Some life expectancies are shrinking

For generations of Americans, it was a given that children would live longer than their parents. But there is now mounting evidence that this enduring trend has reversed itself for the country’s least-educated whites, an increasingly troubled group whose life expectancy has fallen by four years since 1990.

And this:

The steepest declines were for white women without a high school diploma, who lost five years of life between 1990 and 2008, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. By 2008, life expectancy for black women without a high school diploma had surpassed that of white women of the same education level, the study found.

Here is more, scary throughout.  We are not as healthy as we thought we were.

Comments

Fewer earning years, by the way, impact total return to education investments.

The dramatic change suggests that it might have something to do with not just health, but access to and affordability of health care. There are some policies that could help that...

Breaking news. White women have less access to healthcare than do black women. I'm sure many people will be surprised at what you've found.

And when we control for income and a couple other factors like drug/alcohol use?

So, if the assumption is that healthcare is zero sum, probably why these people don't have "access," then does giving them access reduce the access of others? That also explains why the "access" word (incorrect to begin with, there are no armed guards checking IDs at the entrance) is not a neutral term.

Diabetes is the single largest demographic explanation for this disturbing trend, I recall reading maybe 5 years ago, particularly the occurrence of diabetes among young adults. That average isn't declining in major part because 50 years are dying younger - it is because a growning number of 20 year olds are dying long before they reach 50.

Worse, this trend was expected to intensify if nothing was done to stop it (the problem having multiple factors, none being a single simplistic explanation). Nothing like making a prediction, and then seeing how the data supports or rejects it. But then, I guess demographics is no more a science than climatology - after all, you can't design an experiment to research future life expectancy, you can only measure the data it after it happens.

The quality of diabetic management is also strongly related to education. Less educated individuals have a tendency to think they're "cured" when their sugar and insulin levels are balanced and they begin to feel good. Once "cured", they stop taking their insulin or monitoring their diet. The more times through this management cycle, the more irreversible damage is done.

I have to say this is anecdotal evidence. My mother has been a home health nurse for about 20 years now (and a nurse since "before man walked on the moon") and teaching diabetes management is one of her specialties. She deals with this issue regularly.

Interesting.

I wonder if she has noticed a significant rise in patients under 20, and whether such a group of younger patients poses a different set of challenges.

I don't think she sees too many under 20 for diabetes, but her patient load has gotten younger. Her biggest demographic shift has been smokers to obesity related illness. When she first started in home health the majority of her patients were older and had health complications related to a lifetime of smoking. Now the majority of her patients are a bit younger and have health issues related to obesity (hence all the diabetics).

I'll have to ask about the younger versus older patients and their challenges. Her biggest ease of care line is usually drawn along how long has the person/family been in the United States. If they're recent immigrants, the sick individual will be well taken care of. She might have to work through a language barrier, but once understood, everything (medication, changing bandages) will be done diligently and carefully. If they've been in this country generations, getting the family to help is much more difficult, regardless of race or socioeconomic group.

This is probably a good thing, actually.

Yep. If a country is to have health care policies (which I do not for a minute concede), the policies ought to be based on Darwinism.

I wish people would actually understand what Darwinism means.

Maybe, as long as your goal is to maximize human suffering.

correction: short term suffering. in the long run, denying darwinism's cleansing effect will increase human suffering, for everyone involved.

Darwin's 'cleansing'. I LOVE it! Forget the comment below, we know your theme music.

http://www.youtube.com/verify_controversy?next_url=/watch%3Fv%3DGPBqyv_kJRM

Do capital letters harm us as well?

But there is now mounting evidence that this enduring trend has reversed itself for the country’s least-educated whites, an increasingly troubled group whose life expectancy has fallen by four years since 1990.

I hate sentences like this. The dietary and exercise habits, and/or access to health care, of "the country's least educated whites" may be far more relevant to their shrinking lifespans than the fact that they are "the country's least educated whites". Carving people into categories on the basis of habit, when the data doesn't support those categorizations, is lazy. Does anyone think that getting more education will make you liver longer, ceteris paribus?

In general, getting more education doesn't happen unless a lot of the ceteris is not paribus.

Isn't this just saying that poverty is the leading cause of death and white women without a high school diploma are experiencing more poverty?

There may be a selection bias. In the 50's, the high scholl graduation rate was only 50% but it has increased to almost 90% in the early 80's and has plateaued since this time. So the group of people with no high school diploma is more and more selected and it is likely that those who do not graduate high school nowadays have on average worst characteristics than those who did not graduate 50 years ago when it was harder to graduate. And these characteristics such as IQ, consciousness or preference for the future are very likely to be correlated with life expectancy.

I think the most important is that life expectancy increases in the samples of all men and all women for every race and that it is hard to tell anything meaningful for a self-selected group.

The article has a nod in that direction:

Researchers said they were baffled by the magnitude of the drop. Some cautioned that the results could be overstated because Americans without a high school diploma — about 12 percent of the population, down from about 22 percent in 1990, according to the Census Bureau — were a shrinking group that was now more likely to be disadvantaged in ways besides education, compared with past generations.

but doesn't, I think, fully discuss that possibility. It's pretty significant. Note in particular that the life expectancy for all white women and all white men has continued to increase (though, granted, not as quickly as the rate among all Hispanics and blacks, though the overall number for blacks is lower.) There's a strong indication that this is not the same group it used to be.

They do discuss smoking and prescription drug overdoses (the latter can cause death at a young age, and deaths at a young age particularly impact life expectancy.)

This is the key point I think. It would be interesting to see if the study accounted for this.

One interesting thing to note (at the end of the NYT article) is that the population that lacks a high school diploma has shrunked dramatically, even since 1990. So in some sense these comparisons are not of similar groups.

And today's modern materials and techniques used in the manufacture of saddles and stirrups are attributed to dramatically reducing the number of riding accidents since the 1920s.

See an in depth article on this trend, Monday, in the New York Times!

Thanks, that would explain it, especially for women as far fewer women than men fail to complete high school and those that do fail are way out of the norm.

This was my thought as well. The further back you go, the more acceptable it was for people to not have a high school degree. Now, most people understand you need to have a degree, and the individuals who don't get one probably have additional mitigating factors. These folks were always part of the "no high school degree" group, but with the exit of more individuals that may have "chosen" not to get a degree in the past they become a larger portion of the selected group. This seems so obvious, in fact, that it almost makes it difficult to understand how you would use this statistic.

The HS drop out rate among White females is what? 4% or so. And has been dropping. So the biggest factor seems more likely to be the result of selection bias than anything else. I'd like to see what the results are of a similar group from both time periods, not a group that was larger and more talented 30 years ago vs a smaller less talented group today.

This table shows that the high school dropout rate among white females in the US declined from 14% in the early 1970s to 12% in 1990 to 4% today:
http://nces.ed.gov/programs/digest/d11/tables/dt11_116.asp

Today's pool of young white women without diplomas is much more restricted than it was a generation ago. It is no surpise that the very bottom of the cup contains more dregs.

Is this decrease in life expectancy "on average" or "on the margin"?

Unsurprising given the "food" this demographic eats.

I have a couple of second cousins that fall into this demographic group. Very sad to say but I think meth, prescription pill abuse, and domestic violence have huge role to play as well. A small uptick in the number of 20 something's dying can have a huge impact on average lifespans.

"We are not as healthy as we thought we were."

This is an instance where the use of "we" obscures rather than clarifies. The whole point of the research is not that "we" are less healthy than we thought we were ("we" are on average healthier: http://www.nytimes.com/interactive/2012/09/21/health/a-troubling-trend-in-life-expectancy.html?ref=us), but that the life expectancy gap between the well and poorly educated has increased substantially over the past twenty years, especially for whites, and that a lot of that change has been, shockingly, caused by a large decline in the life expectancy of the least educated.

And some of that change has been caused by a large move of people at the margin from the uneducated group to the educated group.

It would be interesting to see the numbers for something like the "20% least educated" held constant.

Exactly. Not doing so suggests the study had some ulterior motive, or was conducted by idiots.

"Not doing so suggests the study had some ulterior motive, or was conducted by idiots."

To paraphrase Dogbert, Don't rule out idiots with ulterior motives.

I agree. The researchers should try to untangle whether some or all of this effect is caused by a changing demographic (eg the subset of people without high school degrees in 2010 is
in some way different than those without such degrees in 1990). The fact remains though that it is not a "we are less x than we thought" kind of story.

Thank you. Seriously, who the hell is "we"? I knew of Tyler's alter personality shtick, but wasn't aware he believed himself to be a white female high school dropout.

“We are not as healthy as we thought we were.” I am not sure I agree with this. We were what we were in 1990 and we are what we are today.

Seems like the 'self-selection' problem would be very large here as the data in 1990 was mostly compromised of women born from 1900 - 1940, the data set in 2010 is compromise of women born from 1920 - 1960. The high school graduation rate was rising greatly the first era while plateauing in the second. The first era high school graduates probably really signaled the class women (upper middle and above) were in and what career choices they made. The second era, non-graduates were the exception to the population.

Just think, the Bryan Caplan's of the 1920's & 1930s were writing how much 'signaling' (probably in the marriage market) was going on for women to become high school graduates.

Some demographics have shrinking lifespans in America for the first time in a long time. It is showing up more clearly in the poorest demographics first. The great growth, prosperity and increasing lifespans Americans had from 1800-1970 is over. We have started doing dumb things over the last 100 years that have negatively impacted our ability to grow and prosper.

I wonder what it is.

The Fed!

Giving women the vote! Civil rights for black people! The pill!

Reading your comment.

"giving women the vote!"

female suffrage increased the size and scope of government.

http://www.people.fas.harvard.edu/~iversen/PDFfiles/LottKenny.pdf

"civil rights for black people!"

equality under the law has predictably morphed into its evil cousin, equality of outcome.

"the pill!"

the pill not only affects women's mate selection judgment, it reduces the leverage beta provider males bring to the sexual market.

try thinking outside the liberal shibboleth box for once in your life.

What are you talking about, lol? I agree women shouldn't vote, blacks should know their place, and birth control pills were a huge mistake. I didn't know Ralph Nader agreed (he's a big liberal, right?).

Like you, I wish everything was as it was 100 years ago. For example, I wouldn't have ever made your acquaintance without computers.

Have you picked out your theme music yet?

Three for three.

Yippee! I get triple points for being a woman, working at the Fed, and using birth control....wait, these are bad things? I thought I was doing the good, responsible thing with my life. Sigh.

I recognize that my life choices (and a lot other well-intentioned policies) have negative consequences. (When I forget, I can count on mr. lies for reminders.) And yet, I see even larger positive consequences...which oddly seem to go unmentioned around here.

Yippee! I get triple points for being a woman, working at the Fed, and using birth control….wait, these are bad things? I thought I was doing the good, responsible thing with my life. Sigh.

You're spending your prime childbearing and childrearing years working 60 hours a week for a cartel engaged in a massive multi-generational transfer of purchasing power to upstream recipients of new dollars. I can tell you with 100% certainty that your superiors do not care one bit that you will never get those years back.

If you're satisfied with your chain of being that stretches from the beginning of the universe to the present ending with you while you work for the perceived greater good for someone else's children well, whatever makes you happy.

Honestly don't worry about my little place in the universe. I have been blessed with two lovely children in addition to meaningful paid work. Though it's not always easy, my work is supportive of my life outside work. And you know nothing about my superiors and what they think, so you can save some electronic ink on that argument. I don't pretend to have made all the "right" choices, but it's hard for me to see how choices like mine have been socially (or personally) destructive on net.

selection bias.
Only the dumbest of whites don't graduate high school. These low IQs are often due to other genetic problems that produce poorer overall health.

A greater % of moderately dumb whites graduate high school than moderately dumb blacks. My prediction is that hispanic high school drop-outs have greater lifespans than black or white high school drop-outs

A better measure than educational achievement is to compare the life-spans of the poorest 10% of whites vs poorest 10% of blacks. Or the lowest 10% in IQ of whites vs lowest 10% in IQ for blacks.

A much greater % of blacks are high school dropouts compared to whites. Apples and oranges.

This speaks to the problematic nature of using overall increases in life expectancy as a justification for raising the age of Medicare eligibility (explained well by Austin Frakt).

If the above commenters are correct that they did not properly adjust for the decrease in number of people not graduating this is an example of yellow journalism. I hope that they at least adjusted for decrease in number of people not graduating in regards to people who die before graduating.

It is a terrible paper by all evidence. Its coverage suggests standard NYT biases.

We are not utilizing our resources to the best of our ability like we thought we were supposed to but now many experts are declinist cheerleaders for the status quo.

Can we please focus on what's important? Are the chalupas getting cheaper?

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