Americans die younger in red states

[Patti Beadles]

I wish I could say this surprised me. I wish I could say that this information would change people's minds.

Guardian article: https://www.theguardian.com/us-news/2022/oct/27/life-expectancy-us-conservative-liberal-states

Full study: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0275466

-P

[Quick]

This doesn't surprise me either. There's *way* more liberal sprout heads than conservative.

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[Patti Beadles]

What, pray tell, is a sprout head?

[Ed Baker]

On Tue, Nov 1, 2022 at 3:26 AM Patti Beadles <pat...@pattib.org> wrote:
>
> What, pray tell, is a sprout head?

[Dave Horwitz]

Sprout head is a term affectionately applied to vegans.

On November 1, 2022 12:26:20 AM PDT, Patti Beadles <pat...@pattib.org> wrote:

What, pray tell, is a sprout head?

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[Rick Charles]

Which is quite the term since I'm an obvious omnivore who loves sprouts (from bean to Brussel and everything in between) on his salads that he eats with his big ole Ribeye.

I've always loved veggies of all kinds, but I love meat too much to only eat "plant-based".

RC

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[Edmund Hack]

From the article: For example, we do not adjust for education levels or income of states’ residents.

I have a friend that is a VP-level actuary at an insurance company (head of research) of that studies causes of death, life expectancy, and that has a long publication record. When similar studies have come out she points out that the one of the strongest geographic correlations for life expectancy in the US is income. Another is education level.

So, I have pinged her for her reaction.

Edmund

[Regis Donovan]

On Tue, Nov 1, 2022 at 10:10 PM Edmund Hack <ehl...@emhack.com> wrote:

When similar studies have come out she points out that the one of the strongest geographic correlations for life expectancy in the US is income.

That's unsurprising since access to medical care is linked to income in the US.  I would expect that that has shifted a little bit for some states, depending on how the individual states have expanded access to Medicare or not, but maybe not that much since that's less likely to happen where the state government is controlled by the Republicans.

Another thing is economic factors pushing companies to close hospitals (particularly those owned by for-profit companies) in some areas, making it harder for people to access certain services in their area even if they have insurance that will cover it.  

--Regis

[Edmund Hack]

So, she reviewed the article. A few of her comments, after I mentioned that they didn't control for income or education:
"or their smoking levels
or obesity
or all the stuff that causes them to die earlier
...

they didn't even include the fact that these states have very different racial compositions?
this is trash"

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[Paul Zuzelo]

"Sprout head is a term affectionately applied to vegans."

Thanks for clarifying!  I was unfamiliar with this "affectionate" terminology.

In a similar spirit of elucidation and enlightenment, I too will clarify that "Democracy-destroying, shamelessly hypocritical MAGA Republican" is a term affectionately applied to anyone who supports Trump.

[Paul Zuzelo]

"That's unsurprising since access to medical care is linked to income in the US.  I would expect that that has shifted a little bit for some states, depending on how the individual states have expanded access to Medicare or not, but maybe not that much since that's less likely to happen where the state government is controlled by the Republicans."

With regard to medical costs, it's pretzel-twisting time!

Anyone out there want to explain how McConnell and all his fellow Republicans are adamantly pro-capitalistic when it comes to allowing buyers of oil to freely negotiate a price with sellers of oil (Exxon, etc.) but adamantly anti-capitalistic and even socialistic when it comes to preventing Medicare from freely negotiating drug prices with the drug companies?

[Edmund Hack]

On 11/2/2022 10:39 AM, Paul Zuzelo wrote:
> ...

> Anyone out there want to explain how McConnell and all his fellow
> Republicans are adamantly pro-capitalistic when it comes to allowing
> buyers of oil to freely negotiate a price with sellers of oil (Exxon,
> etc.) but adamantly anti-capitalistic and even socialistic when it
> comes to preventing Medicare from freely negotiating drug prices with
> the drug companies?

Because:
 - the price of oil is set internationally, not just in the US
 - base Medicare doesn't cover prescription drugs except when hospitalized
 - Medicare Part D providers DO negotiate prices on drugs with the drug
companies. That's why different plans have different prices and formularies.

Edmund

[Edmund Hack]

It's not just linked to income, there is a strong urban/rural divide in what is available. There are places in Texas where an ER might be an hour's drive away, if not more. Also, there is no real difference in how non-profit and for-profit hospitals are run. There is a major non-profit chain here in Texas that is the most bottom-line, savagely capitalist hospital chain out there. When they acquired another non-profit chain, their first act was to go to court to break the founder's will that established the hospital and required that they provide substantial free care to the indigent.

Medicaid (not Medicare) expansion is probably not a major factor in outcomes. The Oregon Medicaid expansion experiment had mixed outcomes. No real impact on physical health, some affect on diabetes detection (not management) and a reduction in depression.

Edmund

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[Paul Zuzelo]

"Because: 
 - the price of oil is set internationally, not just in the US "

So what?  Capitalism is only exercised if it's international and not domestic?

"- base Medicare doesn't cover prescription drugs except when hospitalized "

So what?  Medicare, which is fundamentally designed to reduce medical costs to an affordable level for seniors, shouldn't be allowed to negotiate when the sellers are big contributors to Republicans?  Just like the DOD isn't allowed to negotiate for military equipment prices with private industry suppliers?

"- Medicare Part D providers DO negotiate prices on drugs with the drug 
companies. That's why different plans have different prices and formularies. "

So what?   Only third-party providers are allowed to be capitalists when they negotiate prices with suppliers?

You're in first place in the pretzel-twisting contest so far.

[Regis Donovan]

On Wed, Nov 2, 2022 at 1:03 PM Edmund Hack <ehl...@emhack.com> wrote:

>  It's not just linked to income, 

I was thinking specifically that in the US, most folks get access to medical insurance via their employer.  The lower paying or more unstable a job is, the less likely it is to include access to any insurance via the employer, nevermind how much of a contribution for insurance an employer may provide.  

--Regis

[Patti Beadles]

The esteemed Mr. Hack writes:

> So, she reviewed the article. A few of her comments, after I mentioned
> that they didn't control for income or education:
> "or their smoking levels
> or obesity
> or all the stuff that causes them to die earlier
> ...
> they didn't even include the fact that these states have very different
> racial compositions?
> this is trash"

I completely understand her arguments.

However, I think she's missing the meta point, which is that the variables she listed have ties to red/blue state differences. Income and educatoin are very much tied to state policies, e.g. blue states are more likely to invest in education and mandate a living wage. Smoking and obesity also have ties to political policies. Racial demographics are more complex but it seems likely that they too have political underpinnings.

-P

[Edmund Hack]

Nope. She knows more about this than we do. A lot. Literally billion
dollar decisions are based on her research into death statistics in the US.

For example, when other factors are controlled, black Americans have a
shorter lifespan than white. Non-African origin Hispanics have a longer
lifespan than black Americans and white Americans.

Near as I can tell, smoking policies are pretty uniform across the US.
The only variation is in taxes on it.

Edmund

[Patti Beadles]

Ed writes:

> For example, when other factors are controlled, black Americans have a
> shorter lifespan than white. Non-African origin Hispanics have a longer
> lifespan than black Americans and white Americans.

Why are those things true?

-P

[Claudia Mastroianni]

I’m pretty cobfused

> On Nov 2, 2022, at 7:15 PM, Patti Beadles <pat...@pattib.org> wrote:

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[Claudia Mastroianni]

I’m pretty confused by this response from your friend, because the main method of analysis seems to be longitudinal *within* a given state. It’s the extrapolation of the results that can be summarized as a between-states distinction.

Claudia

On Nov 2, 2022, at 11:18 AM, Edmund Hack <ehl...@emhack.com> wrote:



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[Quick]

Yikes! so it's extrapolation that's killing people?

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