Living in the US is like having a super-dangerous job

To make a more valid comparison, what is the annual death rate of European Americans compared to Europeans?

Isn’t most of the mortality difference in that particular age group primarily due to drug overdoses? If so, then living in the US is dangerous insofar as it “causes” a risk of catching a case of opioids. I think looking at differences in, say, vehicular mortality or gun mortality would more accurately capture “danger” and would be more consistent with the underlying VSL approach.

I think Hey Skipper knows perfectly well that if you don’t count non-whites, then the US looks better.

Of course, if non-whites don’t count, what does that mean about the US?

Wage compensation for dangerous work would be a good thing, especially if the work is intrinsically dangerous and not the result of employer neglect or malfeasance. While some workers in the US do get hazard pay (unionized workers, most likely those with scarce skills as well), most don’t. The unexpected onset of the coronavirus pandemic was a remarkable natural experiment, since it quickly changed the objective mortality risks of a range of occupations. There was a brief flurry of hazard bonuses offered to front line workers in a few public-facing firms, but they were rescinded before any meaningful return to the old risk structure had occurred. Highly exposed workers, like those in meatpacking plants, who were out of the public eye, received nothing.

For those who want to delve deeper into the dubious theory and econometrics behind the “value of statistical life” literature, here is “Risk Without Reward: The Myth of Wage Compensation for Hazardous Work”, which I co-wrote with Les Boden for the Economic Policy Institute.

While I agree with JQ that income differentials between the US and some other countries are offset by disamenities, I find it difficult to see how this could be the result of personal choices. Even the aggregate tradeoff between work hours and income is due more to policy and institutional factors than a bunch of individual decisions to worker longer for more money.

Is this being offered as a micro explanation of the flight from work?

Yes, eg by Mohammed El-Erian a few months ago.

Brief response to JQ @11: The critique of VSL estimation is not (only) that compensation is heterogeneous, but that there are huge measurement problems, missing variables (esp on the employer side) and anomalous subgroup results that call the underlying model into question. A minor point: if nonfatal risks are correlated with fatal ones, excluding them will raise measured wage premia.

But really, the natural experiment of covid strikes me as very powerful. (I’ve thought of doing it up as a formal study, but I doubt it would add anything to plain old eyeballs other than another publication.) It isn’t plausible that the non-compensation of the vast majority of newly exposed workers was offset by some super-compensation of the privileged few.

Although that contradicts its self-image, nearly all of Australia lives in a handful of large cities, so there may actually be less opportunity for road crashes than in the USA. That being said, the official urbanisation rate of the USA is not that far behind Australia’s.

Mexican national newspaper La Jordana had a front-page headline claiming that 20% of the population of the US have a relative who has died of gun violence. Via social media, I see that there’s some statistical backup for that (19%) if we include suicide. The figure for Europeans would be very much lower, though I imagine that would-be suicides, deprived of access to guns, use other methods:

https://www.kff.org/other/poll-finding/americans-experiences-with-gun-related-violence-injuries-and-deaths/?fbclid=IwAR27c7IleaoG29CStz2Vtu4ebzHkQUSw7EJpr9ks5pF1cLlQYIFISMRV5VA

If living in US is a dangerous job, it’s one that a lot of children are being forced to do.

road crashes…US way above other wealth countries, including Australia

I’m not able to speak confidently about driving in countries other than the US, Australia, and, to a lesser degree, Russia, but one thing that really stuck me when I moved to Melbourne from the US was that traffic rules were much more strictly enforced. The speed limits were lower, and they were strictly enforced, mostly (but not completely) by the extensive use of road cameras. The fines are also very large. So, in the US the “unofficial” rule is that you can drive up to 10mph (about 16kph) over the speed limit w/o getting a ticket. (This isn’t the real rule – if you actually get a ticket for going, say, 5pmh over the limit, and challenge it in court, you’ll lose, but it’s very rare to get a ticket for going less than 10mph over the limit.) People know this, and so most people drive close to 10mph over the speed limit on many roads. (On some roads most people drive even faster, as the norm.) In Victoria, if you drive 2.5kph (about 1.5mph) over the speed limit, you risk getting a $200 ticket. Because of this, the large majority of people drive very close to the speed limit. It’s actually very common for people to drive below the limit. (Sometimes they drive well below the limit. This is annoying.) No doubt people internalize this as well, but the strict enforcement is a big part. I moved to Queensland recently, and the speed limits are not as strictly enforced as in Victoria. There are, at least where I live, fewer cameras, though still a lot more than in most places in the US. Unsurprisingly, people speed more often, though still a lot less (both fewer people speeding and lower speeds) than in the US. Unsprisingly as well, the per capita traffic deaths are higher in Queensland than in Victoria, but still a lot lower than in the US.

Another factor is the the minimum blood alcohol level to get arrested for drunk driving is lower in Australia than in the US – 0.05 vs 0.08. And, in Australia, police will have random stops of cars to give breath tests and sometimes tests for drugs. (I had one just today!) Again, these were, in my experience, much more common in Victoria than in Queensland, but they are done here, too. In the US these sorts of suspiscionless searchs of people are very heavily limited by federal constitutional law, and sometimes completely banned by state constitutional law. I have mixed feelings on these tests – I disfavour suspiscionless searches in general, and random tests of large numbers of people will always lead to significant false positives, even with fairly accurate tests. There is secondary testing, but this is already a pretty significant intrusion, even if the wrong is righted. But again, it’s undeniable, I’d think, that this contributes to lower road deaths. That’s not nothing.

On road deaths:

One reason that speed cameras are so resisted off the east coast (and maybe on it for all I know) is that legislators themselves drive a lot (having no other option with basically non-existent inter-city alternatives) and speed a lot (because they value their time, unlike the public, which pays them pathetic wages). Similarly — cell phone use and alcohol limits. (Again, this is because they don’t have alternative modes of transportation, but travel constantly).

re gun deaths: restrictions on access to guns in Australia led to … a considerable reduction in suicide.

Worth noting in this context that the suicide rate in Australia is very similar to that in the US–the easily available data for Australia is age-standardized, but it looks like both countries are in the 12-13 per thousand category. (Australia has slightly higher suicide rates for women, slightly lower for men vs the US, if I’m reading the data correctly.)

re urbanisation

UK and France are similarly or less urbanised than US and have much lower rates of traffic fatalities (UK’s is lower than Australia’s in fact). Canada is less urbanised than US and had half the traffic fatality rate (but still double Britain’s).

https://en.m.wikipedia.org/wiki/Urbanization_by_sovereign_state
https://en.m.wikipedia.org/wiki/List_of_countries_by_traffic-related_death_rate

One thing that always stuck in mind from staying with right-Americans as a kid was when one of them was furious that the police stopped him for speeding (but let him off iirc) even though he had a veteran sticker on his car.

Hey Skipper wrote “making hazardous decisions has the unfortunate consequence of increased mortality.” Right – like the poor making the decision not to have better health care.

“To make a more valid comparison, what is the annual death rate of European Americans compared to Europeans?”

Not this one is not more valid. Why would it be? Being European American signifies a shift in social class position that it does not signify in Europe. And even if – then we would have to compare 2 generation plus natives of a European nation, not the average to European Americans. And it would be a gutless excuse there aswell. The implication of thinking European Americans vs Europeans is a better comparison is frankly quite ugly. Not that it would put the US ahead.

“The obvious hypothesis is that the US is more poorly governed than Germany. I don’t know this to be true, but no alternative explanation occurs to me.”

Pretty sure Germany is just doing the cultural skript here for better and worse, which is to have strict and rigid rules on anything that are enforced by strict social control. As a rule of thumb German culture is more (formal) rule oriented than any other in the world except maybe Switzerland. Traffic is probably more of an expectation in general. Social control does not work very well to enforce driving by the speed limit and fines/number of speed controls are not particular high by internatioanl standards.

gun homicides and gun ownership are poorly correlated

American states have a problem with gun laws in that there are no border controls between states to stop the flow of guns. Look at the US vs. any wealthy country that can regulate imports, and you’ll find a strong correlation between the availability of guns and gun homicide.

But even in the states, the correlation is there. Here’s what the Harvard Injury Control Research Center says:

Across states, more guns = more homicide

Referring to low gun death rates in Vermont and Idaho:

If guns are instrumental in homicide rates, then that isn’t the result one would expect.

Cherry-picked data is exactly what you’d expect.

and about the complaint that Germany is highly regulated and so them Germans haven’t the freedom to destroy themselves in the numbers the American Freedom provides –

Well – if you want to drive as fast as possible on a ‘Free-Way’ America actually is far more highly regulated than Germany and so the type of regulations are just… different and I personally prefer any regulation where I can’t shoot myself in my own foot.
(even if driving TOO FAST – can have the same effect)

Re https://en.m.wikipedia.org/wiki/Urbanization_by_sovereign_state

I don’t think these urbanization data are very useful. Measuring urbanization is tricky and there are several different definitions of what is an urban area. US in any case is differently urbanized than European countries. Public transit is less available and less used, densities even in urban areas are lower, and so on.

Re” Suicide, I’m using the link you post, and the CDC data for the US:
https://www.cdc.gov/suicide/suicide-data-statistics.html

My read is that the US and Australia are similar in the late teens (omitting 2020 and later as not yet finalized); Australia was much worse than the US in the 1990’s.

@MPAVictoria: Ah yes. People CHOOSE to be poor, POC, rural and so on. If only people would just choose to be rich, white and living in prosperous areas we could avoid all this.

So people who are poor, POC, etc, have no agency?

Guns, cars, food, and opioids do not have agency. People do. Those who do not make hazardous decisions are not all rich and white. A great many of them are poor and Asian.

So why do so many people make bad decisions? It isn’t guns, genetics, or economics; it’s the dads.

@Chris Stevens: Hey Skipper wrote “making hazardous decisions has the unfortunate consequence of increased mortality.” Right – like the poor making the decision not to have better health care.

Assume that’s true. How much difference would “better health care” make to US mortality?

That’s a serious question. After potable water, effective sanitation, modern dentistry and antibiotics, how much does healthcare contribute to average lifespan?

@PatinIowa: Some things are more convincing than others, though. Consider this: If a child of Senegalese immigrants lives in Paris, that person is a “European,” on your account. If that child flies to New York City and takes up residence, they become “non-European.” A quick google shows that 14% of the Europeans in your population would become non-European if they lived in the US.

Germany has 7.8% born outside the EU. No idea of how many are born outside Europe, but based upon my five years living there (2015-2020) it is just as white as Vermont. France, Italy, and the Netherlands and Britain are similar. Most immigration into Europe is Muslim.

In any event, you missed my point. The US population is very different from that of Europe. It wouldn’t make any sense to compare Japanese lifespan with all Americans. Japanese males have a lifespan of 81.1 years. Japanese-American males 83.5 (Table 2).

If the US is a super dangerous place to live, that danger seems to be giving a pass to Japanese-Americans.

That’s why it is important to make comparisons using similar populations, or using distinctly different populations in an otherwise similar milieu. Failing to do so almost ensures missing what is really going on. I’ll bet all manner of things are different, and comparatively better, in largely Muslim Dearborn, MI, vs. largely Black Detroit. Why?

@Vagans: I am fascinated by the suggestion that a high rate of drug overdoses in the USA are individualistic, personal choices. High levels of substance abuse in a society suggest to me that something is deeply wrong with that society. And things like the war on drugs, or the Sacklers promoting opioid use, or tobacco and alcohol subsidies in the 20th century, are policy choices.

Alcohol is cheaper in Germany than anywhere I’ve been in the US. Far more Europeans smoke than Americans. Outside the Netherlands, and Portugal, drugs are just as prohibited as in the US. One big difference is that Europe does not share a long, remote, land border with drug producing regions.

You do have a point with the Sacklers.

@JohnQ: Fifty years ago, we had really terrible roads, unsafe cars, and lax road rules. We had nearly 3700 road deaths in 1975 [decreasing to about 1100 on 2022]

Meanwhile, death rates in the US have barely changed.

You make a couple errors here. First, the figure of merit isn’t quantity, but rate — deaths per miles traveled. You would have been better served by noting that since 1975, Australia’s road death rate per billion km has reduced by a factor of six (36 to about 4.)

Over that same period, the US only reduced its rate from about 40 to 10. So only a factor of four, in billions of miles traveled.

Putting the rate into equivalent units, 10 US v. 6.4 Australia.

Still a difference, but not as big as appears at first glance. Like Australia, US rates have gone down over the period — from somewhat higher to somewhat higher.

Perhaps a more revealing number would be the number of accidents/million miles. I’ve not been able to find that anywhere, because every source I found reported quantity, which is just a proxy for number of cars.

Norway has the lowest fatality rate. I’ve driven in Norway — due primarily to terrain, speeds are low. Most roads are two lane, and the flow of traffic is about 50mph.

Of course Norway is going to have fewer road deaths than the US, all other things being equal. (Which isn’t the case — US driver training is nearly nonexistent, and far too many drivers learn little from experience.)

Anecdata: a careless young son of a friend wound up upside-down hanging by his seatbelt after losing control at 95 mph on a four-lane highway. His mother burst into tears days later when she saw the car. He walked away with bruises. I cite this as a confounding factor in comparison of car-crash fatalities over time. I guess my only point, if any, is that statistical comparisons are very difficult, not that I quarrel with many of the conclusions above.

Hey Skipper

“If the US is a super dangerous place to live, that danger seems to be giving a pass to Japanese-Americans.”

And rich White people. I wonder why?

Of course, if you’re a pregnant Black woman in Mississippi, the danger has you squarely in its sights.

How about we quite quibbling about statistics and do something about that?

Hey Skipper: the Russian empire and USSR subsidized vodka sales. The US in the 20th century subsidized tobacco. Both were policy choices with serious public health consequences.

JQ 51: African and Hispanic Americans are more likely to be killed by cars because they make the hazardous decision of walking in car-centric areas of dangerous traffic design. Why don’t they drive SUVs like “everybody else”?

Similarly, African American women are more than twice as likely to die of pregnancy related complications because they make the hazardous decision of living in a racist misogynist society with a poor health care system. In particular those living in Southern states have adopted the perilous life style of being governed by Republican-fascist governments whose number one priority is taking away reproductive rights from women, and who intentionally refuse to accept federal money available for improving health care in their states.

Since this hasn’t been mentioned yet: the pregnancy related (‘maternal’) mortality rate (MMR) in the US increased from 12 per 100’000 to 21 from 2000 to 2020. The US is globally an absolute outlier since almost all other countries have reduced their MMR in that timeframe, and it’s an absolute outlier among high income countries. 2020 WHO comparison rates: France 8, Germany 4, UK 10, Switzerland 7, Canada 11, Australia 3. (*)

Within the US, no need to guess which states have the worst rates: Southern states have 3-4 times higher rates than California, Arkansas at the bottom. But, as Mississippi Senator Cassidy put it: “If you correct our population for race, we’re not as much of an outlier as it’d otherwise appear.” Only cynics would call that remark racist. Indeed the racial disparity in Mississippi is even higher than nationwide (4:1 vs 2.6:1), it is a total mystery why that might be the case.

(*) The CDC’s own data are actually worse than the WHO estimates and report a staggering MMR increase from 17 in 2018 to 33 in 2021: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm
WHO estimates: Trends in maternal mortality 2000 to 2020, https://data.unicef.org/resources/trends-in-maternal-mortality-2000-to-2020/
MMR by state: https://www.kff.org/other/state-indicator/maternal-deaths-and-mortality-rates-per-100000-live-births
MMR is measured as deaths per 100,000 live births.

John Q @ 51 The thing is though that the 37% rise in pedestrian deaths in the Times article happened during the years 2015-2020. Actually, deaths declined substantially between 2000 and 2010 and then rose sharply thereafter. Car-dominated urban design cannot explain this change because urban design did not become more car-centric during those years. And deaths spiked during the pandemic even while urban driving declined substantially due to the shift to work-from-home (at least part time) for many urban workers who formerly commuted by auto on a daily basis.

Something else must be behind the sudden, dramatic change. Perhaps distracted driving due to mobile phone use plays a substantial role, although was there really an inflection point around 2010? Maybe it is the combination of mobile phones and social media that is proving particularly deadly?

Another oddity is that although both Black and Hispanic death rates are higher than Whites, death rates for Hispanics are dramatically lower than for African Americans. Why would that be? At the same time, the rate for Asians is substantially lower than for Whites. Again, why? Are there big differences between the built environment of the urban neighborhoods where Hispanics vs African Americans tend to live? Or between where Asians and non-Hispanic Whites live?

In any case, the need/desire for suburbanites to drive into dense central cities has clearly declined — likely permanently, so it seems that there shouldn’t be so much opposition to reducing volumes and speeds on major urban arterial roads with various traffic-calming measures.

@55
“USians have worse life expectancies than similarly well-off Europeans throughout the income distribution except at the very top (details in link above).”

Agreed this is the salient point. I’m still uncertain about the why?

At one extreme you can say Americans are just foolish – they drive fast, they weigh too much, eat crap food, don’t get enough exercise, tote guns and eat opioids. No doubt there are supporting facts for all of those and to a great extent are all personal decisions.

The other extreme would be to say society/government is lousy – there is poor public transport so they buy cars and drive fast, there is not universal health care so no one maintains fitness, wages are too low so people work too much, gun laws are flawed so there are handgun deaths. Its easy to go on, the litany of failures are plenty.

Clearly the answer lies somewhere in the middle between individual choice and societal options and where you draw that line would prescribe ultimately what might be done to simply “do better.”

JQs analogy of a ‘dangerous job’ in my view draws the line closer to poor individual decisions and I’d classify most rebuttals as being “whatabout – laws.”

“USians have worse life expectancies than similarly well-off Europeans throughout the income distribution except at the very top (details in link above).”

OR
as Milos Forman so famously said:
You can decide to live in a Zoo or in a Jungle.

Might not one likewise prefer to live where (Orwellian it seems to this USian) speed cameras, sobriety checkpoints, etc are banned in exchange for accepting some greater degree of personal risk? Why would we think risky sports are OK but not risky freedom from some state controls and surveillance?

Peak liberalism: “if you don’t like it, then leave” addressed to (eg) Navajo children killed by radiation poisoning.

engels @68

That seems like a rather over-the-top comment in response to the idea of making different surveillance/privacy vs safety tradeoffs.

I will note that Europeans were smarter in regard to nuclear contamination though — smartly confining the radiation poisoning from their nuclear programs to far-off colonies where the fallout could not reach the home country. (That’s unless you count the Soviets as European, in which case, yikes).

That seems like a rather over-the-top comment

Fair enough. I just think the “choice” framing is a bit problematic (as the kids might say) for many US workers and their ancestors.

@politicalfootball: But if you actually want to measure the impact of gun regulation, it’s easy to look at places with real differences in gun regulation — which is to say, places with different capacities for regulating the import of guns. If anybody needs me to link that information, let me know, but I think we all know that places that are able to regulate guns have fewer homicides.

(Seriously, are we going to pretend that there is a plausible counter-argument??)

Reality disagrees. Since the early 1990’s, there has been a considerable increase in the number of constitutional, which is to say, permitless carry states: from nearly zero to 24. Plus 14 shall-issue states.

If guns are causal, then murders should have increased over that period, not sharply decreased. Similarly, states with widespread legal gun ownership should have higher homicide rates.

Neither is true, and that contradiction is the counter argument you are not addressing.

How about suicide? The US is not particularly different from culturally similar countries, guns notwithstanding. South Korea has nearly twice the suicide rate of the US, despite being nearly gun free.

Nothing more on this thread, please. I have enough trouble dealing with climate denialists

I hadn’t actually realized the distinction was this stark:

The homicide rate in the US was 7.5 times higher than the homicide rate in the other high-income countries combined, which was largely attributable to a firearm homicide rate that was 24.9 times higher.

But 74/76 is so interesting to me. I feel as though if we could solve Skipper’s thought process — he literally quotes an argument whose existence he can’t otherwise acknowledge — then we would solve a great number of the world’s ills.