I live in the country with one of the longest lifespans and visit others regularly. One thing they all have in common is a very low level of obesity. The citizens also tend to be shorter and do a lot more walking. Also the diet is quite healthy with a lot of fresh food. There’s a reason for their long longevity.
Other positives of long lived countries (primarily Hong Kong and Japan) - very low crime and very few deaths from crime as well as less stress and anxiety tied to personal safety, very few (almost none) traffic fatalities. These do factor into lifespans.
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This explains a lot about Hong Kong’s superior life expectancy. I’d probably say the infant mortality rate is a big factor. That homicide rate is pretty amazing too.
And they are the world’s highest consumers of meat:
In fact, Hong Kong’s per capita meat consumption is the highest in the world [11]
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JKPrime
#66
Indeed infant mortality contributes partially to a shorter lifespan (~1.5 years) in the us. Just looking at these 3 datapoints one could think that more medicine spending correlates to a shorter lifespan 
? More likely it is a high level of stress and obesity though.
So my steaks are okay?
I would also think, but I don’t know, that there is not much physical exercise in Hong Kong other than walking or climbing stairs.
“Narrowly beating residents of Japan and other “blue zones” such as Italy, men in Hong Kong are living, on average, up to 81.3 years and women even longer, 87.3 years, as of 2016. “Over the last few decades, (Hong Kong) has caught up in a big way,” said Dr. Timothy Kwok, professor of geriatric medicine at the Chinese University of Hong Kong.”
“Hong Kong has the highest per capita meat consumption in the world. According to a 2018 study, Hong Kong consumes an average of 664g of meat per day, which is equivalent to two 10-oz steaks.”
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I don’t think a giant aggregated number like “life expectancy for 330 million people” has any relevance for the individual. Either you are already doing the things that will promote long, healthy living, or you aren’t. If everyone else is dying because they are fat sedentary smokers, that doesn’t mean you have to.
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cl-user
#69
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arugula
#70
Maybe not. Meat consumption started skyrocketing in 2003.
https://ecyy.medium.com/meat-consumption-growth-in-hong-kong-is-alarming-872e46bf40ca
It’s mainly young people emulating/surpassing Western standards behind this rise. The young people do have health issues as they consume ever-richer diets while it’s the older, longer-lived folks who tend to eat more modestly are driving the longevity trend.
There’s going to be a time lag of decades before we see life expectancies drop accordingly, just as they did in Okinawa.
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I love that map. Especially the “left coast” 
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Two things here. First, any factor that affects life expectancy has less impact as one ages, both because of sheer math (a death at age 10 has a much larger impact on total or remaining life expectancy than a death at age 60) and because intrinsic biological aging processes increasingly become dominant over modifiable risk factors. 73% of your risk of a heart attack in the next 5 years is determined by your age, with LDL-c/apoB, blood pressure, smoking, etc. taking up the rest of the gap.
Second, @RapAdmin posted an iEconomist analysis of many of the factors contributing to low life expectancy in the US vs. other wealthy countries: drug and alcohol overdoses, homicides, suicides, and traffic accidents explain the great majority of it:
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JKPrime
#73
My hypothesis is that the shorter lifespan in the us is mainly due to a lifestyle. Car bound culture. people always in rush. They will fight to get a car parked as close as they can to the store entrance so that they don’t have to walk far… so stress at work, stress from driving and no walking. eating even when not hungry as the food is cheap, accessible. Eating processed salty and sweet food as the taste for natural foods is never developed. In summary people are victims of the system and it is really not their fault. That’s all. No amount of intervention based medicine will matter much at this point as evidenced by a poor ROI of medical healthcare in the us.
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arugula
#74
I don’t agree. Everyone has a choice. One can participate in the status quo or not.
I saw what was happening in the 70s and 80s. All that driving seemed insane–insanely wasteful and insanely unhealthy as well as depressing to me. What people ate–I thought, “How is it possible that everyone isn’t obese?”-- but that happened with time.
I foresaw all the consequences and chose a different life for myself.
I bike to work. I live in a walkable neighborhood. My meals are mainly vegetables. I’ll admit to taking the car once a week, but I could (and have) lived without it.
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The “system” certainly isn’t helping make it easier for people…
WASHINGTON — There’s a panel of 20 nutrition experts that has outsized influence on the American diet — and the food industry has worked hard to get friendly researchers into the group, new documents obtained by STAT show.
The National Potato Council, for example, nominated one of the researchers behind an industry-funded study showing eating french fries each day doesn’t result in more weight gain than eating a comparable amount of almonds. The National Coffee Association put forth an academic who said coffee consumption is tied to lower risk of certain cancers. The soy industry nominated a prominent vegan. The International Bottled Water Association? They like three researchers who study the benefits of — you guessed it — water.
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KarlT
#77
The problem with that view is that a large number of people are not as smart or educated, or knowledgeable or athletic or fortunate as you. Many are raised being taught that the American diet is ok since everyone eats it. And then they get hooked on that great tasting food. They don’t have the money or the means to get good healthy food. After working two jobs they don’t have the time or energy to exercise. The system clearly works against them.
You can make the “choice” argument against almost anything bad that happens to anyone. It’s not that simple.
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KarlT
#78
arugula
#79
So was I.
Beans and brown rice are cheaper than dirt. So are collard greens, onions, cabbage, carrots, etc.
I’ve worked two jobs out of necessity, too. I made it work because I had no other choice. Eating well and exercising despite that were a huge part of what kept me going through many years of difficulties. In the worst times, I had this one thing going for me–the way I took care of myself.
Now, I work with a lot of people who have better credentials, much higher salaries, much better advantages overall, and much worse lifestyles. I still feel like I am the winner.
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RapAdmin
#80
Some would argue there is no free will… choices only appear to be choices because we don’t yet have the ability to understand the cause/effect relationships.
A new book coming out by Robert Sapolsky:
Modern brain research shows that in decision making, for example, seldom do we deliberate on a matter, instead relying on a record of past behavior determined by neural responses and learned actions. Sapolsky notes that the difference between success and failure in academia is contingent on “the womb in which nine months were spent and the lifelong epigenetic consequences of that,” as well as material considerations such as being fed adequately in childhood. The lot of the “crack baby,” another charged example, is similarly determined by factors ranging from neurodevelopmental problems to being marooned in a poor neighborhood.
The book blurb:
One of our great behavioral scientists, the bestselling author of Behave, plumbs the depths of the science and philosophy of decision-making to mount a devastating case against free will, an argument with profound consequences
Robert Sapolsky’s Behave, his now classic account of why humans do good and why they do bad, pointed toward an unsettling conclusion: We may not grasp the precise marriage of nature and nurture that creates the physics and chemistry at the base of human behavior, but that doesn’t mean it doesn’t exist. Now, in Determined, Sapolsky takes his argument all the way, mounting a brilliant (and in his inimitable way, delightful) full-frontal assault on the pleasant fantasy that there is some separate self telling our biology what to do.
Determined offers a marvelous synthesis of what we know about how consciousness works—the tight weave between reason and emotion and between stimulus and response in the moment and over a life. One by one, Sapolsky tackles all the major arguments for free will and takes them out, cutting a path through the thickets of chaos and complexity science and quantum physics, as well as touching ground on some of the wilder shores of philosophy. He shows us that the history of medicine is in no small part the history of learning that fewer and fewer things are somebody’s “fault”; for example, for centuries we thought seizures were a sign of demonic possession. Yet, as he acknowledges, it’s very hard, and at times impossible, to uncouple from our zeal to judge others and to judge ourselves. Sapolsky applies the new understanding of life beyond free will to some of our most essential questions around punishment, morality, and living well together.By the end, Sapolsky argues that while living our daily lives recognizing that we have no free will is going to be monumentally difficult, doing so is not going to result in anarchy, pointlessness, and existential malaise. Instead, it will make for a much more humane world.
Determined: A Science of Life without Free Will
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Hmmm… I’d argue there’s definitely free will. If not, we would all be cookie cutter molds of each other falling for the same impulses from society. I am dumbfounded by the number of people who think differently from me. Even if everyone is driven by signals from our gut microbiome, when we change that biome, wouldn’t it be free will?
In the case of addiction, I do think that is very hard to change, but even there, there are chemicals such as NAC that can help break them. You can use your free will to overcome almost any personal challenge (there are exceptions of course). Saying you can’t or don’t is a lazy excuse IMHO.
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arugula
#82
I think it is more accurate (and far less provocative) to say that people tend to have more agency when they have more money.
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We have free will, but it is more limited than we think. And, I am not talking about socioeconomic status.
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