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June 18, 2011 9:14 AM   Subscribe

    "Despite the fact that the US spends more per capita than any other nation on health, eight out of every 10 counties are not keeping pace in terms of health outcomes. That's a staggering statistic."
According to the Institute for Health Metrics and Evaluation, life expectancy for many US counties fell relative to the world between 2000 and 2007. This Science Daily article gives an overview, and the IHME website has a nice page with links to data and visualizations. Here's the UN's list of countries by life expectancy for 2005-2010 for comparison.
posted by sneebler (31 comments total) 9 users marked this as a favorite

 
Another alarming figure: we're #34 in infant mortality.
posted by phunniemee at 9:18 AM on June 18, 2011 [1 favorite]


Hey, we beat Mexico by more than TWO YEARS! U-S-A! U-S-A!
posted by Huck500 at 9:22 AM on June 18, 2011


If you give any credence to Human Development Index-style geoinformatics, there are quite a few counties in the US with health, income, and education outcomes that are comparable to those of the US population at large in the 1950's. Please note: that's NOT a good thing.

My own hometown Baton Rouge, has a pretty profound divide, the north half of the town has a HDI lower than that of the whole of Mississippi, the southern half is on par with Massachusetts or Connecticut. It's why Baton Rouge is #2 on the list of AIDS prevalence, but it's almost exclusively limited to a big (okay, fuck it, mammoth, obscene, and terrifying) cluster in the north side of town.

I think there's something similar going on nationwide, that the overall health/education/income of the suburbs/exurbs/particular urban enclaves (and possibly rural areas in the upper midwest), are all outstanding, but are balanced out by profound rural and urban poverty.

Oh yeah, and we spend WAYYY to much on healthcare, for some piss poor outcomes, but there's about 15 or so good reasons for that.
posted by The Giant Squid at 9:22 AM on June 18, 2011


it's pretty telling that as you near the end of that list, down in the low 50s and 40s, men start to have a higher life expectancy than women
posted by nathancaswell at 9:24 AM on June 18, 2011




Comparing infant mortality rates is not cut and dried.
posted by found missing at 9:33 AM on June 18, 2011 [1 favorite]


Iceland beat Finland & Belgium by two years? wow! Is it the shark maybe?
Any bets on whether Japan's numbers take a hit, decades down the line, from Fukushima?

posted by jeffburdges at 9:36 AM on June 18, 2011


This visualisation really helps bring home the cost v. life expectancy situation in an international context, and how out-of-whack the US is compared to the rest of civilisation.
posted by Jakey at 9:57 AM on June 18, 2011 [4 favorites]


I think there's something similar going on nationwide, that the overall health/education/income of the suburbs/exurbs/particular urban enclaves (and possibly rural areas in the upper midwest), are all outstanding, but are balanced out by profound rural and urban poverty.

As somebody who's been keeping an eye on these things, I'd be very very worried about the suburbs. With a few exceptions, and home ownership likely completely out of reach to anybody currently under 30, renting in a car-free (or car-minimal) city is becoming very popular.

Similarly, as the baby boomers retire, many of them are finding home ownership to be too much of a hassle, and are relocating to smaller units in multi-family buildings in "safe" cities. Also, having watched the drama surrounding their own parents' declining driving ability, many of them are attempting to settle down someplace where they can live without a car.

In short, urban real estate is becoming a hot, precious commodity. As fuel prices creep higher and higher, the suburbs become cheaper and less attractive. Also, they're an outright bargain when you consider just how many people you can cram into a McMansion. Similarly, living in a detached home and owning a car is seen as a huge status symbol to many poor urbanites — once those options are in reach, they tend to appear very attractive, even though the reality might be somewhat less rosy.

On the flipside, members of ethnic minorities in cities who have managed to climb out of poverty are overwhelmingly moving to (and regrouping in) the suburbs. There are practically no Asians left in DC's Chinatown — that community packed up and moved to Annandale, seemingly overnight. Statistics about the health, economic, and educational wellbeing of African Americans in Washington DC are outright depressing. However, these statistics are highly conflated by the exodus of educated, middle-class African American families from the city into the Virginia/Maryland suburbs. DC is poised to become a city with no ethnic majority in the next few years.

Given this fairly profound and ongoing demographic shift, it's hard to actually keep track of meaningful statistics on a local level, given that these things are often grouped by state, county, and/or census tract, and the fact that many urban areas in the US are located right on a state border. After all, if poor people are fleeing the cities, we can't exactly cheer when we see the life expectancy soar in the urban core, and plummet out in the suburbs.
posted by schmod at 9:58 AM on June 18, 2011 [8 favorites]


Around here, one can get killed for a bag of chips. Find me a stat for that.
posted by clavdivs at 10:01 AM on June 18, 2011


...eight out of every 10 counties are not keeping pace in terms of health outcomes...life expectancy for many US counties fell relative to the world between 2000 and 2007.

Oh, relax. That's just the free market self-correcting.
posted by Thorzdad at 10:07 AM on June 18, 2011 [2 favorites]


Does anybody else remember in the 90s-00s how every hospital was rescued by being sold to a for-profit HMO? And the Senate majority leader was Bill Frist, who "began his career as an heir and major stockholder to the for-profit hospital chain of Hospital Corporation of America", and whose "primary legislative focus has been on issues of concern to the health care industry"? [wikipedia]
posted by benito.strauss at 10:09 AM on June 18, 2011 [1 favorite]


Also, having watched the drama surrounding their own parents' declining driving ability, many of them are attempting to settle down someplace where they can live without a car.

The AARP is all over the carless living thing. As somebody who used to do cycling advocacy, I was amazed at what great allies the AARP were for the pedestrian-friendly half of it.

After all, if poor people are fleeing the cities, we can't exactly cheer when we see the life expectancy soar in the urban core, and plummet out in the suburbs.

Aside from the PG, MD talk, are the poor really fleeing the cities?
posted by The Giant Squid at 10:11 AM on June 18, 2011


Bill Frist, who "began his career as an heir and major stockholder to the for-profit hospital chain of Hospital Corporation of America", and whose "primary legislative focus has been on issues of concern to the health care industry"?

Bill Frist's father, Thomas Frist, also founded Kentucky Fried Chicken. Create a problem, create a solution. Get paid both ways!
posted by The Giant Squid at 10:13 AM on June 18, 2011 [2 favorites]


Why is Denmark 36 when the other Nordic countries are much higher in the rankings? Strange.
posted by three blind mice at 10:26 AM on June 18, 2011


One more thing: I went to a lecture last week by David Foot, who has some interesting things to say about using demographics to forecast policy needs and interesting changes in the world. He mostly focuses on Canada, but he has a different view of the modern world (I'm not a demographer or an economist though...). As luck would have it, he's flogging a book.
posted by sneebler at 10:35 AM on June 18, 2011 [1 favorite]


Divided they fall.
posted by srboisvert at 10:51 AM on June 18, 2011 [1 favorite]


These stats are a transparent way to make us at the very least cry out: But thank the good lord that at least we are not socialists! that is worth dying for.
posted by Postroad at 10:54 AM on June 18, 2011 [2 favorites]


You know how you feel when you hear about some backward place where there are only informal open sewers and if there's running water it's not safe to drink?

That's how the rest of the world feels when they hear how the US health care "system" works.
posted by localroger at 11:23 AM on June 18, 2011 [7 favorites]


schmod:

home ownership likely completely out of reach to anybody currently under 30

I'm 27. I'm starting to see some of my college classmates buying houses. By "see", though, I mean "read about on Facebook", because this only seems to be the ones who live in cheap parts of the country, where I do not.

Also, [the suburbs are] an outright bargain when you consider just how many people you can cram into a McMansion.

My parents bought a McMansion right around the time I graduated from college. By "right around", I mean that they finished moving in, then got in the car and drove to my graduation. They didn't intend to time it this way but things went wrong.

So then we drive back to their house. Which is on the empty side, because they moved from a smaller house so they still needed some furniture, and they weren't totally unpacked yet. Of course when I get there, after four years of being crammed in dorms, the first thing I think is "dude, like fifteen people could live here". Which was true.

(And then I freaked out and thought "shit, my parents can't afford this place!", because it was 2005. Then I did the math and concluded they could, which was a good feeling, because I'm in no position to bail out my parents if they screw up.)

But are the suburbs really a bargain when you factor in the fact that you need to go make money, and most people can't do that by sitting in their house all day?
posted by madcaptenor at 11:50 AM on June 18, 2011


Our society has made a choice to spend an unlimited amount of money extending the last few years of a person's life, while spending no money at all on simple cheap interventions for everyone else.

I'd like to see what would happen to infant mortality and children's health if we instituted paid maternity leave and subsidized daycare.
posted by miyabo at 1:10 PM on June 18, 2011 [2 favorites]


I bet infant mortality is more closely correlated with median healthcare spending than with average spending. Anyone have numbers?
posted by ryanrs at 1:27 PM on June 18, 2011


Why is Denmark 36 when the other Nordic countries are much higher in the rankings? Strange.

In all likelihood a considerably larger consumption of alcohol and tobacco then the rest of the Nordic countries.
posted by Greald at 1:28 PM on June 18, 2011


Aside from the PG, MD talk, are the poor really fleeing the cities?

My experience is only anecdotal, but within the last ten years, it seems like the poor are slowly being driven out of the center of my small city. Property values near the center of the city are slowly rising, while cheap housing on the outskirts is becoming more available. A family of limited means has few choices; either they can live in one of the most dangerous, run-down areas, or they can move to one of the cheaper suburbs. Some of these suburbs have been around for a while and have just been in decline, while others are brand new and filled with identical, cheaply-made houses that have a lot of space.

There are still "poor" areas near the city center, but it seems like gentrification is nibbling at their edges.
posted by Kutsuwamushi at 3:16 PM on June 18, 2011 [1 favorite]


Why is Denmark 36 when the other Nordic countries are much higher in the rankings? Strange.

In all likelihood a considerably larger consumption of alcohol and tobacco then the rest of the Nordic countries.


Yes, and no. Danes do not lead as healthy lives as other Scandinavians, particularly, smoking is a huge problem. But also, the problem is somewhat the same as in the US (and for similar reasons). If one breaks down the statistics, the difference between rich and poor areas is significant pdf in Danish
For Copenhagen, with the worst numbers, the differences between the boroughs are extreme. (I won't link to a Danish pdf where the stats are hidden deep inside).
Again, some of these differences can be attributed to life-style: poor, uneducated people smoke more than rich educated people. And many immigrants have difficulty adapting to the lifestyle here and suffer from diabetes. But there is also a measurable failure in the healthcare system when it comes to dealing with these issues, compared to our neighbors. The Swedes have poor people, smokers and immigrants too, but they treat them.

We all have problems, it's just a question of scale...
posted by mumimor at 3:31 PM on June 18, 2011 [1 favorite]


I've had this conversation with a Tea-Partier. He explained that the reason our life expectancy is lower isn't because our health care system is worse, it's because we don't have gun control, so we shoot each other more than folks in other countries.

No, really, that's how they're explaining this.
posted by qldaddy at 4:13 PM on June 18, 2011 [2 favorites]


So the Tea Party is pro-gun control? I'd love to see that debated in the hustings.
So at what point do the healthcare companies actually start offering reasonably priced care? At this rate there's going to be only ten people with solid gold wheelchairs with an HMO each while everyone else self medicated on aspirin as that's all they can afford.
posted by arcticseal at 5:06 PM on June 18, 2011


I exoect it to go down further yet especially with poverty increasing in a lot of states and people drowning their pains with more alcohol and cheap eats of course it will rise in the richer states
posted by RichMackay at 9:08 PM on June 18, 2011


Kutsuwamushi:

I hardly see any of the actual poor moving to the suburbs. I do see a fair swath of section 8 housing opening in the suburbs, and I also see a good swath of the lower-middle-class moving out that way.

Around here, the logic is: why move someplace and pay rent if you can live in great-granddad's house for free (as long as you pay the 'light bill'). Then again, I'm in the South, and most of the poor (who are overwhelmingly black in the cities) moved here in the 1880s, and are sitting on land/in houses that great and great-great grandparents bought.

Typically, finding heirship on properties is nearly impossible, and it's not uncommon at the time of sale for a property to have over 100 possible legal heirs to a piece of property (created between 3-5 generations), so the property never legally changes hands, and typically ends up lived-in by the most neer-do-well relation of one branch. Getting legal process on this usually runs in the tens of thousands of dollars, which tends to add so much overhead to property transactions that even houses adjacent to the most desirable (read: expensive) parts of land will sit derelict for decades.

The house next door to my own (which is of the same vintage, circa 1930) has sat and rotted to the ground courtesy of this lovely process. City government doesn't find it worth their while to repossess the property (too expensive, and will never yield enough property tax to make it worthwhile), and none of the original owners nor heirs care to be contacted (actually, they've assiduously avoided being found).

So, I suppose, when I hear talk of hand-wringing of displacement of people due to gentrification, I have to just say: "Where? Because it surely isn't happening here".
posted by The Giant Squid at 9:16 PM on June 18, 2011


The Giant Squid, you really can't compare Louisiana to other states in regards to inheritance. Louisiana has got a hybrid legal system that blends Roman civil codes with common law(wiki). My experience living in Louisiana is that things get done differently down there for a bunch of reasons. I definitely did not live there long enough to figure, which are the valid ones.
I have definitely heard of rural getting worse in parts of Louisiana(e.g. Evangeline and St. Landry's Parish), but in part that was due to hurricane Katrina. I have also seen similar issues in the Chicago land area as people are slowly getting priced out. Most of this has a racial undertone since most of the urban poor are African American and most of the migrant farm workers are Hispanic.
posted by roguewraith at 12:43 AM on June 19, 2011


why move someplace and pay rent if you can live in great-granddad's house for free

Why keep great-granddad's house if you can get a good price on it, one that will help pay off pressing debts?

I'm getting from your comment that in Louisiana, the law often makes it difficult for the property to change hands. That's not generally the case here. I also doubt that the sentimental attachment is as strong. People move around a bit more, so there are probably only a small percentage of houses that have been in the same family for over 50 years, or whatever.
posted by Kutsuwamushi at 2:45 AM on June 20, 2011


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