Comment by photonthug
14 hours ago
Kind of a tangent but I think a big part of the explanation for declining life expectancy is hiding here in plain sight.
Since everyone knows smoking is bad for a long time now, we’re going to eventually need to categorize stuff like lung-cancer as a death of despair, similar to other deaths caused by alcoholism, opioids, or suicide.
A lot of people who otherwise might quit smoking are probably looking at impossible dreams of home ownership or retirement, and thinking consciously or unconsciously that there is more dignity in a death at 50-60ish than one at 80ish when you’re unemployable and the thin promises of social safety nets have fallen through.
Smoking (or other high risk activities) might be a dirty habit but it’s still more socially acceptable than suicide.
That's a bleak view. I doubt a substantial percentage of smokers are smoking specifically to die sooner.
Most of them are smoking primarily because they're addicted.
A few of them actually like smoking.
Dying sooner is certainly not why they started.. rather the bleakness of outlook is a (fairly rational) reason why they don’t quit.
If obesity is supposed to be the other main candidate for why life expectancy is down, you can do a similar analysis there. Is life really good enough to prolong or attempt to improve for people that are in at-risk categories? That’s the question people are looking at when they choose to move towards or away from self-care. For someone who makes minimum wage and already has to choose between paying for a date or paying for rent, it makes less sense for them to care much about losing weight, because it makes a bad life longer but won’t help their love life.
This is how practically all population-level analysis of health is just economics in disguise, even without directly looking at costs of medicine/services