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by Legend2440 21 days ago
Not car accidents; obesity from lack of exercise.

40% of Americans are obese and 75% are overweight. This is largely outside of the control of the medical system, but has a significant impact on mortality and life expectancy.
2 comments
t0mpr1c3 21 days ago
> This is largely outside of the control of the medical system

I assure you that preventative medicine does exist, even in the USA. Moreover, healthcare interventions for people with "lifestyle" diseases such as obesity have been extremely effective in reducing mortality from downstream causes such cardiovascular disease (e.g. statins).

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Legend2440 21 days ago
Statins help a bit (and are widely prescribed in the US) but they don't fix the problem.

Diet and exercise are huge health variables that doctors don't really have the tools to do anything about.

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t0mpr1c3 21 days ago
The problem we are discussing here is mortality, and statins definitely have an effect on mortality.

Obesity can be prevented, can be treated, and its effects on health can be managed. We are actually living through something of a miracle in the treatment of lifestyle diseases. For example, the proportion of total deaths among adults with diabetes from vascular causes (heart disease) declined from 48% in 1988–94 to 34% in 2010–15 (https://sci-hub.st/10.1016/S0140-6736(18)30314-3).

The USA is not some kind of global outlier with a uniquely unhealthy population. The problem is *very obviously* something to do with how healthcare is provided here.

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Legend2440 21 days ago
>The USA is not some kind of outlier with a uniquely unhealthy population.

It is, actually. Our obesity rates are the highest in the world at 41%. This is nearly double many European countries, and five times higher than Japan or South Korea. Only a handful of tiny Polynesian islands have us beat.

Better treatments for diabetes are great, but what's even better is not getting diabetes at all by losing weight.

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t0mpr1c3 20 days ago
That's not accurate (in terms of obesity rates, USA ranks #18; Egypt is #17) and does not explain the lower life expectancy in the USA.
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BeetleB 21 days ago
As a sibling comment pointed out, the medical community consider prevention part of the medical system. It took me a while to understand what I thought was some weird (and potentially intrusive[1]) behavior of some doctors/clinics that they indeed do feel it is within their purview.

Not just discussions with a patient, but advising the government, pushing for regulation on things related to obesity, working with schools, etc.

Arguably, the problem in the US isn't that these are outside the control of the medical system, but that most Americans believe they should be outside the control of the medical system.

In (some) other countries, your comment would be a real "WTF?"

[1] Throwing in questions like "Is there a firearm in your house?" and "Is there a swimming pool in your house" intermixed with "normal" medical questions.

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