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PaperclipPerfector  1yr ago (text post)   3931 thread views

Small-Scale Question Sunday for November 12, 2023

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I'm looking for a chart which appears in Peter Attia's book Outlive. The chart shows that the only reason that life expectancy in the U.S. has increased since 1920 is because we eliminated 8 infectious diseases via vaccination, antibiotics, and sanitation.

I want to find the original source and study for this chart. The author of the study is Robert J. Gordon.

Where is it? Why is this impossible to find? Google, you suck.

I will add, on top of what @sarker said about massive progress in treating cancer, that you simply can't meaningfully extend human life expectancy beyond about 80 or 90 with our current approach of addressing disease.

The real culprit for why most humans shuffle off the mortal coil is aging, the net outcome of multiple correlated failures of homeostasis and regeneration that plagues our biology. It's a super exponential process, if aging was merely exponential, then we'd have outlier humans who manage to live to 140 or more, instead of being largely capped at 120 even with the most ideal natural genetics.

We've largely solved the issues of infant mortality and infectious disease in the non-senescent, and modern medicine is good enough to keep you chugging with heart disease and the like until your 80s, at which point pretty much everything starts breaking down faster than we can patch it up. At that point, it becomes inevitable that something gets you, your immunity is shot, your organs operating well below nominal abilities, and us doctors are changing the oil and redoing the upholstery till the engine gives out and you come to a screeching halt.

We've grabbed the low-hanging fruit, built some pretty awe inspiring albeit precarious ladders, but the actual solution is to cut the damn tree down at the roots.

that you simply can't meaningfully extend human life expectancy beyond about 80 or 90 with our current approach of addressing disease.

I think Peter Attia would agree with you. It's more about thriving at 80 than living to 110. He points out that supercentarians are 9 times rarer than billionaires and are mostly there because of genetics.

That said, life expectancy in the U.S. sucks.

Japan's life expectancy is 85. Monaco is 89.64!

https://www.cia.gov/the-world-factbook/field/life-expectancy-at-birth/country-comparison/

I think most of us have the genes to live to 90-100 with ideal diet and exercise.

I'll quibble in that I think that "thriving" should describe a person who remains at peak health, or far closer to it, than even the healthiest 80 yo. Sure, some of them can be surprisingly vigorous, but they're no spring chickens.

My grandpa, a better doctor and person than I am, made it to 95 (he's still kicking!), and it's only been after Covid lockdowns made him stop his regular private practise that any noticeable cognitive decline took place. He saw patients till 92, and performed surgery till 85.

He did take very good care of himself, being quite austere in terms of lifestyle, eating a healthy diet and exercising regularly, even if it's no longer sufficient to keep the worst at bay. I certainly don't do the same, because I'm not remotely as disciplined, and I'm actually content to gamble that advancements in medical science will bail me out of the worst of it in a decade or two.

AFAIK this is not true. There's been lots of progress in reducing cancer deaths too. Brief overview: https://ourworldindata.org/cancer#is-the-world-making-progress-against-cancer

I would like to see more data. Besides cancer, there are several other modern improvements that should have increased life expectancy. Off the top of my head:

  1. Reductions in smoking (this should account for YEARS)
  2. Improved auto safety (U.S. auto fatalities per capita peaked in 1937)
  3. Statins
  4. Improvements for other diseases (miracle cure for Hep-C being a good example).

But perhaps this is offset by:

  1. The massive rise in obesity. Currently 11% of American adults are diabetic. That number rises to 29% of adults over 65.
  2. Drug overdose deaths (from near zero to 100,000+ per year)
  3. Increase in murders

Reductions in smoking (this should account for YEARS)

...

The massive rise in obesity. Currently 11% of American adults are diabetic. That number rises to 29% of adults over 65.

There may be a non-trivial tradeoff here.

Increase in murders

What numbers are we looking at here? Googling around the murder rates per capita for the US as a whole during the 1920s and 30s seem to generally trend higher than murder rates today, but those are just the easiest ones I've found and I could accept the methodology has changed to such an extent it is not an apples-to-apples comparison.

Can you share the data you've found? I was just speculating in my post and I could accept that murders were higher in the 1920s than now. Especially because people who were stabbed or shot would be more likely to die without a 911 system and quality medical care.

For the 1920s and 1930s, I was just going off of this which is just the source from the Wikipedia page.Since that data was from the NCHS, I then compared it to the rates for 2021 and 2022 from their dashboard, which showed 2021 and 2022 as being a bit lower than the averages for the 20s and 30s.

The numbers I saw from the first link seemed ballpark with the other ones I could find (The FBI crime data explorer only goes back to 1985 and tends to show lower rates across the board than the NCHS data, but is in the same ballpark and trends in the same direction by year).

Once again, just what I could find quickly off Google, not a rigorous analysis.

And yeah, not a commentary on rates of violence, just in terms of folks going in the ground.

Thanks! That data is so weird. What happened in 1904? The murder rate jumped from 1.3 to 4.9 just 4 years later! I suppose records from those years weren't great.

It looks like in the Post War period, the murder rate has jumped around a lot and we're sort of in the middle right now.

I'll go ahead and say that I was wrong. Although murder does have a significant affect on U.S. life expectancy, the change in the murder rate since 1920 hasn't lowered life spans.

Modern trauma care turns what would have been murders in the 70s into aggravated assaults. There's a downward trend from medical improvements.

That seems highly relevant when discussing the murder rate in terms of violent crime, but less relevant when discussing the murder rate in terms of life expectancy.

Unless the argument is the life expectancy lost by the increased # of aggravated assaults outweighs the life expectancy gained by the decreased # of outright murders. Though I would not phrase that as life expectancy lost due to increase in murders.

Violence accounts for only a very small share of deaths.

The average murder victim probably loses like 50 years of life compared to the average cancer victim who only loses 5. Very ballpark numbers, but the total number of life years lost to violence is not totally insignificant.

3,389,088 died in the U.S. in 2022 of which 21,156 died by murder.

Applying a 10x factor to murder, we arrive at murders causing something like 6% of the total life years lost. Go ahead and apply a 5x factor instead if that's what you want, but you can't waive away murders.

Drug overdoses are worse though.

The references in Outlive lists it as being from the book "The Rise and Fall of American Growth: The U.S. Standard of Living since the Civil War" by Gordon. You can find it on libgen. It appears to be an updated version of a study from the seventies by John and Sonja McKinlay. Maybe it is this study?

Is Outlive worth reading? I haven't gotten around to it, but I heard Attia say he didn't want himself be part of the book, but the publisher more or less forced him to. I'm a bit fed up with pop science books, but I would probably read this one at some point, if the personal anecdotes aren't egregious and platitudes about the importance of the subject matter are kept to a minimum.

p.s. Thanks for the link!

I think he has a valuable message: If you want to be healthy and active at age 80, you need to be strong, lean, and fit at age 40. There's a strong correlation between VO2 max and muscle mass in middle age and overall life expectancy.

He also has some interesting things to stay about different blood tests that can predict heart attack risk much better than a standard lipid panel. It's something I will be discussing with my doctor as I have hereditary high cholesterol and my dad is on statins.

That said, I'm currently about halfway through and I'm starting to get into skim mode.

He posted a Reddit tier chart about the Dunning-Kruger effect, ignoring the actual study and posting an exaggerated version from Wikipedia. Shame, shame!

He is also extremely hand-wavy at times. For example, he wants people to undergo frequent colonoscopies, despite acknowledging the lack of good evidence in their favor. His response: we need MORE colonoscopies and also ask your doctor if he's ever punctured anyone's colon. Another episode of handwaving occurs when discussing functional stability (for example squat form). He says its very important, but doesn't say anything about how it can be achieved. Apparently his own squat form was fixed by a wündergirl named Beth. According to Beth, there are three types of breathing, all of which are wrong and need to be corrected.

I'm with Hanania here. This book is about 2000% too long. Should be about 20-30 pages.

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