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There are two points to the article.

1) Healthcare spending has rapidly diminishing returns, not only comparing the US to Europe, but comparing countries within Europe (such as the Netherlands versus Spain).

2) The lower life expectancy in the US can be explained mostly by higher obesity. US states with similar obesity to European countries have similar life expectancy.




Re: #2, my understanding from friends at the CDC is that lower life expectancy is due to lower incomes (meaning food, medicine, and doctor visits are unaffordable even with health insurance), suicides, and the opioid crisis.

Suicides and obesity can also be caused by low income and drug abuse, so it sounds like the author may be seeing causation where correlation is more accurate.


Causation isn't mutually exclusive. The relationship between obesity and heart disease is clearly causative. Any causation between income and obesity does not negate this..

This is an important distinction.


That's true and I agree, but if you're asking why people are dying, you're going to be most interested in the root cause (which should be the variable that is least dependent on the others).

While obesity likely does reduce income somewhat (due to stereotypes), income can be considered an independent variable here.

Relatedly, we know that obesity is very hard to treat, while poverty is incredibly easy to treat on an individual level. The only reason we don't is because people see treatment of poverty as unfair, while treatment of obesity is not seen that way.


I would never claim that income/poverty is the root cause of obesity, as obesity poorly correlated with income in the US.

Obesity is prevalent in both the middle class and poor, with the middle class slightly leading the poor[1]

>39% of people ≤130% of the federal poverty line (FPL) are obese.

>40.8% of people 130 to 350% of the FPL are obese.

While individuals should be brought out of poverty for other reasons, it is not a cure-all for obesity. If anything can be implied by the correlation, it will make the problem worse, and the healthcare system should prepare for this.

[1] https://www.cdc.gov/mmwr/volumes/66/wr/mm6650a1.htm


I haven't looked at the numbers. Barely read the article. I bet he's wrong though. I would think it'd be a love affair with firearms (Fuck Yeah. ) and a lot of driving.

Every time I read about weight the dangers of an extra 10 lbs. seem to be pretty ambiguous. Though I'm totally going to drop that 10 lbs. I only had 2 donuts today.


An extra 10 lbs isn't the issue here. The average American man is now 23 lbs overweight.


It is much worse than that. 40% of american men are obese, which,for the average body type, is ~50 lbs above normal.

From wikipedia: >The National Center for Health Statistics at the CDC showed that 39.6% of US adults age 20 and older were obese as of 2015-2016 (37.9% for men and 41.1% for women).[1] Obesity in an adult is defined as a BMI of 30 and above.

The Average american male is 5'10. A "normal healthy" BMI of 22 is 153 lbs. A BMI of 30 is 209 lbs. [2]

[1] https://en.wikipedia.org/wiki/Obesity_in_the_United_States [2] https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi...




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