From Dr James Gundlach
What is up? State middle aged death rates when the percent uninsured goes up. How much? In 2023 I estimate an additional 172,538 age 0-64 deaths and that makes up an estimated 22.1% of all the 2023 middle aged deaths. 🧪💡☠️ #Sociology #Population
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| The Mourning After, by Mr Fish |
In the end, the election was about despair. Despair over futures that evaporated with deindustrialization. Despair over the loss of 30 million jobs in mass layoffs. Despair over austerity programs and the funneling of wealth upwards into the hands of rapacious oligarchs. Despair over a liberal class that refuses to acknowledge the suffering it orchestrated under neoliberalism or embrace New Deal type programs that will ameliorate this suffering. Despair over the futile, endless wars, as well as the genocide in Gaza, where generals and politicians are never held accountable. Despair over a democratic system that has been seized by corporate and oligarchic power.
This despair has been played out on the bodies of the disenfranchised through opioid and alcoholism addictions, gambling, mass shootings, suicides — especially among middle-aged white males — morbid obesity and the investment of our emotional and intellectual life in tawdry spectacles and the allure of magical thinking, from the absurd promises of the Christian right to the Oprah-like belief that reality is never an impediment to our desires. These are the pathologies of a deeply diseased culture, what Friedrich Nietzsche calls an aggressive despiritualized nihilism.
Donald Trump is a symptom of our diseased society. He is not its cause. He is what is vomited up out of decay. He expresses a childish yearning to be an omnipotent god. This yearning resonates with Americans who feel they have been treated like human refuse. But the impossibility of being a god, as Ernest Becker writes, leads to its dark alternative -- destroying like a god. This self-immolation is what comes next.
Kamala Harris and the Democratic Party, along with the establishment wing of the Republican Party, which allied itself with Harris, live in their own non-reality-based belief system. Harris, who was anointed by party elites and never received a single primary vote, proudly trumpeted her endorsement by Dick Cheney, a politician who left office with a 13 percent approval rating. The smug, self-righteous “moral” crusade against Trump stokes the national reality television show that has replaced journalism and politics. It reduces a social, economic and political crisis to the personality of Trump. It refuses to confront and name the corporate forces responsible for our failed democracy. It allows Democratic politicians to blithely ignore their base - 77 percent of Democrats and 62 percent of independents support an arms embargo against Israel. The open collusion with corporate oppression and refusal to heed the desires and needs of the electorate neuters the press and Trump critics. These corporate puppets stand for nothing, other than their own advancement. The lies they tell to working men and women, especially with programs such as the North American Free Trade Agreement (NAFTA), do far more damage than any of the lies uttered by Trump.
Oswald Spengler in “The Decline of the West” predicted that, as Western democracies calcified and died, a class of “monied thugs,” people such as Trump, would replace the traditional political elites. Democracy would become a sham. Hatred would be fostered and fed to the masses to encourage them to tear themselves apart.
The American dream has become an American nightmare.
The social bonds, including jobs that gave working Americans a sense of purpose and stability, that gave them meaning and hope, have been sundered. The stagnation of tens of millions of lives, the realization that it will not be better for their children, the predatory nature of our institutions, including education, health care and prisons, have engendered, along with despair, feelings of powerlessness and humiliation. It has bred loneliness, frustration, anger and a sense of worthlessness.
“When life is not worth living, everything becomes a pretext for ridding ourselves of it … ,” Émile Durkheim writes. “There is a collective mood, as there is an individual mood, that inclines nations to sadness. … For individuals are too closely involved in the life of society for it to be sick without their being affected. Its suffering inevitably becomes theirs.”
Decayed societies, where a population is stripped of political, social and economic power, instinctively reach out for cult leaders. I watched this during the breakup of the former Yugoslavia. The cult leader promises a return to a mythical golden age and vows, as Trump does, to crush the forces embodied in demonized groups and individuals that are blamed for their misery. The more outrageous cult leaders become, the more cult leaders flout law and social conventions, the more they gain in popularity. Cult leaders are immune to the norms of established society. This is their appeal. Cult leaders seek total power. Those who follow them grant them this power in the desperate hope that the cult leaders will save them.
All cults are personality cults. Cult leaders are narcissists. They demand obsequious fawning and total obedience. They prize loyalty above competence. They wield absolute control. They do not tolerate criticism. They are deeply insecure, a trait they attempt to cover up with bombastic grandiosity. They are amoral and emotionally and physically abusive. They see those around them as objects to be manipulated for their own empowerment, enjoyment and often sadistic entertainment. All those outside the cult are branded as forces of evil, prompting an epic battle whose natural expression is violence.
We will not convince those who have surrendered their agency to a cult leader and embraced magical thinking through rational argument. We will not coerce them into submission. We will not find salvation for them or ourselves by supporting the Democratic Party. Whole segments of American society are now bent on self-immolation. They despise this world and what it has done to them. Their personal and political behavior is willfully suicidal. They seek to destroy, even if destruction leads to violence and death. They are no longer sustained by the comforting illusion of human progress, losing the only antidote to nihilism.
Pope John Paul II in 1981 issued an encyclical titled “Laborem exercens,” or “Through Work.” He attacked the idea, fundamental to capitalism, that work was merely an exchange of money for labor. Work, he wrote, should not be reduced to the commodification of human beings through wages. Workers were not impersonal instruments to be manipulated like inanimate objects to increase profit. Work was essential to human dignity and self-fulfillment. It gave us a sense of empowerment and identity. It allowed us to build a relationship with society in which we could feel we contributed to social harmony and social cohesion, a relationship in which we had purpose.
The pope castigated unemployment, underemployment, inadequate wages, automation and a lack of job security as violations of human dignity. These conditions, he wrote, were forces that negated self-esteem, personal satisfaction, responsibility and creativity. The exaltation of the machine, he warned, reduced human beings to the status of slaves. He called for full employment, a minimum wage large enough to support a family, the right of a parent to stay home with children, and jobs and a living wage for the disabled. He advocated, in order to sustain strong families, universal health insurance, pensions, accident insurance and work schedules that permitted free time and vacations. He wrote that all workers should have the right to form unions with the ability to strike.
We must invest our energy into organizing mass movements to overthrow the corporate state through sustained acts of mass civil disobedience. This includes the most powerful weapon we possess – the strike. By turning our ire on the corporate state, we name the true sources of power and abuse. We expose the absurdity of blaming our demise on demonized groups such as undocumented workers, Muslims or Blacks. We give people an alternative to a corporate-indentured Democratic Party that cannot be rehabilitated. We make possible the restoration of an open society, one that serves the common good rather than corporate profit. We must demand nothing less than full employment, guaranteed minimum incomes, universal health insurance, free education at all levels, robust protection of the natural world and an end to militarism and imperialism. We must create the possibility for a life of dignity, purpose and self-esteem. If we do not, it will ensure a Christianized fascism and ultimately, with the accelerating ecocide, our obliteration.
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| Source: Mirriam-Webster |
Can you name the top 10 causes of death in America? Without too much trouble, most Americans could likely come up with some of them: cancer, heart disease, stroke, accidents. But it would come as a surprise to many to know that poverty is right up there with these other dreaded scourges – much higher, in fact, than many ills that have inspired investigative committees, major policy investments and sustained attention from the public and private sectors in American life.
A recent study by one of our colleagues shows that cumulative poverty over many years is the fourth leading cause of death in this country. Current poverty – just being poor right now – is seventh on that list, and it alone causes 10 times as many deaths as homicide, close to five times as many deaths as gun violence, and 2.5 times as many deaths as drug overdoses. Cumulative poverty that lingers year after year is associated with approximately 60% more deaths than current poverty, putting only heart disease, cancer and smoking-related deaths ahead in the number of Americans it kills.
But if this is true, why do we hear so much about crime rates, opioids and gun violence in America, but so little from our elected leaders about the crisis of poverty? Why is there no “Surgeon General’s Warning” on low-wage jobs? The relationship of poverty to disease and death is a well-established fact detailed in reports by the World Health Organization, the World Bank and our own government. But we as a people have become numb to the unnecessary deaths that are normalized by the ways we often think and talk about the economy in public life.
Sadly, the United States is the leader in poverty among the rich countries of the world. As of 2019, the US had the worst poverty rate overall (17.8%) and in children specifically (20.9%) among the other 25 wealthy countries that are part of the Organization for Economic Co-operation and Development (OECD).
In addition, poverty affects us all. Seventy-five per cent of all Americans between 20 and 75 years of age will be among the “current” poor or near poverty for at least one year of their lives. Contrary to popular belief, poverty is hardly just the province of the inner city: only 10% of poor Americans live in high-poverty census tracts – most are spread out across the country. They are our neighbors. And although the rates of poverty are highest among communities of color, by sheer volume most people living in poverty are white.
Finally, poverty is a drag on our economy. Child poverty alone in the US presents an $800bn to $1.1tn price tag, based on reductions in adult productivity, criminal justice costs and the costs of healthcare for children from poor families.
But what if we could end poverty in America, the misery and suffering it generates – the 500 deaths a day it causes in this country? Our colleague Matthew Desmond, a sociologist at Princeton University, estimates that we could lift everyone within our borders above the poverty line for less than 1% of our national GDP – $177bn. Ending poverty is within our grasp. It is something we can accomplish together. So what’s stopping us?
As the economists Daron Acemoglu and James Robinson said in their 2012 book Why Nations Fail, “those who have power make choices that create poverty. They get it wrong not by mistake or ignorance but on purpose.” Matthew Desmond elaborates a similar theme in his recent book Poverty, By America: “Tens of millions of Americans do not end up poor by a mistake of history or personal conduct. Poverty persists because some wish and will it to.”
It is difficult to believe that some people are pro-poverty. The incentives for maintaining the status quo, for keeping many Americans poor, rest on the fact that some people find considerable financial benefit from presiding over the misery of others. This is what a young Friedrich Engels – observing the deaths of factory workers, the conditions of the slums and the exploitation of children in Manchester, England in the mid-19th century – called “social murder”. Many were dying, while a few made a killing from their suffering. It was true then, and it is true now.
But this is not our destiny. We can be the generation that abolishes poverty, the country that goes from the bottom of the heap among its peers – whether it’s about poverty, or life expectancy – to the top of it. We can rise to lead and “we the people” of the US can stand up to form a more perfect union, lifting this generation and the generations after it out of poverty, wiping away the deaths being poor causes in this nation.
But this means holding up a mirror to who we are as a country. Those who gain from keeping people in the chains of poverty, condemning them to early death, must be confronted with a movement that names poverty in the richest nation on Earth as a public health crisis, an economic dead weight, a moral abomination and a stain on the republic. When the poor and low-wealth people of this nation link arms to make the moral case for an economy that works for everyone, we have the power to change the conversation about what is possible in Washington and in our statehouses.
The US claims to be a beacon of democracy abroad and a nation committed to justice and general welfare at home. This cannot be true as long as poverty is the fourth leading cause of death in the richest nation in the history of the world. Poor and low-wealth people are fighting for their lives and for the life of our democracy through the Poor People’s Campaign: A National Call for Moral Revival, which worked with members of the US House of Representatives last year to introduce a Third Reconstruction Resolution that outlines policy priorities that can guide legislation to end poverty.
In an echo of the Bible, this movement is saying, “Woe unto those who make unjust laws and rob the poor of their right.” But this prophetic challenge isn’t a condemnation. It is an invitation to life. Together, we can become the land of “liberty and justice for all” that has never yet been. Indeed, people who know that they do not have to accept the death sentence of poverty are leading the way.
[The Rev Dr William J Barber II is founding director of the Yale Center for Public Theology and Public Policy and co-chair of the Poor People’s Campaign: A National Call for Moral Revival
Gregg Gonsalves is associate professor of epidemiology at the Yale School of Public Health]
Over the last 40 years, real wages in the US haven't risen, while real GDP has. All the increase has gone into the pockets of the top 10% and the top 1%. Much the same has happened over the last 10 years in the UK and Australia. Neo-liberalism has failed. Worse: it is literally killing people.
See also Shit life syndrome
From a tweet by Eric Topol
Now at a 25 year low, life expectancy in the US continues to fall. Covid persists as the 3rd leading cause of death and increasing ~20% over 2020
The third graphic is interesting. I'm not sure how that squares with the USA spending a much larger percentage of GDP on health than other countries, with inferior outcomes. Why it's interesting is that the rise in life expectancy in developed countries is so well correlated with the rise in health expenditure.
See my earlier piece Shit-Life Syndrome. |
| Source: The Economist Does not include 2017 & 2018 data. |
The US is the only wealthy country in the world where the life expectancy needle is moving the wrong way.
Between 1959 and 2014, the average length of time that Americans were expected to live was on the rise. Now, for the third year in a row, it's declining, according to a new study published in the Journal of the American Medical Association.
"Americans operate under a lot of misconceptions about how superior we are in many facets of our lives and this is not one of them," the study's lead author Steven Woolf told Business Insider. "We may think we have best medical care in world and highest life expectancy … but that's not the case."
This decline can't be linked to just one ethnicity, gender, or geographic area, either: It originates among an entire age group. People between the ages of 25 and 64 in the US are dying at higher rates, wracked by health problems like opioid addiction, obesity, alcoholic liver disease, and suicide.
Despite having the highest per capita health care spending in the world, Americans are "more likely to die before age 65 than people in other countries," Woolf added. "Their children, too, are less likely to live as long".
Woolf and his co-author Heidi Schoomaker's new study looked at more than 50 years' worth of data on US life expectancy from the US Mortality Database and the US Centres for Disease Control and Prevention's WONDER database.
Results showed that, in the 1970s, the country experienced a rapid and significant jump in life expectancy. But by the 1990s, that increase started to level off. In 2011, US life expectancy plateaued, and three years later it started to drop.
"We've reached the point where we're going into a free fall," Woolf said.
Medical advances, particularly in the realms of cancer treatment and heart health, prompted an almost 10-year increase in the average American's lifespan. Between 1959 and 2013, life expectancy rose from 69.9 years to 78.9 years. Now, however, that average has dropped to 78.6 years.
The news isn't good if you compare it to other countries, either. In 1960, Americans had the highest life expectancy of any country in the world. But in the past couple of years, the US has plummeted to the bottom of the list of countries with a similar GDP and high average income, according to the Kaiser Family Foundation.
In fact, the US is currently ranked in the mid-40s globally in terms of life expectancy, squished between countries like Lebanon, Cuba, and Chile, which have GDPs that fall far short of our own.
This counterintuitive trend – of an affluent, first-world country that spends billions on privatised healthcare losing swaths of their middle-aged working class – could be traced back to one massive elephant in the room.
"It's a quandary of why this is happening when we spend so much on healthcare," Woolf said, adding: "But my betting money is on the economy."
Upticks in suicides, drug overdoses, and alcohol-related diseases "are all symptoms of people struggling in a poor economy who can't afford housing, find consistent jobs," and despair because of it, according to Woolf.
Drug overdose, alcohol abuse, and suicide – referred to by some as "deaths of despair" – appear to be the primary culprits [of the rising mortality rates].
This age group [25 -64] experienced a nearly four-fold increase in fatal drug overdoses between 1999 and 2017.
Suicide rates went up by nearly 40 percent for people between the ages of 25 and 64, and by 56 percent for people ages 55 to 64 during the same time frame. For Americans between the ages of 25 and 34, the rate of alcohol-related disease deaths spiked almost 160 percent, as well.
Obesity-related mortality rates among this age group also went up by 114 percent, and deaths linked to high blood increased by about 80 percent.
"Working-age Americans are more likely to die in the prime of their lives," Woolf said. Between 2010 and 2017, midlife US adults experienced a 6 percent total increase in mortality rate.
"We are seeing social determinants of health shaping well-being and outcomes," Howard Koh, a professor at the Harvard T.H. Chan School of public health who was not involved in the study, told Business Insider.
"Forces like income inequality and unstable employment cause psychological distress and drive conditions by which diseases and deaths occur," he added.
In countries around the world, research has shown that people with lower incomes die sooner than their wealthier counterparts. A 2017 study linked low socioeconomic status to significant reductions in life expectancy.
But what makes the US unique, according to Woolf, is that "poor people in other countries live longer than poor people in our country".
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Britain and America are in the midst of a barely reported public health crisis. They are experiencing not merely a slowdown in [the rise in] life expectancy, which in many other rich countries is continuing to lengthen, but the start of an alarming increase in death rates across all our populations, men and women alike. We are needlessly allowing our people to die early.
In Britain, life expectancy, which increased steadily for a century, slowed dramatically between 2010 and 2016. The rate of increase dropped by 90% for women and 76% for men, to 82.8 years and 79.1 years respectively. Now, death rates among older people have so much increased over the last two years – with expectations that this will continue – that two major insurance companies, Aviva and Legal and General, are releasing hundreds of millions of pounds they had been holding as reserves to pay annuities to pay to shareholders instead. Society, once again, affecting the citadels of high finance.
Trends in the US are more serious and foretell what is likely to happen in Britain without an urgent change in course. Death rates of people in midlife (between 25 and 64) are increasing across the racial and ethnic divide. It has long been known that the mortality rates of midlife American black and Hispanic people have been worse than the non-Hispanic white population, but last week the British Medical Journal published an important study re-examining the trends for all racial groups between 1999 and 2016 .
The malaises that have plagued the black population are extending to the non-Hispanic, midlife white population. As the report states: “All cause mortality increased… among non-Hispanic whites.” Why? “Drug overdoses were the leading cause of increased mortality in midlife, but mortality also increased for alcohol-related conditions, suicides and organ diseases involving multiple body systems” (notably liver, heart diseases and cancers).
US doctors coined a phrase for this condition: “shit-life syndrome”. Poor working-age Americans of all races are locked in a cycle of poverty and neglect, amid wider affluence. They are ill educated and ill trained. The jobs available are drudge work paying the minimum wage, with minimal or no job security. They are trapped in poor neighbourhoods where the prospect of owning a home is a distant dream. There is little social housing, scant income support and contingent access to healthcare. Finding meaning in life is close to impossible; the struggle to survive commands all intellectual and emotional resources. Yet turn on the TV or visit a middle-class shopping mall and a very different and unattainable world presents itself. Knowing that you are valueless, you resort to drugs, antidepressants and booze. You eat junk food and watch your ill-treated body balloon. It is not just poverty, but growing relative poverty in an era of rising inequality, with all its psychological side-effects, that is the killer.
Nearly all indicators of inequality show American income disparities have increased since the late 1970s. The magnitude of change in inequality is sensitive to the particular income measure we use, but essentially all measures imply that income gaps are bigger today than they were three decades ago.
Statisticians analyzing the most comprehensive income measures find that much of the jump in inequality was due to gains at the very top of the distribution. More than three-quarters of the relative income gains enjoyed by Americans in the top fifth of the income distribution were obtained by people in the top 1% of the distribution.
As many observers have noted, the United States has exceptionally wide inequality for a high-income country. It also has relatively low average life expectancy. Among 34 countries in the Organization of Economic Cooperation and Development (OECD), the U.S. ranks 27th in life expectancy at birth. If we limit our comparison to the 21 large OECD countries with high incomes, America ranks dead last. This lowly rank is especially surprising because average income in the U.S. is about 40% higher than it is on average in other OECD countries, and real health spending per person is about 150% higher than it is in the other countries. Of course, wide income disparities in the U.S. mean that low-income Americans have lower incomes than people in comparable positions in the income distributions of many other rich countries.
A recent study of American life expectancy uncovered trends that may be partly traceable to increased income inequality. S. Jay Olshansky and his colleagues found evidence that white men and women who lack high school diplomas have seen a noticeable drop in life expectancy over the past three decades. These groups have struggled as job prospects for less educated workers have dried up. Their declining economic position may be worsening their chances of living a long life.
An older study of changes in life expectancy used Social Security records to determine the relationship between workers’ position in the wage distribution and their mortality rates. Hilary Waldron, a Social Security Administration researcher, estimated mortality rates of white men born between 1912 and 1941 who had earnings between ages 45 and 55. She divided these men according to their average position in the earnings distribution when they were between 45 and 55, and she then determined the effects of their income position on their mortality rates between ages 60 and 89. Between ages 60 and 80 men with a worse earnings position had a higher mortality rate. More disturbingly, the mortality differential between low-earnings and high-earnings men increased substantially over time. The mortality rates of both low-earnings and high-earnings men improved during the period Waldron examined. However, improvements in life span overwhelmingly favored the men at the top of the earnings distribution. Men born in 1912 who had earnings in the top half of the wage distribution lived 1.2 years longer than men born in the same year who had earnings in the bottom half of the earnings distribution. For men born in 1941 the difference in life expectancy soared. Better paid men in the younger birth cohort can expect to live 5.8 years longer than men born in the same year who are in the bottom half of the wage distribution.
