America Fails the Civilization Test - The Atlantic - 0 views
www.theatlantic.com/...673799
civilization test children life expectancy US culture policy history economics
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The true test of a civilization may be the answer to a basic question: Can it keep its children alive?
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For most of recorded history, the answer everywhere was plainly no. Roughly half of all people—tens of billions of us—died before finishing puberty until about the 1700s, when breakthroughs in medicine and hygiene led to tremendous advances in longevity. In Central Europe, for example, the mortality rate for children fell from roughly 50 percent in 1750 to 0.3 percent in 2020. You will not find more unambiguous evidence of human progress.
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ow’s the U.S. doing on the civilization test? When graded on a curve against its peer nations, it is failing. The U.S. mortality rate is much higher, at almost every age, than that of most of Europe, Japan, and Australia.
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compared with the citizens of these nations, American infants are less likely to turn 5, American teenagers are less likely to turn 30, and American 30-somethings are less likely to survive to retirement.
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I called the U.S. the rich death trap of the modern world. The “rich” part is important to observe and hard to overstate. The typical American spends almost 50 percent more each year than the typical Brit, and a trucker in Oklahoma earns more than a doctor in Portugal.
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the typical American is 100 percent more likely to die than the typical Western European at almost every age from birth until retirement.
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magine I offered you a pill and told you that taking this mystery medication would have two effects. First, it would increase your disposable income by almost half. Second, it would double your odds of dying in the next 365 days. To be an average American is to fill a lifetime prescription of that medication and take the pill nightly.
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1.8 figure as “the U.S. death ratio”—the annual mortality rate in the U.S., as a multiple of similarly rich countries.
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By the time an American turns 18, the U.S. death ratio surges to 2.8. By 29, the U.S. death ratio rockets to its peak of 4.22, meaning that the typical American is more than four times more likely to die than the average resident in our basket of high-income nations.
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The average American my age, in his mid-to-late 30s, is roughly six times more likely to die in the next year than his counterpart in Switzerland.
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The average U.S. death ratio stays higher than three for practically the entire period between ages 30 and 50, meaning that the typical middle-aged American is roughly three times more likely to die within the year than his counterpart in Western Europe or Australia.
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America suffers not from a monopoly on despair and aggression, but from an oversupply of instruments of death. We have more drug-overdose deaths than any other high-income country because we have so much more fentanyl, even per capita
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Americans drive more than other countries, leading to our higher-than-average death rate from road accidents
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he argued that Americans’ health (and access to health care) seems to be the most important factor. America’s prevalence of cardiovascular and metabolic disease is so high that it accounts for more of our early mortality than guns, drugs, and cars combined.
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First, American obesity is unusually high, which likely leads to a larger number of early and middle-aged death
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Second, Americans are unusually sedentary. We take at least 30 percent fewer steps a day than people do in Australia, Switzerland, and Japan
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Finally, U.S. access to care is unusually unequal—and our health-care outcomes are unusually tied to income.
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voters and politicians in the U.S. care so much about freedom in that old-fashioned ’Merica-lovin’ kind of way that we’re unwilling to promote public safety if those rules constrict individual choice. That’s how you get a country with infamously laissez-faire firearms laws, more guns than people, lax and poorly enforced driving laws, and a conservative movement that has repeatedly tried to block, overturn, or limit the expansion of universal health insurance on the grounds that it impedes consumer choice.
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Among the rich, this hyper-individualistic mindset can manifest as a smash-and-grab attitude toward life, with surprising consequences for the less fortunate. For example, childhood obesity is on the rise at the same time that youth-sports participation is in decline among low-income kids
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What seems to be happening at the national level is that rich families, seeking to burnish their child’s résumé for college, are pulling their kids out of local leagues so that they can participate in prestigious pay-to-play travel teams. At scale, these decisions devastate the local youth-sports leagues for the benefit of increasing by half a percentage point the odds of a wealthy kid getting into an Ivy League school.
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The problem with the Freedom and Individualism Theory of Everything is that, in many cases, America’s problem isn’t freedom-worship, but actually something quite like its opposite: overregulation
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In medicine, excessive regulation and risk aversion on the part of the FDA and Institutional Review Boards have very likely slowed the development and adoption of new lifesaving treatments.
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Are Americans unusually sedentary because they love freedom so very much? It’s possible, I guess. But the more likely explanation is that restrictive housing policies have made it too hard for middle- and low-income families to live near downtown business districts, which forces many of them to drive more than they would like, thus reducing everyday walking and exercise.
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America is caught in a lurch between oversight and overkill, sometimes promoting individual freedom, with luridly fatal consequences, and sometimes blocking policies and products, with subtly fatal consequences.