Secular Right | Reality & Reason

Jul/09

28

Socialized medicine, numbers are of the essence?

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I don’t know if there is some context to this Bill O’Reilly assertion that Canadian life expectancy is higher because of fewer people, and so fewer absolute fatalities (e.g., he got turned around on the words?). But it got me wondering, how do Canadian provinces relate to American states in terms of life expectancy at birth? It was easy to find male and female life expectancy online from the US and Canadian Census. Below the fold is a dot chart showing the male life expectancies rank ordered. Additionally, there is table (also sorted by male life expectancy) where I’ve bolded Canadian provinces and American states which border Canada. If readers are interested in demographic correlates of mortality, I recommend Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States.

malelifeexpec

State/Province Life expectancy at birth Male Life expectancy at birth Female
British Columbia 78.0 83.0
Hawaii 77.1 82.5
Ontario 77.0 82.0
Alberta 77.0 82.0
Utah 76.5 80.6
Minnesota 76.5 81.3
Colorado 76.1 80.4
Nova Scotia 76.0 81.0
New Brunswick 76.0 82.0
Quebec 76.0 82.0
Manitoba 76.0 81.0
Saskatchewan 76.0 82.0
New Hampshire 75.9 80.7
Idaho 75.9 80.2
Washington 75.9 80.5
California 75.9 80.6
Vermont 75.8 80.4
North Dakota 75.8 81.7
Iowa 75.8 80.8
Massachusetts 75.8 80.7
Connecticut 75.7 80.8
Nebraska 75.6 80.6
Oregon 75.5 80.0
Rhode Island 75.5 80.3
Wisconsin 75.4 80.5
New York 75.1 80.2
Maine 75.1 80.0
South Dakota 75.0 80.9
Newfoundland and Labrador 75.0 81.0
Prince Edward Island 75.0 82.0
Kansas 74.9 79.8
Wyoming 74.9 79.3
New Jersey 74.8 79.8
Arizona 74.7 80.2
Montana 74.7 80.0
Florida 74.6 80.3
New Mexico 74.4 80.1
Virginia 74.3 79.1
Alaska 74.2 79.1
Texas 74.1 79.2
Pennsylvania 74.0 79.3
Delaware 74.0 78.9
Illinois 73.9 79.2
Michigan 73.9 78.7
Ohio 73.8 78.7
Maryland 73.6 78.8
Indiana 73.4 78.6
Nevada 73.4 78.7
Missouri 73.4 78.7
North Carolina 72.7 78.4
Oklahoma 72.6 77.6
Georgia 72.3 77.8
Kentucky 72.3 77.9
West Virginia 72.3 77.7
Arkansas 72.1 77.9
Tennessee 71.8 77.7
South Carolina 71.6 77.9
Alabama 71.3 77.5
Louisiana 71.2 77.3
Mississippi 70.4 76.7
District of Columbia 68.5 76.1

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11 comments

  • John · July 28, 2009 at 12:37 pm

    Interesting, David Hume. The state/province data indicates a large racial difference in life expectancy. The paper had good numbers, although the conclusions were not always believable. I was struck by the line:

    “Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US…”

    Were they kidding?!

  • Susan · July 28, 2009 at 1:14 pm

    Probably not kidding, John. It really depends on how you choose to define “policies aimed at reducing fundamental socioeconomic inequalities.” By my standards, there are plenty of those policies in place. By the standards of Jeremiah Wright or Henry Louis “Squeaky” Gates, Jr., there are no policies in place for reducing socioeconomic equalities.

  • Author comment by David Hume · July 28, 2009 at 3:32 pm

    correlation != causation tends to go out of the window for “rigorous” scientists when politics comes into the picture :-) correlation for thee, but not for me….

  • Rich Rostrom · July 28, 2009 at 4:33 pm

    O’Reilly’s comment is of course mathematically illiterate.

    However, a straight comparison between U.S. states and Canadian provinces is not valid unless adjusted for the ethnic differences between the various populations. The U.S.’s large black population has bad public health stats. The U.S. also has a large hispanic population, much of which is recent-immigrant – both categories associated with public health problems.

    There is very little health-statistics difference between white-bread Americans and Canadians.

  • Author comment by David Hume · July 28, 2009 at 6:45 pm

    The U.S. also has a large hispanic population, much of which is recent-immigrant – both categories associated with public health problems.

    the immigrant latinos have better health than native born latinos. this is a robust finding, and generally brought up in public health circles because of its counterintuitve nature.

    There is very little health-statistics difference between white-bread Americans and Canadians.

    that’s false. please read the attached paper if you are dubious. there are big differences *among* white americans by region. this is a well known. canadian whites are like new englanders and upper midwesterners, not like southerners. but it does look like canadians do still have a modest advantage over new englanders and upper midwesterners, on average (see the table).

    you should do some digging into the data before assuming and asserting. you can tell there are differences among whites simply by inspection of the list above; arkansas, western virginia, and kentucky don’t have large enough black populations to skew it that much. west virginia doesn’t have a large latino population. do some algebra first, it’s pretty simple (though to be fair, you don’t need to, the paper i linked has demographic breakdowns by region & race).

  • Author comment by David Hume · July 28, 2009 at 7:09 pm

    for the record, white non-hispanic life expec in 2000:
    male – 74.8
    female – 80.1

    hispanic:
    male – 73.7
    female – 79.6

    canada life expec, 2000
    male – 76
    female – 83

    the modest life expec. diff between canada and american whites masks the fact that there’s a relatively large variance in the USA, so that whites who live near canada are basically like canadians, and whites who live far from canada drag the average down.

    cite, cite and cite.

  • Tony · July 29, 2009 at 8:32 am

    The authors of the Eight Americas paper point out the the disparity in death rates is highest for young and middle aged males. In a book called “Health Disparities in the United States,” there is a table that summarizes life expectancy by age and sex for nine industrialized nations. At age 40, life expectancy for Canadian males is 38.9y, and life expectancy for US males is 37.0y, for a difference of 1.9y. At age 60, the difference in Canadian and US male life expectancies is 0.9y, and at age 80, the difference is 0.1y. Among the nine nations, the US ties with Germany for lowest male life expectancy at age 40, but it ranks 3rd (behind Canada and Japan) for male life expectancy at age 80.

    This makes me wonder, how much of the difference in Canadian and US life expectancy is attributable to the fact that the US more than Canada concentrates its health care expenditures on older patients? And is this difference compounded by the fact that the US has a younger population than Canada?

  • Tenrou Ugetsu · July 29, 2009 at 3:15 pm

    When will this country finally learn and socialized health care? Though any socialized public service may lead to poorer service overall (e.g. every government worker I’ve met). With the right safe guards and policy in place, it can work. I’m glad President Obama seems to be taking steps toward that direction.

  • Chris · July 30, 2009 at 1:29 pm

    You have to go almost halfway down the chart (i.e. into the higher-life-expectancy part of the distribution) to find a province of Canada; meanwhile, 3 of the best 5 and 6 of the best 10 are Canadian provinces, despite being numerically outnumbered by U.S. states.

    Demographic quibbles notwithstanding, that’s a pretty stark difference.

  • TangoMan · July 31, 2009 at 5:09 pm

    Here’s a challenge for politicians – put your health where your mouth is. The sad news reported today is that Senator Christopher Dodd has prostate cancer. I would suggest that he arrange to have it treated in Canada or in France, in cooperation with their governments, but to do so anonymously by not playing on his status.

    If politicians believe that socialized medicine doesn’t involve rationing of care or a lowering of quality of care, then Senator Dodd should have nothing to worry about with his health. He can film a documentary which shows how he, playing an ordinary Canadian or French citizen, is processed through a government run health care system. My only suggestion before he embarks on this PR coup is that he shouldn’t read reports like this:

    The U.S. has a five-year survival rate in all the cancers studied of 91.9 per cent, while Europe’s is much lower at 57.1 per cent. However, survival rates within the U.S. can vary.

    In Canada, the five Canadian provinces included in the study had almost identical results.

    “For those five provinces, the survival rate does not differ very greatly from one to the other,” said British cancer researcher Prof. Michel Coleman. “That probably indicates the overall effectiveness of universal health care for setting a high standard.”

    The range of survival rates across the five provinces was quite narrow, from a low of 79.3 per cent in Nova Scotia to a high of 85.4 per cent in British Columbia.

    In the report, data from almost 2 million cancer patients from 31 countries showed that the U.S. has the highest survival rates for breast and prostate cancer, Japan has the highest survival rates for colon and rectal cancers in men and France has the highest survival rates for colon and rectal cancer in women.

    I bolded the assertions that Canadian rates don’t have great variance. If the lower and upper bounds on survivability are 0% and 100%, then I could buy into the notion that a variance of 6.1% is pretty narrow, but if the bound are 60% and 90% then a 6% difference, by my subjective standards, would be something to be concerned about.

  • Polichinello · August 3, 2009 at 10:31 am

    Interesting how narrow the band of variation is once you toss out the outliers, like the South, Hawaii and BC. I don’t think lifespan is much of an argument either way when it comes to this issue.

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