A Little Older, A Little Sicker

      39 Comments on A Little Older, A Little Sicker

According to a new survey, Americans are living longer (not much), but not because we’re healthier. Here are some quotes from an NBC article:

Americans may be living longer and even exercising a little more, but we really are not much healthier than we were 10 years ago and we are still far behind other rich countries when it comes to our health, researchers said Wednesday.

Journalists love to point out how we lag behind other rich countries. More on that later.

The biggest survey of U.S. health in 15 years breaks down death, disease and disability county by county – and makes some very unflattering comparisons to other countries. It’s a big, comprehensive dive into what kills us and what makes us sick.

Journalists love to point out how we lag behind other countries. Wait … I already said that. Well, the journalist felt compelled to mention how we lag behind other countries twice in two successive paragraphs, so we’re even.

It finds that how healthy you are depends on where you live.

No, it depends on what kind of person you are: health-conscious or not health-conscious.

If you live in a rich area like San Francisco, Colorado or the suburbs of Washington D.C., you’re likely as healthy as the Swiss or Japanese. If you live in Appalachia or the rural South, you’re likely to be as unhealthy as people in Algeria or Bangladesh.

Hmmm, I’m pretty healthy. If I move to Appalachia, will my health decline? If an obese diabetic from Appalachia moves to San Francisco, will his health improve? I think not. All we’re seeing here is that San Francisco and the suburbs of Washington D.C. are damned expensive places to live. That means mostly rich people live there, and rich people tend to be more health-conscious. They’re not healthier because they live in “rich areas.”

Our biggest enemies are our own bad habits – poor diet, smoking and obesity. They’re far more dangerous to our health than pollution or risks from radiation.

Our own bad habits are also the reason we’re lagging behind other countries. Again, more on that later.

But Americans lost ground compared to people living in other countries in the Organization for Economic Cooperation and Development. “Among 34 OECD countries between 1990 and 2010, the U.S rank for the age-standardized death rate changed from 18th to 27th,” Murray’s team wrote.

Wait for it …

“The United States spends more than the rest of the world on health care and leads the world in the quality and quantity of its health research, but that doesn’t add up to better health outcomes,” Murray said in a statement.

I knew that was coming.  Here’s a similar quote from an article in The Washington Post:

What surprised Murray and his team was that despite increased consciousness about disparities and per capita spending on health care that is at least 50 percent higher than European countries, the United States is falling farther behind them with each passing year.

Whenever I read or hear something along the lines of “The U.S. spends more on health care than any other country — and yet we have worse health outcomes!” as if that’s shocking news, it’s a head-bang-on-desk moment for me. Why? Well, if you read any of these statements in the news, would you be shocked?

The U.S. spends more on pianos than any other country in the world – and yet we have more piano players!

The U.S. spends more on cars than any other country in the world – and yet we have more auto accidents!

The U.S. spends more on food than any other country in the world – and yet we eat more!

I think you get the idea. We don’t have an unhealthy population in spite of spending more on health care.  We spend a lot on health care because we have an unhealthy population.  Healthy populations don’t rack up big health-care bills.

The researchers partly blame obesity for our health woes, but I believe rising obesity rates are mostly a symptom of the real problem: skyrocketing rates of diabetes. Among the “rich” developed countries, the U.S. has the highest rate of diabetes. (I put “rich” in quotes because I don’t believe a country that’s $16 trillion in debt and pays its bills by borrowing another $1 trillion annually is actually rich anymore. But we still spend like we’re rich, so bear with me.) About one-quarter of our senior citizens have diabetes. When people get sick and you treat them (and treat them and treat them and treat them), you get medical bills.

Older Americans today are sicker than previous generations of older Americans. (See this post for more on that.)  In spite of that, they’re living longer largely because as a “rich” country with advanced medical technology, we make heroic efforts to extend their lives.  Those heroic efforts produce big medical bills. According to one study I looked up, 32% of all Medicare expenditures are for “end of life” medical care — i.e.,  treating old people who die within the next two years. On average, they’re treated by 10 different doctors during those last two years. Or as the Wall Street Journal noted:

Medicare patients rack up disproportionate costs in the final year of life. In 2009, 6.6% of the people who received hospital care died. Those 1.6 million people accounted for 22.3% of total hospital expenditures, the Journal’s analysis shows.

I’m not suggesting we tell old people who are sick to go away and die. I’m suggesting that the country can’t survive the financial burden resulting from the bad foods our government subsidizes and the bad diet our government recommends. We can’t afford to make people ill and then pay for every procedure imaginable to treat their many illnesses. Something’s got to change.

But never fear. This latest report on illness and longevity is inspiring some much-needed action:

First Lady Michelle Obama said the report shows communities and policymakers need to help Americans eat better. “We’re going to be working with food companies and restaurants who are offering more healthy options to families so that when they go into a restaurant they have some decent choices,” she said at an event at the White House for her “Let’s Move” campaign.

Awesome.  The government’s going to step in and help Americans eat better.

Don’t you feel more optimistic already?


39 thoughts on “A Little Older, A Little Sicker

  1. Lori

    He lost me at “rich area like Colorado.” There are places within walking distance of my house that are so run-down that I won’t get out of my car.

    As someone in the “rural South,” I’d no doubt feel at home there.

  2. Pierson

    Tom, not even one mention of how our consumption of red meat and non-PUFAs is killing us? Aww shuchks, I was looking forward to that

    I guess they didn’t get the memo.

    1. Marilyn

      Don’t worry, Pierson. There are others out there bashing red meat. The other day I was reading about the effects of phosphate additives on our health. One web page suggested reading all labels carefully and then avoiding anything containing phosphates. So far, so good. Then they went on to say that since a lot of red meat is processed with phosphates, one should avoid ALL red meat — just in case.

      1. Kathy from Maine

        I was listening to Fox & Friends this morning and they had Dr. Marc Siegel on talking about how Unhealthy the popular detox diets and cleanses are. He actually said that eating steak every day would be less damaging to your health than doing these cleanses … and we KNOW how bad steak is for you! I can’t believe he said that. Maybe if HE ate steak every day for a week, some of his brain cells might grow back.

        He frustrates me. Sometimes he makes very good points, but other times he just spouts the same old nonsense.

        1. Joyce

          Ha ha! Yes, like other networks, Fox still goes with the old propaganda about fats…although I do have to hand it to O’Reilly for mentioning Atkins in a positive light last year.

          He also recommended “Wheat Belly.”

          1. Joyce

            You’re so good at dissecting studies. What do you make of this one?


            The title of the study from June 2013 is “Men With Prostate Cancer Should Eat Healthy Fats, Study Suggests”

            Of course the healthy fats are the polys and monos not sat fats. I read with great interest that the recommendations (in the colorful sidebar) suggest cutting carbs like bread. I only wonder what they would have found if they’d studied carb cutting with intake of saturated fat. They mention studying different dietary factors, but don’t mention which ones.

            I once read with interest that Arthur Agatston, in his first edition of the South Beach Diet, noted that studies of saturated fats and cardio disease were limited. In fact, his “success stories” in the original book used butter and cream in their coffee. My how he changed his tune over the years. Very curious. No wonder I abandoned that plan.

            In any event, keep giving us your take on these studies. Out of all the blogs I read, you take them, dissect them and make them so easy to understand. I’m a study nerd, but sometimes I just don’t know what the hell they’re talking about! Thanks for spooning them out in baby doses. Bet I’m not the only one scratching my head sometimes!

            That’s yet another set of observational data drawn from the Physicians’ Health Study, which is riddled with confounders — starting with the fact that the entire study population is comprised of doctors. I wrote about it here:


            In a nutshell, doctors who follow the standard health advice are younger, leaner, less likely to drink too much, less likely to eat white flour, less likely to drink soda, less likely to develop diabetes, more likely to exercise, etc. It’s the adherer vs. non-adherer phenomenon that shows up all the time. Trying to pluck out a variable or two and call it a cause-and-effect relationship is ridiculous.

  3. Cameron Baum

    I have started to wonder if all of this is a deliberate attempt to have population control/reduction. If they have too little money for health care, ill they exclude obese people from treatment, saying it is their fault, and they must suffer the consequences?

    After spending a week listening to pop songs backwards, and seeing worrying messages (Britney Spears’ Baby One More Time, Christina Aguilera’s Dirty, and Kesha’s Dancing With The Devil are good examples of this) I am ready to suspect anything these days…

    If people are in a vulnerable position, they are easy to control…

    Or maybe my paranoia is running away with me. I see efforts to make food a commodity that is provided by big business, and health provided if you are lucky or rich. The problem with this is that you end up with nature evolving better solutions to weed killers and altered crops, and people will riot and force through violence health care for them. Not to mention the fact people are listening to them less and less, and are more willing to try diet alternatives.

    Sorry for the misspellings and broken post, I am typing this on my phone…

    I don’t want to be paranoid either, but it does seem as if they’re taking down real-food producers while promoting Monsanto’s interests.

    1. Tony Dickson

      Well, the great cholesterol scare was a plot to reduce American testosterone levels, so there’s that.

      OK, if it wasn’t a plot, it may as well have been.

    2. Jill

      The UN wants to reduce the population of the world from 7 billion to 1 billion.

      Hence bad diet advice, “population control” forced sterilisation, the carbon trading scheme and “carbon emissions reduction etc.

      REad about UN Agenda 21, it’s all there.
      check out Rosa Koire’s Behind thje Green Mask (video youtube nd the book)
      and google Agenda 21 for Dummies.

    3. michael

      “I have started to wonder if all of this is a deliberate attempt to have population control/reduction.”

      You are a nutball.

      Capitalism requires growth, including & especially population growth, so that the consumer class grows.

      This is what most people (even investors) don’t understand about Wall Street. All that matters in a stock is its potential for growth. A company that makes a trillion dollars this years would get absolutely hammered on Wall Street if it was expected to only make a trillion dollars next year.

      So no, there is no great cabal to control the population. If anything, the powers at be want as many new babies born as possible.

  4. Cameron Baum

    Better solutions to weed killers and altered crops, and people will riot and force through violence health care for them. Not to mention the fact people are listening to them less and less, and are more willing to try diet alternaives.

    Sorry for the mispellings and broken post, I am typing this on my phone…

  5. Matt

    You know you’re in trouble when Michelle Obama is coming to help you get healthy…

    She means well, but she went to the USDA for advice on how to “help” Americans eat better. She may as well have consulted with Monsanto.

  6. Marilyn

    I sometimes get the feeling that the general health of Americans is deteriorating precisely because they are taking all the pills and potions that are supposed to fix all their ailments.

    Some of those pills help, some don’t, some make things worse.

    1. Susan


      That was my thought, too. Doctors too quick to whip out that prescription pad for every tiny symptom or complaint.

      Try treating the underlying causes instead of the symptoms for a change.

  7. Dallas

    “Our biggest enemies are our own bad habits – poor diet, smoking and obesity.”

    So what I’ve learned the most from this whole article is that obesity is actually just a bad habit.

    Obesity can be the result of bad habits, yes. Unfortunately, some of those bad habits — like eating lots of grains — are encouraged by the USDA and labeled as good habits.

    1. Dallas

      Of course, I totally agree that eating lots of grains is a bad habit. What I was more referring to was the wording. If they’re going to call obesity a bad habit, then they should also call lung cancer a bad habit because obesity isn’t a bad habit in an of itself; it’s the RESULT of bad habits as you mentioned.

  8. Luke

    I think it’s time a caricature for Michelle Obama to made similar to the cspi guy.

    I think Michelle Obama means well but has been given bad information. The Guy From CSPI hasn’t been given bad information; he ignores information he doesn’t like and often passes out bad information.

  9. Mike P

    As you’ve mentioned many times, along with every crime investigation show ever…follow the money. There isn’t money in prevention, but there is money in treatment. Especially when each doctor gets 3-4 cracks at ‘treating’ the problem. The same is true with politicians and government agencies whose ‘interests’ align with big Pharma and big Agra.

    It’s like The Matrix, except instead of being used for energy we’re being used for money at the expense of our health…

    I believe most doctors genuinely want their patients to get better, but they’re trained at seminars put on by drug companies — who probably don’t want the patients to get better. They want the patients on life-long drug therapy.

  10. Ham-Bone

    “more healthy options”? What else are they going to take the fat out of? I can barely eat healthy at restaurants now, what else are they going to do to make it worse?

    Smaller portions and less fat.

  11. ET

    The statement “One underlying cause is poor diet. “The most important dietary risks in the U.S. are a diet low in fruits, low in nuts and seeds, high in sodium, high in processed meats, low in vegetables and high in transfats,” Not once do they mention all the sugar in the standard American diet.

    In addition, sodium intake is directly correlated with the consumption of processed foods.

    Yeah, I thought sugar was curiously absent from the list.

  12. Dan

    Hospitals suck. I had rhabdomyolysis in April. I spent 3 days in the hospital. My Dr said they were basically babysitting me (They were. There is no treatment for that.). The bill was $24K (I have ins, but that was the bill). The next time I need to get “babysat” by Drs, I’m going to the Four Seasons, calling Elliot Spitzer’s madam, and having the VNA stop by every hour just to save money. Perhaps the sheer size of our medical bills accounts for us spending more too.

    I believe a veterinarian would baby-sit you for far less. The food would probably be better too.

  13. Kabir

    I’m not sure there really is a “solution” to this problem. If everybody in the country ate a healthy diet (whatever that may be) and lived longer, would that really drive down healthcare expenses? The assumption is, I suppose, that we’ll all be healthy until one day we die peacefully in our sleep. The longer you live, the more likely it is you will get sick, regardless of your lifestyle. So eat and (perhaps more importantly) drink 😉 whatever the hell you want. Enjoy life!

    As long as we make heroic efforts to save old people who are going to die anyway (we all die of something), expenses will be high. The high rate of diabetes is making the situation worse, however.

    1. Linda

      Just heard from a friend of mine that a 91 year old friend of theirs, who has Stage Four prostate cancer that has gone into some bone, is being given a hip replacement. This is not only expensive but speaks to malpractice in my book. This guy will not be able to perform any post op physical therapy which is required for successful hip replacement. I asked a lot of questions and there was simply no rational answer as to why this surgery was being performed. Simply money I guess.

      Bingo. People don’t spend other people’s money as carefully as they spend their own. Never have, never will.

    2. j

      Kabir, it is that mentality that has gotten many obese, diabetic, and just sick people in general into the s**thole theyre in..

      Yes enjoy life, but dont be recklessly irresponsible about it (which goes for everything else too).

  14. JayMan

    While this analysis is pretty good, and is very much in line with something I’d say, there is one thing missing:

    “The researchers partly blame obesity for our health woes, but I believe rising obesity rates are mostly a symptom of the real problem: skyrocketing rates of diabetes. Among the ‘rich’ developed countries, the U.S. has the highest rate of diabetes.”

    There is a simple reason for that: of those countries, the U.S. has the largest fraction of people vulnerable to diabetes. That is, Blacks and Hispanics.

    Perhaps at some point I’ll break down diabetes rates by race. I’ll go out on a limb and wager that the White diabetes rate is very similar to Britain’s and Germany’s (the two countries that supplied the bulk of the U.S. White population).

  15. The Older Brother

    Of course the health care system is totally hosed, since it’s been in the process of being socialized since the inception of “employer paid” health insurance during the post-WWII wage freezes.

    However, if you back out the deaths and medical spending due to auto accidents and violent crime, both of which us Americans tend to overindulge in, all of the numbers come back in our favor.


  16. Don in Arkansas

    I just have to wonder if the upswing in Europe’s death rate stats have anything to do with Europe’s position on GMOs. Food for thought here.

  17. Jo

    While we don’t know much about Nelson Mandela’s health, I wonder whether it is his own will or his family’s that he is still alive in hospital. My Gran got sick at 92 and refused to go into hospital. She died two weeks later with her son by her bedside. Her doctor said that as a result of recent appointments he believed she was ready to go. She could have got excellent care but chose to go in her own sweet time.

  18. Kynykya211

    I am currently doing an internship in a skilled nursing facility. Their luncheon menu on the last day I was there consisted of a small bowl of iceberg lettuce, a large portion of fettucini alfredo (no meat, just noodles and sauce), a thick slice of white bread, and a thick slice pound cake with non-dairy whipped topping and a few syrupy raspberries. I gained five pounds just looking at it.

    I couldn’t help but wonder how the health of the residents would improve if the grain and sugar in their diets was eliminated. Or at least dialed way way back.

    I also couldn’t help but wonder how I would survive in facility like that.
    The answer: I wouldn’t.

    I was horribly sick for years and turned my health around (and lost 100 lbs) by eliminating grains and sugar from my diet. The thought of being “helped” in my old age by being asked to consume a diet like that has given me nightmares.

    The food in hospitals and nursing homes seems designed to keep you there.

  19. Ulfric Douglas

    Is the ‘report’ AND this blog ignoring the Race thing?
    Is it because everyone on t’internet gets all up in arms when it IS mentioned as a HUGE factor in both relative wealth and health … statistically, that is.

  20. alexandra

    It seems to be a common belief that doctors make us healthy…ergo… the more we see doctors, the more we spend on “healthcare” the healthier we are or will become… This explains the reporter’s astonishment.

    Most reporters are stunningly ignorant of basic economics.

  21. Angel

    I assume the VA has similar disproportionate costs for end-of-life care as Medicare, if not more so. Most of the people in the VA system are well past retirement age (younger vets like myself don’t qualify for the same comprehensive benefits as the older vets, for which I am quite frankly grateful). My dad passed away 2 months ago, and he was a heavy user of the VA system for the last few years. He drank like a fish, smoked like a chimney, ate crap for food when he ate at all, and was extremely sedentary, but he kept going to most of his VA appointments because, to summarize his justification, you have to get your medical care and take care of yourself.

    The VA didn’t even pay for all his medical care; he was in considerable debt when he died, and most of that debt was medical debt. It wasn’t unusual for him to get billed for treatment that the VA provided but that the VA decided they shouldn’t have to pay for. I advised him to ask before receiving care to find out if he would get billed for it or not, but I really don’t know how easy it was to determine ahead of time what the VA would cover and what it wouldn’t. It is a very broken system.

    We don’t want to discriminate against vets, so the plan is to break the entire health-care system soon. (Not that it’ll need much more breaking.)


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