries, homicides, adolescent pregnancy, HIV/AIDS, obesity, diabetes, and heart disease. It also found that many factors contribute to the health disadvantage; for example, Americans are more likely to engage in unhealthy behaviors (such as heavy caloric intake, drug abuse, and firearm ownership), live in cities designed for cars rather than pedestrians or cyclists, have weaker social welfare supports, and lack universal health insurance.

The panel reported high death rates in the US from drugs, a problem that has grown over time. Between 2000 and 2014, the rate of fatal drug overdoses rose by 137%, a crisis fueled by the growing use of highly addictive opioid drugs.4 In 2015 alone, more than 64 000 Americans died from drug overdoses,5 exceeding the number of US casualties in the Vietnam war. Drug addiction is devastating families and the social fabric of communities. The country is belatedly scrambling to reduce access (with, for example, prescription drug monitoring and drug take back programs), improve emergency responses to reverse overdoses (such as naloxone programs), and enhance access to effective addiction treatment (such as medication assisted treatment).

But the opioid epidemic is the tip of an iceberg, part of an even larger public health crisis in the US: death rates from alcohol abuse and suicides have also been rising. Between 1999 and 2014, the suicide rate rose by 24%.6 These “deaths of despair,” as some have called them, are disproportionately affecting white Americans, especially adults aged 25-59 years, those with limited education, and women.7 The sharpest increases are occurring in rural counties, often in regions with longstanding social and economic challenges.89

Why white Americans are dying at higher rates from drugs, alcohol, and suicides is unclear, complex, and not explained by opioids alone. The answer—likely some combination of factors in American life—must explain why the rise in mortality is greatest in white, middle aged adults and certain rural communities. Possibilities include the collapse of industries and the local economies they supported, the erosion of social cohesion and greater social isolation, economic hardship, and distress among white workers over losing the security their parents once enjoyed.910 By contrast, greater resilience might explain why black Americans—who have contended with longstanding structural disadvantages, discrimination, and higher all cause mortality—have not experienced a surge in drug deaths or suicides.

Other data are also enlightening. Over the three decades in which survival advances slowed in the US, educational performance weakened, social divides (including income inequality) widened, middle class incomes stagnated, and poverty rates exceeded those of most rich countries.3 The US is rich, but its wealth is not inclusive.11 Its social contract is weaker than in other countries—those in need have less access to social services, healthcare, or the prevention and treatment of mental illness and addiction. The “American dream” is increasingly out of reach, as social mobility declines and fewer children face a better future than their parents.12

In theory, policy makers jolted by the shortening lifespan of Americans would hasten to correct these conditions. They would promote education, boost support for children and families, increase wages and economic opportunity for the working class, invest in distressed communities, and strengthen healthcare and behavioral health systems. But the pro-business policy agenda favored by elected officials rarely prioritizes these needs. On the contrary, recent legislation and regulations may prolong or intensify the economic burden on the middle class and weaken access to healthcare and safety net programs.

Ironically, leaders are outspoken about ending the opioid epidemic and bemoan spiraling and unsustainable healthcare costs. Solutions to both problems—which involve investment to support struggling families and communities and thereby improve public health—are often rejected, usually by leaders with competing self interests or ideological objections. The consequences of these choices are dire: not only more deaths and illness but also escalating healthcare costs, a sicker workforce, and a less competitive economy. Future generations may pay the greatest price.

Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: The authors were, respectively, the chair and study director of the joint panel from the National Research Council and the Institute of Medicine on understanding cross national health differences among high income countries, cited in the article.

Understand the policy on this forum is No Politics, but the healthcare facts should be shared. Bolds in story mine.
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  #2   ^
Old Fri, Feb-09-18, 11:09
deirdra's Avatar
deirdra deirdra is offline
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Posts: 3,845
Stats: 197/136/150 Female 66 inches
Progress: 130%
Location: Alberta

Has caloric intake actually increased? I thought people following the low-fat high-carb dogma were eating the same or fewer calories. Barely a day goes by without some Registered Dogmatist reminding mainstream media consumers to cut their fat and eat more healthywholegrains.

Living in Canada, where we get both Canadian & some US TV stations, I am always shocked at how prescription drug ads dominate late night (they are banned in Canada & most countries 24/7). One ad for drugs to relieve opioid-related constipation seems to run 6+ times an hour.
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  #3   ^
Old Fri, Feb-09-18, 12:10
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GRB5111 GRB5111 is offline
Posts: 2,303
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
Progress: 98%
Location: Herndon, VA

Apparently, there is much opiod-related constipation. Would think they'd be better off with ads to discourage opiod use? Ads are paid for and a big business, why would they ever campaign against the very reason for the existence of these meds????

I know, asked and answered, but it is bizarre and more bizarre that more are not questioning this practice. Not paying attention in today's world can be an expensive and sometimes fatal practice.
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  #4   ^
Old Fri, Feb-09-18, 15:42
Nrracing Nrracing is offline
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Posts: 397
Plan: CLC 19/5 Clean Fast
Stats: 269.7/241.2/205 Male 72.5
Progress: 44%

This also has to be a part of what we are eating and new technology advancements. People eating and drinking carbs like it the end of the world, on tablets, phones, Netflix, eating SAD, and not moving much anymore.

I grew up with no smart phones, a computer, video games, or anything, but regular tv. we could not and was not allowed to sit at home and do nothing. My parents had us riding bikes, and we played outside till I started driving.

Kids and adults do not move or do anything much anymore. Put down the interwebz, get out side, and eat clean. If it is man made I stay away from is as much as possible.
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  #5   ^
Old Sat, Feb-10-18, 08:51
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 10,318
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
Progress: 96%
Location: NC

Same author was quoted following a 2013 report in this article,
U.S. Ranks Below 16 Other Rich Countries In Health Report

The statistics about maternal and infant mortality were shocking then, and apparently not much better.
In 2014, infant mortality was 28th of developed countries, and maternal mortality 46th.

Now our treatment of obesity and diabetes will fall behind as the healthcare system is overwhelmed by the number of cases.
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  #6   ^
Old Sat, Feb-10-18, 10:29
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Meme#1 Meme#1 is offline
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Posts: 9,070
Plan: Atkins DANDR
Stats: 210/183/160 Female 5'4"
Progress: 54%
Location: Texas

One thing that comes to mind right away is something my GD told me two years ago when she was in Junior High School.
She told me that all of these girls were pregnant and in the bathrooms they were all congregated around those Preg girls bragging and talking about it like it was a cool thing!
Now these were 13 and 14 year old girls.
Of course my GD thank goodness was appalled at all of this and that's why she was telling me about it...
I have a feeling that this is our main problem since these little girl's bodies are not mature enough to bring a healthy baby to full term so they end up being born pre-mature costing tax payers a million dollars per baby just to help them survive.
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  #7   ^
Old Sun, Feb-18-18, 22:32
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mike_d mike_d is offline
Grease is the word!
Posts: 8,294
Stats: 236/181/180 Male 72 inches
Progress: 98%
Location: Alamo city, Texas

"Registered Dogmatist"
Ill have to remember that one

Yeah, I quit watching TV due to so many "talk to your Dr about XYZ..." ads -- should be illegal.
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  #8   ^
Old Mon, Feb-19-18, 04:04
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WereBear WereBear is offline
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Plan: Epi-Paleo/IF
Stats: 220/161/150 Female 67
Progress: 84%
Location: USA

Originally Posted by mike_d
Yeah, I quit watching TV due to so many "talk to your Dr about XYZ..." ads -- should be illegal.

In more advanced countries, they are.
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