It's an unnecessarily inflammatory title. It seems to imply that we were making progress until those damn millennials screwed it up and undid it. Also "undid" seems to imply some deliberate action.
Also from the article.
"Yancy sees three explanations for higher death rates from heart failure: First, the persistence of risk factors and the necessity to intervene there. “That’s actionable,” he said. Second, the persistence of health inequities. “That is theoretically actionable, but it will require as much public policy as it will require medical therapeutics and lifestyle change.” Third is the outsized influence of Covid-19, a phenomenon he said we have yet to understand."
So why are risk factors and interventions "actionable" but health inequities only "theoretically actionable"? There's also a direct connection and large overlap between health inequities and lack of interventions so the first and second are almost the same thing. The influence of covid-19 was the most interesting but they just shrugged and said, "We don't really know much bout that".
What's hard to understand here? Older generations are showering themselves with money to wash away their problems while the younger generation is poor and suffer from unaddressed health issues.
What's the reason for Hispanic being much better than Black and White? Is it a more relaxed lifestyle? Maybe not, as "Non-Hispanic Other" would probably indicate Asians so it's hard for me to grasp the reason for such a large difference.
Millennials are also dying of cancer at increased rates compared to previous generations. I think obesity is the most obvious suspect, but one does wonder about environmental issues as well.
Though the article (and one of the comments here) is suggesting Covid could be the source, I don't think we should discount the impact of simple lockdowns and work from home could have on exercise rates, and potentially diet as well.
Of course, Covid itself also increased mortality in an already vulnerable population.
Basically, we need more data past 2021 to understand the trend.
There's a jump in Covid times but you can see on the graph that it started around 2011, which is about the same time US life expectancy started stagnating. It's interesting that Australia has a life expectancy of 83 years, 7 years more than America (before Covid this was 4 years, and I expect America to bounce back up because it affected elderly people more).
Australians are only 4% less obese and 4% less overweight than Americans. However the percentage of Australians that are morbidly obese (BMI over 35) is 9.4%, and for Americans that's 18% - so the obese people in America are more likely to be really obese. Alternatively it could be to do with Americans being less likely to go to the doctor or have operations done due to higher healthcare costs.
I live in Australia!! Though I'm from Canada originally.
When I first started travelling to Australia in 2000, I was amazed by how small all the food was. Plates where tiny, drinks were 1/3 the size of North American (except beer).
Australia has caught up, and serving sizes have increased to near North American sizes. I wonder what affect this will have on Australian life expectancy in the next decade.
Commuting has long been known to be detrimental to health.
Exercise may have ticked up since walking became much more common. People were “locked down” at least in the US for like a bad winter season.
Maybe diet was a problem (too much sourdough carbs)
But if it’s not COVID, I would look at isolation. Perhaps the young deaths were especially isolated, and we have all suffered from the epidemic of loneliness over the last half decade.
Heart failure is not the same as coronary artery disease (I.e. what people typically think of when they think of people who get heart attacks). While it can be related.
Hypertension, diabetes, etc can all contribute to heart failure.
What do you mean? Are we talking about conspiracies where all branches of government, clinicians and pharmaceutical companies all agreed to bury the truth?
Yes, 100s of billions of dollars were at risk on that vaccine. Kickbacks all over the place to the politicians to make sure everyone got it as many times as possible.
Never mind, there were cheap and effective drugs available that were more effective anyway, but emergency approval for a vaccine required that there was no alternatives available. Hence The demonization of anything other than the vaccine.
People keep saying that about more effective drugs but treating viruses is incredibly hard, and non-specific. Which drugs are you talking about? Ivermectin, mefloquine?
there is good evidence that Fluvoxamine works (https://pubmed.ncbi.nlm.nih.gov/34717820/) but it was never approved for use by the FDA who prefers approving drugs that cost an arm and a leg with very little proof that they do anything
That paper says nothing about fluvoxamine's effect on outpatients and doesn't compare its efficacy in terms of viral load to things known to directly impact it such as antivirals and vaccines. I'm also not 100% sure how to read those graphs to be honest but at one point being vaccinated imbued you with 99.99% chance of infection without hospitalization.
I'm not saying fluvoxamine is bad or anything. By all means use it if you lack access to the vaccine. The FDA isn't dictating what Brazil can do. The point of the vaccine was to get us to a place where we can go back to our normal lives while avoiding the usual catastrophic circumstances that accompany a pandemic.
Most people play their role in this sort of thing without being clued into any sort of explicit conspiracy. For example, my friend's PCP who attributed his newfound cardiac issues in his mid 30s to a mild COVID infection, and not the 3 Moderna injections he had had before that. No report, nothing to investigate or attribute. There are countless stories of people who suffered severe adverse effects in close proximity to a vaccine dose being similarly shrugged off as hysterical by their doctors.
I’m fairly confused by some comments here claiming Covid or vaccines were the cause as the article clearly points out the uptick in deaths started in 2012.
I tend to think it might be the uptick in use of amphetamines. Millineials and late genx were the first to use them in wide scale with a 2.5 increase and a second derivative maxima in 2012, the same time heart failures began dramatically increasing.
The increase from 2019-2021 (+2 years) was higher than the increase from 2012-2019 (+7 years). I wouldn't want to make any specific claims about the cause, but clearly the pandemic or the response to the pandemic was involved somehow.
Not necessarily. The CDC reported a sharp increase of stimulant prescriptions at the same time. Adjusted for population it’s not as dramatic as 2012 but still. Amphetamines are incredibly dangerous and cause heart failure and were being prescribed at an alarming rate until the last year.
Amphetamine usage steadily increased over decades while heart failure rates were decreasing. The article itself suggests that maybe opioid overdoses are being marked as heart failure rather than cardiac arrest which would make way more sense considering how relatively rare amphetamine overdoses are.
Also from the article.
"Yancy sees three explanations for higher death rates from heart failure: First, the persistence of risk factors and the necessity to intervene there. “That’s actionable,” he said. Second, the persistence of health inequities. “That is theoretically actionable, but it will require as much public policy as it will require medical therapeutics and lifestyle change.” Third is the outsized influence of Covid-19, a phenomenon he said we have yet to understand."
So why are risk factors and interventions "actionable" but health inequities only "theoretically actionable"? There's also a direct connection and large overlap between health inequities and lack of interventions so the first and second are almost the same thing. The influence of covid-19 was the most interesting but they just shrugged and said, "We don't really know much bout that".
What's hard to understand here? Older generations are showering themselves with money to wash away their problems while the younger generation is poor and suffer from unaddressed health issues.
https://cdn.jamanetwork.com/ama/content_public/journal/cardi...
[1] https://jamanetwork.com/journals/jamacardiology/fullarticle/...
Of course, Covid itself also increased mortality in an already vulnerable population.
Basically, we need more data past 2021 to understand the trend.
Australians are only 4% less obese and 4% less overweight than Americans. However the percentage of Australians that are morbidly obese (BMI over 35) is 9.4%, and for Americans that's 18% - so the obese people in America are more likely to be really obese. Alternatively it could be to do with Americans being less likely to go to the doctor or have operations done due to higher healthcare costs.
When I first started travelling to Australia in 2000, I was amazed by how small all the food was. Plates where tiny, drinks were 1/3 the size of North American (except beer).
Australia has caught up, and serving sizes have increased to near North American sizes. I wonder what affect this will have on Australian life expectancy in the next decade.
Exercise may have ticked up since walking became much more common. People were “locked down” at least in the US for like a bad winter season.
Maybe diet was a problem (too much sourdough carbs)
But if it’s not COVID, I would look at isolation. Perhaps the young deaths were especially isolated, and we have all suffered from the epidemic of loneliness over the last half decade.
Commuting that isn't walking/biking.*
Heart failure is exceedingly rare.
Heart failure is not the same as coronary artery disease (I.e. what people typically think of when they think of people who get heart attacks). While it can be related.
Hypertension, diabetes, etc can all contribute to heart failure.
Never mind, there were cheap and effective drugs available that were more effective anyway, but emergency approval for a vaccine required that there was no alternatives available. Hence The demonization of anything other than the vaccine.
I'm not saying fluvoxamine is bad or anything. By all means use it if you lack access to the vaccine. The FDA isn't dictating what Brazil can do. The point of the vaccine was to get us to a place where we can go back to our normal lives while avoiding the usual catastrophic circumstances that accompany a pandemic.
I tend to think it might be the uptick in use of amphetamines. Millineials and late genx were the first to use them in wide scale with a 2.5 increase and a second derivative maxima in 2012, the same time heart failures began dramatically increasing.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/
https://www.cdc.gov/mmwr/volumes/72/wr/mm7213a1.htm
I don’t want to put words in your mouth, I’d like for you to expand on your two sentences.
There are lots of analogs. At a population scale it seems reasonable.