Thursday, June 16, 2011

Depressing Health Facts

Using data from the U.S. Bureau of Justice Statistics and Census Bureau, I estimate death rates of working-age prisoners and nonprisoners by sex and race. Incarceration was more detrimental to females in comparison to their male counterparts in the period covered by this study. White male prisoners had higher death rates than white males who were not in prison. Black male prisoners, however, consistently exhibited lower death rates than black male nonprisoners did. Additionally, the findings indicate that while the relative difference in mortality levels of white and black males was quite high outside of prison, it essentially disappeared in prison. Notably, removing deaths caused by firearms and motor vehicles in the nonprison population accounted for some of the mortality differential between black prisoners and nonprisoners. The death rates of the other groups analyzed suggest that prison is an unhealthy environment; yet, prison appears to be a healthier place than the typical environment of the nonincarcerated black male population. These findings suggest that firearms and motor vehicle accidents do not sufficiently explain the higher death rates of black males, and they indicate that a lack of basic healthcare may be implicated in the death rates of black males not incarcerated.

emphasis mine

Source (You may not be able to read the paper without access from a university library.)

So basically, this study says that being locked in a cage with people selected for their violent and antisocial tendencies is a healthier environment than black men normally live in, and that remains true even if you ignore deaths from cars and guns. I have skimmed the paper and it looks like they used decent methodology.

There are a lot of ways you could spin this. It could be due to a better diet and increased access to health care, or it could be due to controlling dangerous actions and habits, or maybe a combination of both. Nobody is going to claim that quality of life is higher in prison, but it is kind of disheartening to see data showing that, for a segment of the population, having the government lock you in a cage and manage your life (badly) results in less mortality than living on your own in our society. No matter if you blame society or the individuals involved, something is seriously wrong here.

The second link is a newspaper article about life expectancy: 

Women in large swaths of the U.S. are dying younger than they were a generation ago, reversing nearly a century of progress in public health
In some parts of the United States, men and women are dying younger on average than their counterparts in nations such as Syria, Panama and Vietnam.
Communities with large immigrant populations — Southern California, for example — fared considerably better than average despite relatively high poverty rates. The worst-performing counties were clustered primarily in Appalachia, the Deep South and the lower Midwest. In those places, women died as much as a year younger in 2007 than women did a decade earlier. Life expectancy for women slipped 2 1/2 years in Madison County, Miss., which recorded the biggest regression.

Again, you have the same debate over social causes versus individual responsibility, but it is clear that something is very wrong. There are pockets of people in our country that are regressing in the most basic measures of well-being.

Just like with prison, there is a lot more to your overall quality of life than your mortality rate. Most people would probably think that living in the modern world and dying at 70 is better than living a hundred years ago and dying at 75, just like they would prefer to not be in prison. But mortality is related to health, and your health has a huge impact on your quality of life.

This is a big problem. Something is missing. When analyzing problems like this, the key is to try to find the relevant scarcity, to figure out what is lacking so you can provide it.  

Living a healthy life requires both knowledge and willpower. The two are substitutes. For example, the more you know about cooking, the less willpower you need to eat healthy, because you know how to cook healthy food that tastes really good. Giving people more knowledge is something most people agree on, but the problem is that it is often hard and expensive to do so.

One thing that might help is to provide people with 'artificial willpower' by making systems that allow you to make and enforce commitments. People should be able to tell their credit card companies and grocery stores to refuse to process any transaction involving junk food. I have talked about this before. 

Hopefully in the future we will all have robot butlers to do our shopping for us. They can be our commitment mechanisms; we can tell them to get healthy food and not buy bad things, and we will not go in stores and be confronted with impulse purchases.

No comments: