New research published in JAMA last week examined how big a difference earning more money makes in life expectancy, as well as how this changes by geographic location across the United States. Researchers collected tax records from 1.4 billion individuals from 1999 to 2014 aged 40 to 76. Of these, around 4 million men died, compared to 2.7 million women (mortality rates of 596.3 and 375.1 per 100 000 respectively). They examined these data to look at what predicted life expectancy at age 40, after adjusting for race and ethnicity.
One of the most important issues facing public health today is obesity. Worldwide, approximately 30% of adults are obese, and costs around $2 trillion annually. A health concern with complex determinants and many intertwined causes, there’s no single magic bullet solution to the rising prevalence of obesity. A new report by the McKinsey Global Institute studied 74 interventions to see what was effective. They studied 74 interventions that target obesity, which range from subsidizing school meals, adding calorie and nutrition labels, as well as restrictions on advertising high-calorie food and drinks.
The report covers areas one would expect, such as energy balance and changing dietary and physical activity behaviours. While these issues are important and do require study, the authors also looked at the environment and how that impacts obesity. There’s a lot of literature that shows that your environment plays a large role in obesity, and simply telling someone to “eat less and move more” is an ineffective strategy at best, and one that further stigmatizes at worst. It’s something we’ve discussed in relation to poverty, and illustrated with the retailer IKEA.
I imagine most of my readers have never heard of Dauphin, Manitoba. A small, farming community in Canada, Dauphin is a town that was part of an experiment back in the 1970s. The “mincome” project was launched in 1974, and offered everyone a minimum income. Unfortunately, the project was shut down in 1979 with a change in the government, and so the effects weren’t long term enough. The purpose of the mincome project was to see what would happen if a “top up” was offered to everyone. Dr. Evelyn Forget has been studying records from those years, and following up on people to see how it impacted their life. Would people stop working? Would there be higher rates of employment? How would people respond?
The best findings in science aren’t the ones that make you go “cool!”, they’re the ones that make you go “huh?”
A study in the Proceedings of the National Academy of Sciences reported a strange and unexpected finding. By looking at data from the CDC, researchers were able to evaluate mortality rates per 100,000 individuals, and compare this between ethnic groups. While there’s generally been a decrease in all-cause mortality, they found an increase in the mortality of middle-aged white non-Hispanic men and women in the US between 1999 and 2013 (solid red line below). This finding was unique to middle-aged White Americans – data from other countries also reported a drop in death rates.
So what makes White, middle-aged, non-Hispanic Whites unique?
1976 was a busy year in Philadelphia. They were holding the Bicentennial celebration, commemorating the two-hundredth anniversary of the Declaration of Independence. As part of the year-long festivities, the city had become a hub for events, hosting the championship game of the NCAA Final Four, as well as the all-star games for baseball, basketball and hockey. On the 4th of July, around 2 million people descended on the city for the celebrations, which featured a five hour parade with over 40,000 marchers and floats from every state. But it was to be a small, 2000 person event that would go down in history.
Image courtesy Flickr user DaveZ
When I was 6 or 7, my uncle gave me a book of Aesop’s Fables. I liked their imagery, and the idea of talking animals with anthropomorphized human traits appealed to my child sensibilities. Recent news about Turing Pharmaceuticals raising the price of Duraprim, a potentially life-saving drug, from a paltry $13.50 to an astonishing $750 brought one of these fables vividly back to mind: the story of the Scorpion and the Frog.
I’m back! I took an extended hiatus from the blog while I finished up my PhD, but, at the end of March, I successfully defended my PhD, and after making the changes suggested by the examining committee I submitted in the middle of April and started working. Those of you following along on Twitter will recognize the change in my Twitter handle from @MrEpid to @DrEpid; those of you who know me in real life will have heard me go on about it for the last few months as I prepare. For those wondering, I will eventually change the URL of my blog as well so they all match 🙂
For those unaware of the process, the PhD defence is an oral exam. At Queen’s (the process may differ at other universities), you submit your thesis, and then have to wait (a minimum) of 25 business days for the exam. The exam consists of 4 examiners; an examiner external to your university, one external to your department, one from your department, and the final examiner is your department head (or a department head delegate). You also have a chair from another department from your institution, as well as your supervisors there. After you give a 15-20 minute presentation, the examiners ask their questions. Typically, there are two rounds of questions, after which you leave, and the examiners deliberate. You’re then called back in, and they let you know their decision, and any changes you have to make before submitting your final thesis. My examiners were amazing, and while the questions were tough, they were fair. I actually really enjoyed the discussion I had with my examiners during my defence, and they ranged from the details of my analysis, to the concept of “ethnic identity” and what it actually means in terms of my research.
I want to thank everyone for their support over the past 4 and a bit years. As per prior precedents (Janiszewski, 2010; Saunders, 2013), I will be copy-pasting the acknowledgements section from my thesis below. I’d also like to thank the PLOS Blogs network, especially Victoria Costello for giving me the opportunity to join the network, and Travis and Peter for their support and encouragement when I started blogging. In addition, thank you to my co-authors Beth and Lindsay here who picked up the slack when I took a hiatus this year to focus on finishing up.
Finally, a special thank you to all the readers of the blog. It’s been a privilege to write for you, and it means a lot when you tell me how much you enjoy my work. Thank you, and I’m looking forward to getting back into writing more regularly.
I would like to start by thanking my supervisors, Dr. Will Pickett and Dr. Ian Janssen. I am grateful to have had the opportunity to learn from you both, and appreciate your support through my PhD journey. Your honesty, integrity, and willingness to always provide me feedback and support was always appreciated. Will, I look forward to our teams meeting in the playoffs again (hopefully with better results for me this time!)
I would also like to thank those in the Department of Community Health and Epidemiology/Public Health Sciences and the Clinical Research Centre for their support, with a special thank you to Lee Watkins and Deb Emerton for their help. Thank you also to the Clinical Research Centre Student Group. Your antics, customized t-shirts, snack breaks, and random dance parties always kept me entertained, and it’s been a pleasure working with all of you. The Thought Tub is richer for having you.
This work would not have been possible without the financial support of Queen’s University, the Ministry of Colleges, Training and Universities Ontario Graduate Scholarship, and the Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarships Doctoral Award.
I would also like to thank my friends and colleagues, especially Anne, Kim, Raymond, Sarah, Alison, Hidé and Marion who have been unwavering in their support over the years. I also owe a special debt of gratitude to Rim, Lydia, Liam, Hoefel, Brian and the Gong Show/Danger Zone family for ensuring that I always get some physical activity, and that yes, I do even lift.
Finally, thank you to my family. Your love, support, guidance, and willingness to listen to me at all times of the day have allowed me to complete this project. Thank you.