Christopher Ingraham, writing in the Washington Post, points with alarm to a 20-year gap in life expectancies between the poorest and the richest Baltimoreans. This begs the question of whether that gap is too small or too large, or better yet, what the optimal gap would be. Surely it is not zero, which is to say that longevity is only one of the problems poor Baltimoreans face, that directing more resources to life extension means directing fewer resources elsewhere, and that redirecting enough resources to close a 20-year longevity gap would almost surely leave poor Baltimoreans worse off than they are. Even if we were prepared to spend whatever it takes to close that gap, it’s not implausible that most poor Baltimoreans would rather have the cash.
More striking is Ingraham’s observation, in the same article, that in some Baltimore neighborhoods, life expectancies are lower than they are in North Korea. Poor Baltimoreans are certainly wealthier than average North Koreans, so you’d expect them to live longer. Unless there’s some other variable at play (like, for example, a Korean genetic predisposition to long life), this suggests either that poor Baltimoreans die too young or that North Koreans live too long. It’s not clear which.
Are you assuming that greater wealth confers greater longevity?
From Wikipedia: “Diseases of affluence is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society.”
http://en.wikipedia.org/wiki/Diseases_of_affluence
Perhaps one incurs a health risk when he can afford to eat fancy fried foods instead of a traditional Asian diet of rice and a few vegetables.
I don’t know how Christopher Ingraham did his statistics, but they might suffer from the same confusion which is applied to US mortality. US healthcare is supposedly worse than in Europe because our overall mortality is a bit lower.
The following article from 2007 details a statistical confusion. The US has more death from acccidents and murder than its peers, among other causes. US infant mortality is higher primarily due to a strict reporting standard (all births, no matter how premature) and more premature and defective births from aggressive in-vitro fertalization.
Total mortality is a bad measure of medical effectiveness. One might think that such organizations as the World Health Organization wanted the US to look bad. A government pushing ObamaCare might also want the (former?) capitalist health system to look bad.
Natural Life Expectancy in the United States
=== ===
[edited] The CDC’s (US Center For Disease Control) life expectancy figures also incorporate non-natural causes of death, such as those resulting from fatal injuries, which include motor vehicle accidents, falls, accidental poisonings, and homicides.
These factors represent the leading causes of premature death in the United States for all ages up through 44 years old. Premature deaths caused by these non-natural factors result in a lower life expectancy figure for the U.S., which gives a somewhat misleading picture of the general health of U.S. individuals.
Without accounting for the incidence of fatal injuries, the United States ties for 14th of the 16 nations listed. But once fatal injuries are taken into account, U.S. “natural” life expectancy from birth ranks first among the richest nations of the world.
=== ===
It is likely that Baltimore has more early death from accident, drug overdose, and crime than other US cities, and certainly EU countries. This tells us nothing about the poor medical effects of poverty, but maybe much about the risks of living in a poor and demoralized city culture.
Statistics reported by the totalitarian state of North Korea are worthless. They report that they are a paradise in Earth.
The problem was not well presented:
Lower average life expectancy because of death from gunshot wounds? Starvation? Weakened immune systems due to malnutrition? An overwhelming number of sudden infant deaths?
Middle age deaths from heart attacks or treatable conditions?
No early deaths to skew the statistics but earlier deaths from typical old-age problems? Lifestyle choices like smoking?
There is no adequate basis to establish even correlation without a definition/qualification of life expectancy.
Andrew_M_Garland: Is it possible, paradoxically, that paradise on Earth is being able to leave it more quickly than elsewhere on this planet without the messiness of dealing with suicide?
#2 “but they might suffer from the same confusion which is applied to US mortality. US healthcare is supposedly worse than in Europe because our overall mortality is a bit lower.”
This article is not about medical services. Overall life expectancy may be a fairly crude measure to compare medical services, but it is an excellent one to compare overall life expectancies, which will include many other factors as a feature of the measure, not a bug. The linked articles on why there is a problem and what to do about it mention the war on drugs and general poverty issues, but not medical services. Violence, stress, poor education and poor sanitation are not medical, but they are very important in measuring how groups in a society are doing. The mortality rate tells us something about all these things.
One statistic that was quite shocking to me was the number of 0-6 yr old’s with elevated lead levels – 7%. Apparently this comes from old lead paint. This would seem to be a pretty good target for spending to improve everyone’s life.
Steve: “this suggests either that poor Baltimoreans die too young or that North Koreans live too long. It’s not clear which.” I was puzzled for a short while by what it means to live too long (ignoring for now the suspect nature of N. Korean statistics). I guess you mean that N. Koreans may spend too much on life extension at the cost of something else, so they would be better off cutting back on whatever it is that keeps them alive so long, and spending more on things they would enjoy more but would shorten their lives. I think we all agree that they not getting everything right. I think it also pretty obvious the the USA is also not getting it right. All else being equal, longevity is a good thing (or lets take it as such). The USA achieves a poor level of longevity for its wealth. It is possible that this is made up for elsewhere, but looking at the reasons for it it mostly seems to be due to side effects from bad things that nobody wants.
Assuming gang /drug violence must be a significant factor in differences between areas in such close proximity, it seems some of these averages really reflect binary outcomes. In which case it does seem like a clear mischaracterization to say “Imagine being a child and knowing that you could expect to die 20 years earlier than another kid who simply had the good fortune of being born just a few miles up the road from you”. That is, particular behavioral decisions are endogenous to such an expectation, and probably lead to similar conditional outcomes in most major urban areas.
The comparison with infant mortality is that this is another example of apples not being apples (i.e. why statistics are sometimes put after “damned lies”).
BTW some data:
Male Life expectancy in Calton, Glasgow Scottland is about 54 years
See here: http://www.theguardian.com/society/2006/jan/21/health.politics
So access to free healthcare may not matter at all.
Harold wrote:
One statistic that was quite shocking to me was the number of 0-6 yr old’s with elevated lead levels – 7%. Apparently this comes from old lead paint. This would seem to be a pretty good target for spending to improve everyone’s life.
This would cost very little compared to what is spent but our corrupt politicians are unlikely to a simple cost benefit analysis.