Might American deaths of despair spread to other developed countries? On the one hand, perhaps not. Parsing the data shows just how uniquely bleak the situation is in the United States. When it comes to deaths of despair, the United States is hopefully less a bellwether than a warning, an example for the rest of the world of what to avoid. On the other hand, there are genuine reasons for concern. Already, deaths from drug overdose, alcohol, and suicide are on the rise in Australia, Canada, Ireland, and the United Kingdom. Although those countries have better health-care systems, stronger safety nets, and better control of opioids than the United States, their less educated citizens also face the relentless threats of globalization, outsourcing, and automation that erode working-class ways of life throughout the West and have helped fuel the crisis of deaths of despair in the United States.
Inequality in Life Expectancies Across Europe by Radim Bohacek, Jesus Bueren, Laura Crespo, Pedro Mira, Josep Pijoan-Mas :: SSRNOctober 17, 2018
We use harmonized household panel data from 10 European countries (SHARE) plus US (HRS) and England (ELSA) to provide novel and comparable measurements of education and gender differences in life expectancy and disability-free life expectancy, as well as in the underlying multi-state life tables. Common across countries we find significant interactions between socio-economic status and gender: (a) the education advantage in life expectancy is larger for males, (b) the female advantage in life expectancy is larger among the low educated, (c) education reduces disability years and this added advantage is larger for females, and (d) females suffer more disability years but this disadvantage is hardly present for the high educated. Common across countries we also find that the education advantage in disability years is due to better health transitions by the highly-educated, and that the female disadvantage in disability years is due to better survival in ill-health by females. Looking at the differences across countries, we find that inequalities are largest in Eastern Europe, lowest in Scandinavia, and that the education gradient in life expectancy for males correlates positively with income inequality and negatively with public health spending across countries.
Rich Man, Poor Man: The Policy Implications of Canadians Living Longer by Kevin S. Milligan, Tammy Schirle :: SSRNSeptember 16, 2018
A longevity gap between rich and poor has persisted over the years in Canada with significant policy implications, according to a new report from the C.D. Howe Institute. In “Rich Man, Poor Man: The Policy Implications of Canadians Living Longer” – the first study of long-term changes in longevity across earnings groups in Canada – authors Kevin Milligan and Tammy Schirle provide new evidence on the incomes and life expectancy of Canadians.
The Canary in the Coal Mine: Continence Care for People with Dementia in Acute Hospital Wards as a Crisis of DehumanizationMay 5, 2018
Continence is a key moment of care that can tell us about the wider care of people living with dementia within acute hospital wards. The spotlight is currently on the quality of hospital care of older people across the UK, yet concerns persist about their poor treatment, neglect, abuse, and discrimination within this setting. Thus, within hospitals, the care of people living with dementia is both a welfare issue and a human rights issue. The challenge of continence care for people living with dementia can be seen as the ‘canary in the coal mine’ for the unravelling of dignity within the acute setting. This paper draws on an ethnographic study within five hospitals in England and Wales, selected to represent a range of hospital types, geographies and socio‐economic catchments. Observational fieldwork was carried out over 154 days in acute hospitals known to admit large numbers of people living with dementia. This paper starts to fill the gap between theory and data by providing an in‐depth ethnographic analysis examining the ways in which treatment as a person is negotiated, achieved or threatened. We examine how the twin assaults on agency of a diagnosis of dementia and of incontinence threaten personhood. The acute threats to this patient group may then act to magnify perils to treatment as a person. Our findings suggest that personal dignity and the social construction of moral personhood are both threatened and maintained in such a setting. We show how empirical ethnographic data can lend weight to, and add detail to, theoretical accounts of moral personhood and dignity.
Preliminary figures show faster growth in the amounts governments are budgeting for healthcare over the past three years, according to a new report from the C.D. Howe Institute. In “Healthcare Costs in Canada: Stopping Bad News Getting Worse,” author William B.P. Robson warns that the preliminary figures likely understate the acceleration, since later figures typically reveal that provinces and territories have overshot their budget targets.
A study by the Fraser Institute titled The Effect of Wait Times on Mortality in Canada estimated that “increases in wait times for medically necessary care in Canada between 1993 and 2009 may have resulted in between 25,456 and 63,090 (with a middle value of 44,273) additional deaths among females.” Adjusting for the difference in populations (the US has about 9 times as many people), that middle value inflates to an estimated 400,000 additional deaths among females over a 16 year period. This translates to an estimated 25,000 additional female deaths each year if the American system were to suffer from increased mortality similar to that experienced in Canada due to increases in wait times.
The Declaration of Independence states that all people are endowed with certain unalienable rights, and that among these is the pursuit of happiness. But is happiness available equally to everyone in America today? How about elsewhere in the world? Carol Graham draws on cutting-edge research linking income inequality with well-being to show how the widening prosperity gap has led to rising inequality in people’s beliefs, hopes, and aspirations.
For the United States and other developed countries, the high costs of being poor are most evident not in material deprivation but rather in stress, insecurity, and lack of hope. The result is an optimism gap between rich and poor that, if left unchecked, could lead to an increasingly divided society. Graham reveals how people who do not believe in their own futures are unlikely to invest in them, and how the consequences can range from job instability and poor education to greater mortality rates, failed marriages, and higher rates of incarceration. She describes how the optimism gap is reflected in the very words people use—the wealthy use words that reflect knowledge acquisition and healthy behaviors, while the words of the poor reflect desperation, short-term outlooks, and patchwork solutions. She also explains why the least optimistic people in America are poor whites, not poor blacks or Hispanics.
Happiness for All? highlights the importance of well-being measures in identifying and monitoring trends in life satisfaction and optimism—and misery and despair—and demonstrates how hope and happiness can lead to improved economic outcomes.