1) The Amish do not live an 1800 lifestyle. For example, if someone is sick and needs to go to the hospital, they use a phone to call an ambulance to take them there.
2) There are a lot of things wrong with the American health care system, but a lack of care for white males is not actually one of them.
> The Amish do not live an 1800 lifestyle. For example, if someone is sick and needs to go to the hospital, they use a phone to call an ambulance to take them there.
The Amish are very deliberate about what changes they incorporate into their communities. Each community also sets their own rules, so it's poor practice to generalize.
(For example, their attitudes towards electricity are quite complicated and I don't think I could do it justice in a quick post.)
I almost want to disagree with you here but I’m not fully apprised of the greater situation.
My dad is poor and neglectful of himself. He had a stroke. He got ambulanced to the emergency room and spent a good deal of time there.
The hospital discussed billing which was several hundreds of thousands of dollars. Well he can’t afford that. The hospital had us talk to some advisers and they got him on a state Medicaid (?) plan. The plan retroactively paid for it all.
He then got checked out for a variety of other issues including a severe spinal issue and a hip replacement for 0 out of pocket.
It’s great. He’s a changed man who is active and takes care of himself now.
I also had a major medical event and I have since paid tens of thousands out of pocket after insurance. At one point we were investigating if I could essentially quit work for a bit, go on the Medicaid plan, get better, and then go back to my job. That is madness!
You have rights in an emergency room under EMTALA
Doctor talking to a patient
You have these protections:
1. An appropriate medical screening exam to check for an emergency medical condition, and if you have one,
2. Treatment until your emergency medical condition is stabilized, or
3. An appropriate transfer to another hospital if you need it
The law that gives everyone in the U.S. these protections is the Emergency Medical Treatment and Labor Act, also known as "EMTALA." This law helps prevent any hospital emergency department that receives Medicare funds (which includes most U.S. hospitals) from refusing to treat patients.
No screens is a good assumption for everyone at the time the study covered - TVs were just coming out towards the end, and were expensive enough that not everyone owned one yet.
When I was very young, my stepfather started a trucking company. We didn’t get along terribly well so my mom thought that driving together would solve our problems. We would hotshot recreational vehicles two to a flatbed and haul them from an Amish community east of Chicago to their dealer destination.
So, we got to know some people in the community and learned some things that would be relevant to this. One big one is the Amish view on technology. With 1965 data, especially looking at farmers, you’ll see variations in pest control tech. Amish people are not against all technology but they evaluate it differently.
For the Amish, they look at a technology and ask whether it will pull them together or push them apart. Farm chemicals would increase yields, but dramatically reduce the number of people they could have working on fields. So many colonies avoided highly toxic chemicals like DDT that were released during or after WW2. And because there was some resistance to Amish people, they tend to congregate together and so you’ll have colonies bunched up in areas - some colonies avoided water table contamination through a freak of geology and cousins who shared a belief on technology.
So nutrition does play a role - food in Amish communities is very whole and very close to natural. As an example, my stepfather was quite affable and so we’d take doughnuts to the factory where we picked up RVs. Certain companies have so much sugar in their doughnuts that it felt like giving people drugs. Physical activity is a constant. And their community plays a massive role in life and life expectancy but this data is from 1965 and looks at farmers so chemical use is definitely part of these findings as well.
EUs have lower chronic diseases like diabetes and hypertension than USA. Those are not diseases that have any answers in medical system so it wouldn't matter how advanced and available the system is.
For example, 40% of ppl in usa are obese vs 12% Switzerland. 50% of ppl in usa have hypertension vs 20% Swiss.
So what exactly is a medical system supposed to do if half your population is sickly and obese ?
I see this 'medical system' stuff even from very educated ppl but I feel like i am missing something. Do ppl think having access to a doctor is going prevent one from being obese ? whats the logic.
To me there is a big difference between a "health care system" and a "medical system".
One is only here to try and fix issues, while the other will invest in prevention campains and help direct the overall politics around having an healthy population.
To me the recent EPA decision around PFAs is a signal of a deficient "health care system".
The difference doesn’t come down to one single factor.
Comments that try to reduce population-scale differences to a single factor, like access to healthcare, are overly reductive. When it comes to obesity (not using being overweight, but truly past the obese threshold) you don’t need a doctor to inform you that it’s unhealthy.
The reductive claims about access to healthcare are also ignoring the fact that people in the US do actually use a lot of healthcare. The rate of GLP-1 use in America for weight loss is around 1 in 8 people, which is significantly higher than anywhere in Europe last time I checked. Obviously the higher obesity rate contributes to higher usage, but it demonstrates that many obese people in the United States are not lacking access to health care.
> Do ppl think having access to a doctor is going prevent one from being obese ? whats the logic.
Doctors can vary in whether or not (and for how long) they advocate trying a healthy diet and exercise before prescribing drugs. In the UK the system is incentivised to avoid drug prescriptions unless necessary, as it reduces the financial burden on the NHS - both for buying the drugs and for managing complications linked to obesity. In the US, pharma companies can offer money and perks to doctors who promote their products.
Some people have no idea how to diet or exercise, or have no idea that they're overweight, or have specialised conditions that make it hard to follow generic advice. These people might find it really valuable to receive individualised advice and education from their doctor.
Also this would often be in the context of the patient coming to the doctor with a complaint. If the doctor says "trying eating healthily and exercising, then come back in a month for a follow-up", some might just do nothing but many people will actually try it.
I realized that I ate way more chocolate than average Swiss people (Googled and it says around 24 grams per day for average people in Switzerland). I usually eat about 50 grams daily...and 72% dark
Having a socialized healthcare system incentivizes the government to ban the worst public heath offenders. High fructose corn syrup would have been long gone from most foods in a sane society, for example. Generally, making the government have a vested interest in its citizenry's good health is a good thing.
A while back I got curious and tried to do a bit of digging on this.
I looked into the Hutterites in Canada as a group that lives a somewhat similar lifestyle, but don't entirely eschew modern technology and have free access to healthcare (where-as the Amish largely self-fund as a community, and I'm not sure how much pressure that would put on _not_ using healthcare services).
In that case, the only real causes of death that showed a substantial difference from the surrounding population were the rates of cancer, and mostly the lung cancer for men and cervical cancer for women. The study didn't directly attribute it, but that would be pretty directly explained by lower rates of smoking and a lower rate of STDs (since we now know that a huge driver of cervical cancer is HPV).
the amish diet is pretty unhealthy. lots of carbs, fats, pies, bacon, etc. if you had an amish diet with an "english" lifestyle you would definitely have health issues.
Given the date ranges, air pollution could have factored in as well, though I'm not sure "processed food" would have been as prevalent, especially for the earliest cohort (which had the most disparate outcome)
I bet that's about as effective as banning vaping in school.
It's also quite common to hear of Amish coming to work on an Englishman's property, and they are very happy to take beer as payment, to be consumed on site...
Again, that varies from community to community. There are some communities where there is less religious fervor, and more just following tradition, and there are other communities that see their religious experience as the most important part of their identity. The stories you are referencing tend to come more from the communities that emphasize tradition over religious experience.
Many people make the mistake of thinking of Amish as a single uniform blob, whereas in fact there are many very distinct subgroupings that don't have much to do with each other. In the state where I live, for example, there are at least 3 different distinct Amish groups (each with multiple communities, expanding at a very rapid rate), each of which does not necessarily consider the others to be true Amish, with the dividing lines primarily being this difference on or not tradition is prioritized over religious experience.
I'm referring to communities that have banned smoking, specifically. I'm betting that's about as effective as banning vaping in school, mind you to kids who don't even have a job or a car and have mostly been educated from the beginning not to do it.
I had the opposite impression. Lots of orders will ban tobacco outright. Those that don’t, it’s usually kept only in social settings or breaks and it’s never commercial cigarettes. Usually pipes but I guess they could roll their own cigarettes.
The issue with raw milk is that over time it’s much more likely to grow bacteria if there is any interruption in the cold chain.
Drinking it on the farm or close to when it’s very fresh isn’t super high risk. My family was in dairy and did it all of the time. Once it’s off the farm, all bets are off.
> It is highly unlikely to be dangerous enough to have a significant, or even measurable, effect on life expectancies.
Assuming you are a normal healthy adult who gets plenty of nutrition - like someone in the modern world. If you are eating near starvation your immune system won't be as strong. If you are otherwise unhealthy the potential bacteria can overwhelm you...
So, do you leave your burritos out for 3 hours so the listeria can grow?
Online arguments about anything like this since COVID boil down to “if you don’t die, it’s ok”. An old or sick person can easily die from food poisoning. If you are hearty and hale, you’re going to feel like crap and get stuff like violent diarrhea.
And some entire US states have been declared TB-free and/or brucellosis free, and cows are routinely tested under various circumstances to ensure that they stay that way. So some of the risks of the past, whether or not they've been exaggerated, are no longer an issue.
Does it still taste good if you pasteurize it yourself? Maybe in a more controlled way than industry does it?
I'm wondering if it is the freshness that partially makes the non-pasteurized milk taste good, since it is illegal to sell over state lines and possibly to sell at all, it is probably much fresher.
I do not think pasteurisation affects fat content?
Homogenisation is a separate process and it is possible (at least in the UK) to buy not homogenised pasteurised milk which should have the same far content.
To me filtered milk (which is filtered to remove bacteria and other things before pasteurisation to keep it fresh for longer tastes very good, which favours the argument it is the freshness that matters.
> If they can get ice cream to just about anywhere and still have it be the right texture
Which it frequently doesn't? Nothing more fun than grabbing a pint of ice cream and then discovering it's full of ice crystals at home, because it thawed and refroze somewhere in the shipping chain or at the supermarket.
Of course it's more of an issue with Haagen-Dazs since it doesn't use the stabilizers like guar gum. And more of an issue with smaller supermarkets and shops with less staff where they're more likely to leave the ice cream sitting around for hours between delivery and loading into the freezer.
>Which it frequently doesn't? Nothing more fun than grabbing a pint of ice cream and then discovering it's full of ice crystals at home, because it thawed and refroze somewhere in the shipping chain or at the supermarket.
This is mostly a consumer problem.
You (or, the HN demographics being what they are, more likely your SO) toss it in a cart and then proceed to shop recreationally for some time, toss it in the back of your potentially hot car, stop to get Starbucks and then eventually sometime later it gets into a freezer. It might've been out of the freezer for over an hour. Almost certainly 15-20min
The next longest time it spends out of the freezer is the pallet jack ride from the walk in in the back of the store to the frozen food isle, typically single digit minutes, tops.
>Of course it's more of an issue with Haagen-Dazs since it doesn't use the stabilizers like guar gum.
Package size and resultant thermal mass has a big effect on it. Higher end ice creams suffer this more than cheaper ones bought in bigger sizes.
>smaller supermarkets and shops with less staff where they're more likely to leave the ice cream sitting around for hours between delivery and loading into the freezer.
This is just not how it works. The delivery person will put refrigerated goods specifically into the fridge specifically to avoid "well you left it on the dock and didn't tell us" accusations.
I'm sure somewhere there's a foodservice supplier that doesn't do this but that's a them problem and it's the exception rather than rule, their suppliers are likely wheeling the stuff right from reefer to walk in when they deliver to the supplier.
My local supermarkets and bodega would like to disagree with you.
I'm a 10 minute walk from them, tops. I put it straight in my freezer. It's frozen solid when I buy it and frozen solid when I put it in my freezer.
And yet, 5-10% of the time, when I go to eat it, it's icy crystals throughout.
The frozen supply chain is not as reliable as you seem to think it is, and it seems like it's mostly a retailer problem. I'm glad it seems to be better where you are though.
How long is your drive home? Pasteurized milk can become unsafe at temperatures over 4 C for 2 hours over 30 C for one hour. Those timelines are much lower for unpasteurized milk.
My family on both sides were dairy farmers for generations, I have pasteurized, non-homogenized milk delivered to my house. I’m a huge advocate for dairy. But commercial raw milk is dumb.
I think a lot of the noise about this is from folks who would like to bypass the dairy industry and their abuse of farmers. I’d love to see regulatory changes where small scale dairy processing would enable farmers to operate direct to consumer models more safely. The folks I get my milk from do that, which was only possible because their mom in the previous generation was an attorney who could navigate the regulatory nonsense.
It’s the way humans consumed milk forever, though? Every infant consumes raw milk. Every milk-consuming culture on the planet did it until Pasteur. So… I’m not advocating raw milk consumption, but to call it poison is pure ignorance.
It wasn't an issue until dairies started turning into factories to supply growing cities, with cows crowded inside and the manure concentrated in one place which encourages the growth of pathogens, and low-wage employees who weren't necessarily as careful about keeping the cows healthy and manure out of the milk as a traditional "dairy maid" might have been.
So the industry had a choice: go back to keeping cows on pasture, which would mean the expense of transporting the milk further into the city from distant farms, or use the new technology of pasteurization to kill all life in the milk, good or bad. As always, industry went with the cheaper option. Which is fine; I wouldn't drink raw milk off the grocery shelf if I thought it came from a large factory dairy. Milk produced that way should be pasteurized.
But it wasn't necessary to criminalize doing it the other way. That's just an industry trying to protect itself from competition. If your raw milk comes from cows on pasture, milked by people who make an effort to keep the cows healthy and the milk clean, there's nothing to worry about.
From their mother. Human breast milk is very bitter and I'm sure protein wise very different than cow milk. I doubt scientists have really studied this. Humans are not supposed to be drinking bovine milk. As a visitor to this planet I find it strange. Milk has a lot of lactose and will have interesting affects on adults including but not limited to insulin resistance whereas babies are developing very fast and need simple quick energy.
> Humans are not supposed to be drinking bovine milk.
Humans aren't "supposed" to eat anything. You think we're supposed to eat flour or sausage or arugula or lentils?
But because we like to survive, we eat anything and everything that gives us nutrition and helps us live. Also, there are pastoral tribes like the Maasai in East Africa that historically have lived on bovine milk as a staple food. Is that authentic and traditional enough for you that you might no longer consider it "strange", but rather as traditional as it gets?
You think we're supposed to eat flour or sausage or arugula or lentils?
We are not. The dumb grazing animals are supposed to eat the various forms of grass. Their guts and stomachs are designed to convert those to energy correctly. Humans since time immemorial have eaten mostly vegetables and meats when they can catch them. Only recently did we start poisoning ourselves for the profits.
> Humans since time immemorial have eaten mostly vegetables
This is just not true. Since time immemorial, humans have eaten meat and fish constantly as a main part of their diet. Catching fish and animals isn't that much different from digging up roots. We've eaten everything we can, not just vegetables.
And humanity has been drinking bovine milk for many millennia. Long before even the concept of capitalist "profits" existed. Again, see the Maasai for example.
> Humans are not supposed to be drinking bovine milk.
Humans are not "supposed" to eat and drink most of what we do (maybe fruits are an exception). However, we have evolved to consume a lot of things - including, if we have the right genes, milk.
Most fruits are highly bred, nutrition wise they're very different from their wild-type predecessors. Many of which are outright inedible, or close to it.
That said, we've coevolved with technology of one sort or another (the broadest definition, to include cooking, plant breeding, hunting with weapons, domestication and animal husbandry) ever since we began to master fire, a million years ago give or take.
Yeah, no. It's not normal just because people have been doing this for a long time. It has sugar which makes people addicted to it and will argue until they are blue in the face to defend it just like drug addicts will defend their behavior until their last breath. Milk can cause just as much a fatter liver as beer. People can get all their calcium from green leafy vegetables. Raw milk will also contain IGG, IGB, IGA that humans can create on their own. Adding animal immunoglobulins is not well studied. Humans can create their own.
Definitely not poison. Risk of bacterial infection? Yes. I don’t know the stats on what that risk is though and for all I know perhaps it starts getting closer to zero when it’s your own farm and you are the one handling the whole process.
Please note I am not advocating for raw milk, I think it is not a wise decision but I also don’t believe it to be poison.
One of the few times I have used the downvote button in Hn for a comment.
Its not a huge effort to at least try to add some source with such a claim, besides the comment does not even bring anything of value to the discussion.
Amish men have very limited to no screen time at work and at home. The modern lifestyle is very rough on men, sedentary work, rest of the time on app/game/content screens.
They also don't get their income garnished by social security, so that basically frees up 12% (employee + employer) that can be used by the community directly for health rather than a scamfest by the government.
Amish life expectancy is now 71 compared to 84ish. OP's data is 100+ years old and wqs analyzed in the 60s during a notable peak for medical quackery (cigarettes recommended for pregnant women, etc.)
> These calculations were completed for cohorts of men born during 1895–1904, 1905–1914, 1915–1924, and 1925–1934
and the gap gradually closed with time. There was an 10-year difference in the first cohort which closed by about two years per cohort.
So, a four-year gap in the most recent cohort is notable, but the narrative's probably a little different than you might guess when looking at the headline alone.
Small sample size of about 1500 Amish men divided across 4 cohorts, all exposed to the great depression. Entry age minimum of 25 years.
Sorry, but this is really marginal science. There are much stronger demographic and statistical studies of aging and mortality in humans. Here are some alternative examples of stronger studies to explore from PubMed. I keyed my search using the surnames of two well respected longevity demographers (Vaupel and Christensen):
You'd have to be outside to get that "benefit". Sedentary people have sunlight blocked by their roof.
Sunlight kills bacteria and viruses, stimulates vitamin D production, and has a number of emotional/cognitive benefits. Being inside 24/7 is not good for you. For most of our history we spent every daylight hour outside hunting or farming, we're adapted to this situation.
HackerNews claims to be scientific and logical, but this paper comes out from old old data (1965!), and the ant-science, pro-RFK Jr come out of the woodwork to say how it's valuable for today.
Also disciplined breathing techniques, Om chanting strengthens the lungs and regulates O2 flows. FWIW they do get sunlight. People need some sunlight. More specifically Mitochondria need sunlight or artificial sunlight from 600nm -> 1200nm.
From documentaries I've seen of Christian monks, there is no talk of personal benefits and emotions like a self-help book, instead it's spiritual motivations about being compelled to follow a path of devotion in service to their faith.
I get the impression that it's a hard life as such orders are dwindling and they report the deprivation of things they did since joining that we might find mundane like "going to buy music" (you can tell they joined pre '80s).
I recall reading the rules of a Buddhist monastery and it was basically a compendium of all the bad things monks have done, written down to make it ambiguous it's off-limits. It did not give the suggestion of fulfilled people. It had a lengthy chapter of all the things you can't put your penis in: people, children, animals, dead things, clay vessels, fabric dolls, trees, holes in the wall, holes in the ground etc. Feels like some desperate rules-lawyering had happened over the years.
Same family is likely not a useful comparison because lifestyle would be different. Eunuchs would be expected to serve the royal family, which implies plenty of food - not as good as the royals, but still plenty of it unlike their families back on the farm who lived closer to starvation at best and a bad year would cause a lot of deaths.
At least that is what I'd expect, but I'm trying to extrapolate what I know of European history (acoup) to Korea. Anyone have better expertise able to talk about the experience of the different groups?
Notably, still less than in any country in the European Union: given the lifestyle, is this a matter of the health care system, I guess?
Anyway given that random EU folks live longer without switching to 1800 lifestyle, looks like there are better options.
I’m not convinced that’s the case for the studied birth cohorts (1890-1930) given the loss of male life in Europe through the world wars.
>still less than in any country in the European Union
In the birth cohorts that the study was looking at? Do you have data to support this?
1) The Amish do not live an 1800 lifestyle. For example, if someone is sick and needs to go to the hospital, they use a phone to call an ambulance to take them there.
2) There are a lot of things wrong with the American health care system, but a lack of care for white males is not actually one of them.
> The Amish do not live an 1800 lifestyle. For example, if someone is sick and needs to go to the hospital, they use a phone to call an ambulance to take them there.
The Amish are very deliberate about what changes they incorporate into their communities. Each community also sets their own rules, so it's poor practice to generalize.
(For example, their attitudes towards electricity are quite complicated and I don't think I could do it justice in a quick post.)
I know a number of white males who would disagree with you, myself included.
All it takes is a single, major non-routine event to learn that lesson.
The system is really broken for everyone and the incentives are really skewed away from healthcare.
It was the first time I realized that people are existentially truly on their own and despite its claims, “the system” truly isn’t there for them.
> There are a lot of things wrong with the American health care system, but a lack of care for white males is not actually one of them.
A lack of care for those who can't afford it is, though.
I almost want to disagree with you here but I’m not fully apprised of the greater situation.
My dad is poor and neglectful of himself. He had a stroke. He got ambulanced to the emergency room and spent a good deal of time there.
The hospital discussed billing which was several hundreds of thousands of dollars. Well he can’t afford that. The hospital had us talk to some advisers and they got him on a state Medicaid (?) plan. The plan retroactively paid for it all.
He then got checked out for a variety of other issues including a severe spinal issue and a hip replacement for 0 out of pocket.
It’s great. He’s a changed man who is active and takes care of himself now.
I also had a major medical event and I have since paid tens of thousands out of pocket after insurance. At one point we were investigating if I could essentially quit work for a bit, go on the Medicaid plan, get better, and then go back to my job. That is madness!
US hospital waiting rooms are filled with poor people btw.
https://www.cms.gov/priorities/your-patient-rights/emergency...
You have rights in an emergency room under EMTALA Doctor talking to a patient
You have these protections:
1. An appropriate medical screening exam to check for an emergency medical condition, and if you have one,
2. Treatment until your emergency medical condition is stabilized, or
3. An appropriate transfer to another hospital if you need it The law that gives everyone in the U.S. these protections is the Emergency Medical Treatment and Labor Act, also known as "EMTALA." This law helps prevent any hospital emergency department that receives Medicare funds (which includes most U.S. hospitals) from refusing to treat patients.
...also, plenty of EU countries appear to have a life expectancy, for males, less than the 76 years of Amish men for this cohort: https://en.wikipedia.org/wiki/List_of_European_countries_by_...
Probably eastern European countries haven't caught up yet in safety and public health, but its coming.
I don't disagree, but could you provide some references/links to the datasets you're basing this on?
Based on births and deaths from 1965? We’ll need to see some data on that.
> looks like there are better options.
I wouldn’t say that, imagine an Amish lifestyle of lots of exercise and no screens mixed with EU better healthcare.
No screens is a good assumption for everyone at the time the study covered - TVs were just coming out towards the end, and were expensive enough that not everyone owned one yet.
Without any scientific evidence just by observing the lifestyle I am almost certain that the "secret" lies in nutrition.
They also have a cohesive family and social circles. Probably can't hurt?
That seems to be the commonality with Seventh Day Adventists, as well.
When I was very young, my stepfather started a trucking company. We didn’t get along terribly well so my mom thought that driving together would solve our problems. We would hotshot recreational vehicles two to a flatbed and haul them from an Amish community east of Chicago to their dealer destination.
So, we got to know some people in the community and learned some things that would be relevant to this. One big one is the Amish view on technology. With 1965 data, especially looking at farmers, you’ll see variations in pest control tech. Amish people are not against all technology but they evaluate it differently.
For the Amish, they look at a technology and ask whether it will pull them together or push them apart. Farm chemicals would increase yields, but dramatically reduce the number of people they could have working on fields. So many colonies avoided highly toxic chemicals like DDT that were released during or after WW2. And because there was some resistance to Amish people, they tend to congregate together and so you’ll have colonies bunched up in areas - some colonies avoided water table contamination through a freak of geology and cousins who shared a belief on technology.
So nutrition does play a role - food in Amish communities is very whole and very close to natural. As an example, my stepfather was quite affable and so we’d take doughnuts to the factory where we picked up RVs. Certain companies have so much sugar in their doughnuts that it felt like giving people drugs. Physical activity is a constant. And their community plays a massive role in life and life expectancy but this data is from 1965 and looks at farmers so chemical use is definitely part of these findings as well.
> , is this a matter of the health care system
EUs have lower chronic diseases like diabetes and hypertension than USA. Those are not diseases that have any answers in medical system so it wouldn't matter how advanced and available the system is.
For example, 40% of ppl in usa are obese vs 12% Switzerland. 50% of ppl in usa have hypertension vs 20% Swiss.
So what exactly is a medical system supposed to do if half your population is sickly and obese ?
I see this 'medical system' stuff even from very educated ppl but I feel like i am missing something. Do ppl think having access to a doctor is going prevent one from being obese ? whats the logic.
You quote:
> , is this a matter of the health care system
And you say:
> I see this 'medical system' stuff
To me there is a big difference between a "health care system" and a "medical system".
One is only here to try and fix issues, while the other will invest in prevention campains and help direct the overall politics around having an healthy population.
To me the recent EPA decision around PFAs is a signal of a deficient "health care system".
The difference doesn’t come down to one single factor.
Comments that try to reduce population-scale differences to a single factor, like access to healthcare, are overly reductive. When it comes to obesity (not using being overweight, but truly past the obese threshold) you don’t need a doctor to inform you that it’s unhealthy.
The reductive claims about access to healthcare are also ignoring the fact that people in the US do actually use a lot of healthcare. The rate of GLP-1 use in America for weight loss is around 1 in 8 people, which is significantly higher than anywhere in Europe last time I checked. Obviously the higher obesity rate contributes to higher usage, but it demonstrates that many obese people in the United States are not lacking access to health care.
> Do ppl think having access to a doctor is going prevent one from being obese ? whats the logic.
Doctors can vary in whether or not (and for how long) they advocate trying a healthy diet and exercise before prescribing drugs. In the UK the system is incentivised to avoid drug prescriptions unless necessary, as it reduces the financial burden on the NHS - both for buying the drugs and for managing complications linked to obesity. In the US, pharma companies can offer money and perks to doctors who promote their products.
I have hard time accepting that ppl stop being obese only if their doctor tells them 'eat healthy and move more' .
Why do ppl believe this kind of stuff. It is so bizarre and defies any commonsense.
Some people have no idea how to diet or exercise, or have no idea that they're overweight, or have specialised conditions that make it hard to follow generic advice. These people might find it really valuable to receive individualised advice and education from their doctor.
Also this would often be in the context of the patient coming to the doctor with a complaint. If the doctor says "trying eating healthily and exercising, then come back in a month for a follow-up", some might just do nothing but many people will actually try it.
If just the doctor tells it, it won't have much impact. If health education/advertisement from public funds frames it, it has impact.
Of course there is the role of availability of options, but they come from demand, which comes from the above.
I realized that I ate way more chocolate than average Swiss people (Googled and it says around 24 grams per day for average people in Switzerland). I usually eat about 50 grams daily...and 72% dark
I suppose if you extend the definition of "medical system" to include education and intervention, it makes sense.
There's also medications in there - hypertension can be controlled with drugs, no?
But, yes, I agree with your main point - obesity in the US is widespread and a massive influence on both longevity and health care costs.
Nowadays maybe they could get Ozempic?
Not sure that will make you live longer.
Using a GLP-1 drug to reduce obesity or diabetes will increase lifespan, unquestionably.
...barring unforeseen and severe long-term side effects. But this seems unlikely, agreed.
Having a socialized healthcare system incentivizes the government to ban the worst public heath offenders. High fructose corn syrup would have been long gone from most foods in a sane society, for example. Generally, making the government have a vested interest in its citizenry's good health is a good thing.
no country with socialized medicine has banned hfcs. EU has lower hfcs due to trade reasons not from health advocacy.
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I'm glad they mention diet. I would imagine the 5 year difference could be explained simply by not smoking and not eating so much processed food.
A while back I got curious and tried to do a bit of digging on this.
I looked into the Hutterites in Canada as a group that lives a somewhat similar lifestyle, but don't entirely eschew modern technology and have free access to healthcare (where-as the Amish largely self-fund as a community, and I'm not sure how much pressure that would put on _not_ using healthcare services).
In that case, the only real causes of death that showed a substantial difference from the surrounding population were the rates of cancer, and mostly the lung cancer for men and cervical cancer for women. The study didn't directly attribute it, but that would be pretty directly explained by lower rates of smoking and a lower rate of STDs (since we now know that a huge driver of cervical cancer is HPV).
the amish diet is pretty unhealthy. lots of carbs, fats, pies, bacon, etc. if you had an amish diet with an "english" lifestyle you would definitely have health issues.
Given the date ranges, air pollution could have factored in as well, though I'm not sure "processed food" would have been as prevalent, especially for the earliest cohort (which had the most disparate outcome)
I don’t think any Amish group has a prohibition on smoking, though of course some communities probably frown on it.
It varies from community to community. There are some communities that don't care, and others that do definitely prohibit it.
I bet that's about as effective as banning vaping in school.
It's also quite common to hear of Amish coming to work on an Englishman's property, and they are very happy to take beer as payment, to be consumed on site...
Again, that varies from community to community. There are some communities where there is less religious fervor, and more just following tradition, and there are other communities that see their religious experience as the most important part of their identity. The stories you are referencing tend to come more from the communities that emphasize tradition over religious experience.
Many people make the mistake of thinking of Amish as a single uniform blob, whereas in fact there are many very distinct subgroupings that don't have much to do with each other. In the state where I live, for example, there are at least 3 different distinct Amish groups (each with multiple communities, expanding at a very rapid rate), each of which does not necessarily consider the others to be true Amish, with the dividing lines primarily being this difference on or not tradition is prioritized over religious experience.
I'm referring to communities that have banned smoking, specifically. I'm betting that's about as effective as banning vaping in school, mind you to kids who don't even have a job or a car and have mostly been educated from the beginning not to do it.
> I'm betting that's about as effective as banning vaping in school
As I said, it varies from community to community.
I had the opposite impression. Lots of orders will ban tobacco outright. Those that don’t, it’s usually kept only in social settings or breaks and it’s never commercial cigarettes. Usually pipes but I guess they could roll their own cigarettes.
I'm surprised. Amish are known for drinking raw milk and making raw dairy, which is all basically pure poison.
The issue with raw milk is that over time it’s much more likely to grow bacteria if there is any interruption in the cold chain.
Drinking it on the farm or close to when it’s very fresh isn’t super high risk. My family was in dairy and did it all of the time. Once it’s off the farm, all bets are off.
Its very tasty. I used to be able to buy raw milk from a local farm but its largely been killed off by regulation (in the UK).
It is highly unlikely to be dangerous enough to have a significant, or even measurable, effect on life expectancies.
Alot of the tastiness is cream content. Look for non-homogenized milk or some of the fancy milk varieties at Whole Foods or a coop.
It usually tastes great and is often ultra pasteurized, as it’s a low volume product.
It tastes better (and is not that hard to get here in the UK) but I prefer filtered milk which stays fresher.
> It is highly unlikely to be dangerous enough to have a significant, or even measurable, effect on life expectancies.
Assuming you are a normal healthy adult who gets plenty of nutrition - like someone in the modern world. If you are eating near starvation your immune system won't be as strong. If you are otherwise unhealthy the potential bacteria can overwhelm you...
So, do you leave your burritos out for 3 hours so the listeria can grow?
Online arguments about anything like this since COVID boil down to “if you don’t die, it’s ok”. An old or sick person can easily die from food poisoning. If you are hearty and hale, you’re going to feel like crap and get stuff like violent diarrhea.
The thing about milk is that its usually pretty obvious if its gone off.
The risk lies in certain diseases (TB is the highest risk) which can kill. However, there is a TB vaccine.
And some entire US states have been declared TB-free and/or brucellosis free, and cows are routinely tested under various circumstances to ensure that they stay that way. So some of the risks of the past, whether or not they've been exaggerated, are no longer an issue.
Oh my god, wrong wrong wrong. Stop drinking raw milk. Louis Pasteur is spinning in his grave. https://arstechnica.com/features/2025/07/its-shocking-massiv...
Does it still taste good if you pasteurize it yourself? Maybe in a more controlled way than industry does it?
I'm wondering if it is the freshness that partially makes the non-pasteurized milk taste good, since it is illegal to sell over state lines and possibly to sell at all, it is probably much fresher.
Yes, it may well be the freshness. In the UK it has to he sold directly by the farm (either on premises, or they can take it to a market AFAIK).
I think pasteurising it yourself would be worse as its harder to control temperatures precisely without the right equipment.
It’s more likely higher fat content.
I do not think pasteurisation affects fat content?
Homogenisation is a separate process and it is possible (at least in the UK) to buy not homogenised pasteurised milk which should have the same far content.
To me filtered milk (which is filtered to remove bacteria and other things before pasteurisation to keep it fresh for longer tastes very good, which favours the argument it is the freshness that matters.
If they can get ice cream to just about anywhere and still have it be the right texture there's no reason they can't do milk.
Of course, that level of care wasn't economically practical for milk back when the laws were written.
> If they can get ice cream to just about anywhere and still have it be the right texture
Which it frequently doesn't? Nothing more fun than grabbing a pint of ice cream and then discovering it's full of ice crystals at home, because it thawed and refroze somewhere in the shipping chain or at the supermarket.
Of course it's more of an issue with Haagen-Dazs since it doesn't use the stabilizers like guar gum. And more of an issue with smaller supermarkets and shops with less staff where they're more likely to leave the ice cream sitting around for hours between delivery and loading into the freezer.
>Which it frequently doesn't? Nothing more fun than grabbing a pint of ice cream and then discovering it's full of ice crystals at home, because it thawed and refroze somewhere in the shipping chain or at the supermarket.
This is mostly a consumer problem.
You (or, the HN demographics being what they are, more likely your SO) toss it in a cart and then proceed to shop recreationally for some time, toss it in the back of your potentially hot car, stop to get Starbucks and then eventually sometime later it gets into a freezer. It might've been out of the freezer for over an hour. Almost certainly 15-20min
The next longest time it spends out of the freezer is the pallet jack ride from the walk in in the back of the store to the frozen food isle, typically single digit minutes, tops.
>Of course it's more of an issue with Haagen-Dazs since it doesn't use the stabilizers like guar gum.
Package size and resultant thermal mass has a big effect on it. Higher end ice creams suffer this more than cheaper ones bought in bigger sizes.
>smaller supermarkets and shops with less staff where they're more likely to leave the ice cream sitting around for hours between delivery and loading into the freezer.
This is just not how it works. The delivery person will put refrigerated goods specifically into the fridge specifically to avoid "well you left it on the dock and didn't tell us" accusations.
I'm sure somewhere there's a foodservice supplier that doesn't do this but that's a them problem and it's the exception rather than rule, their suppliers are likely wheeling the stuff right from reefer to walk in when they deliver to the supplier.
My local supermarkets and bodega would like to disagree with you.
I'm a 10 minute walk from them, tops. I put it straight in my freezer. It's frozen solid when I buy it and frozen solid when I put it in my freezer.
And yet, 5-10% of the time, when I go to eat it, it's icy crystals throughout.
The frozen supply chain is not as reliable as you seem to think it is, and it seems like it's mostly a retailer problem. I'm glad it seems to be better where you are though.
How long is your drive home? Pasteurized milk can become unsafe at temperatures over 4 C for 2 hours over 30 C for one hour. Those timelines are much lower for unpasteurized milk.
My family on both sides were dairy farmers for generations, I have pasteurized, non-homogenized milk delivered to my house. I’m a huge advocate for dairy. But commercial raw milk is dumb.
I think a lot of the noise about this is from folks who would like to bypass the dairy industry and their abuse of farmers. I’d love to see regulatory changes where small scale dairy processing would enable farmers to operate direct to consumer models more safely. The folks I get my milk from do that, which was only possible because their mom in the previous generation was an attorney who could navigate the regulatory nonsense.
It’s the way humans consumed milk forever, though? Every infant consumes raw milk. Every milk-consuming culture on the planet did it until Pasteur. So… I’m not advocating raw milk consumption, but to call it poison is pure ignorance.
It wasn't an issue until dairies started turning into factories to supply growing cities, with cows crowded inside and the manure concentrated in one place which encourages the growth of pathogens, and low-wage employees who weren't necessarily as careful about keeping the cows healthy and manure out of the milk as a traditional "dairy maid" might have been.
So the industry had a choice: go back to keeping cows on pasture, which would mean the expense of transporting the milk further into the city from distant farms, or use the new technology of pasteurization to kill all life in the milk, good or bad. As always, industry went with the cheaper option. Which is fine; I wouldn't drink raw milk off the grocery shelf if I thought it came from a large factory dairy. Milk produced that way should be pasteurized.
But it wasn't necessary to criminalize doing it the other way. That's just an industry trying to protect itself from competition. If your raw milk comes from cows on pasture, milked by people who make an effort to keep the cows healthy and the milk clean, there's nothing to worry about.
Every infant consumes raw milk
From their mother. Human breast milk is very bitter and I'm sure protein wise very different than cow milk. I doubt scientists have really studied this. Humans are not supposed to be drinking bovine milk. As a visitor to this planet I find it strange. Milk has a lot of lactose and will have interesting affects on adults including but not limited to insulin resistance whereas babies are developing very fast and need simple quick energy.
> Humans are not supposed to be drinking bovine milk.
Humans aren't "supposed" to eat anything. You think we're supposed to eat flour or sausage or arugula or lentils?
But because we like to survive, we eat anything and everything that gives us nutrition and helps us live. Also, there are pastoral tribes like the Maasai in East Africa that historically have lived on bovine milk as a staple food. Is that authentic and traditional enough for you that you might no longer consider it "strange", but rather as traditional as it gets?
https://en.wikipedia.org/wiki/Maasai_people#Cuisine
You think we're supposed to eat flour or sausage or arugula or lentils?
We are not. The dumb grazing animals are supposed to eat the various forms of grass. Their guts and stomachs are designed to convert those to energy correctly. Humans since time immemorial have eaten mostly vegetables and meats when they can catch them. Only recently did we start poisoning ourselves for the profits.
> Humans since time immemorial have eaten mostly vegetables
This is just not true. Since time immemorial, humans have eaten meat and fish constantly as a main part of their diet. Catching fish and animals isn't that much different from digging up roots. We've eaten everything we can, not just vegetables.
And humanity has been drinking bovine milk for many millennia. Long before even the concept of capitalist "profits" existed. Again, see the Maasai for example.
> Humans are not supposed to be drinking bovine milk.
Humans are not "supposed" to eat and drink most of what we do (maybe fruits are an exception). However, we have evolved to consume a lot of things - including, if we have the right genes, milk.
Most fruits are highly bred, nutrition wise they're very different from their wild-type predecessors. Many of which are outright inedible, or close to it.
That said, we've coevolved with technology of one sort or another (the broadest definition, to include cooking, plant breeding, hunting with weapons, domestication and animal husbandry) ever since we began to master fire, a million years ago give or take.
Yeah, no. It's not normal just because people have been doing this for a long time. It has sugar which makes people addicted to it and will argue until they are blue in the face to defend it just like drug addicts will defend their behavior until their last breath. Milk can cause just as much a fatter liver as beer. People can get all their calcium from green leafy vegetables. Raw milk will also contain IGG, IGB, IGA that humans can create on their own. Adding animal immunoglobulins is not well studied. Humans can create their own.
If you're drinking milk in the quantities many guys drink beer, it's going to fatten a lot more than just your liver.
If you're drinking milk in the quantities many guys drink beer, it's going to fatten a lot more than just your liver.
As many people do and get a fatty liver and ultimately Cirrhosis.
According to this meta-analysis dairy reduces the risk of fatty liver: https://pmc.ncbi.nlm.nih.gov/articles/PMC9992538/
>Human breast milk is very bitter
Aggressively incorrect.
Definitely not poison. Risk of bacterial infection? Yes. I don’t know the stats on what that risk is though and for all I know perhaps it starts getting closer to zero when it’s your own farm and you are the one handling the whole process.
Please note I am not advocating for raw milk, I think it is not a wise decision but I also don’t believe it to be poison.
Citation very much needed
One of the few times I have used the downvote button in Hn for a comment.
Its not a huge effort to at least try to add some source with such a claim, besides the comment does not even bring anything of value to the discussion.
Amish men have very limited to no screen time at work and at home. The modern lifestyle is very rough on men, sedentary work, rest of the time on app/game/content screens.
They also don't get their income garnished by social security, so that basically frees up 12% (employee + employer) that can be used by the community directly for health rather than a scamfest by the government.
The study was of time periods mostly before screens though.
Amish life expectancy is now 71 compared to 84ish. OP's data is 100+ years old and wqs analyzed in the 60s during a notable peak for medical quackery (cigarettes recommended for pregnant women, etc.)
If you didn't read the article -
> These calculations were completed for cohorts of men born during 1895–1904, 1905–1914, 1915–1924, and 1925–1934
and the gap gradually closed with time. There was an 10-year difference in the first cohort which closed by about two years per cohort.
So, a four-year gap in the most recent cohort is notable, but the narrative's probably a little different than you might guess when looking at the headline alone.
Small sample size of about 1500 Amish men divided across 4 cohorts, all exposed to the great depression. Entry age minimum of 25 years.
Sorry, but this is really marginal science. There are much stronger demographic and statistical studies of aging and mortality in humans. Here are some alternative examples of stronger studies to explore from PubMed. I keyed my search using the surnames of two well respected longevity demographers (Vaupel and Christensen):
https://pubmed.ncbi.nlm.nih.gov/?term=%20vaupel%20christense...
>the narrative's probably a little different than you might guess when looking at the headline alone
Stop talking mysteries. What's A and what's B?
A and B are the first two letters of the Latin alphabet, though I don't see the relevance.
Sorry, I didn't know about your capabilities in particular.
Please forget this interaction ever happened.
Balanced diet of fresh and unprocessed foods, extremely active lifestyle, no drugs/drinking. Of course they live a long time.
More sunlight too.
I wonder if the opposite is a factor: like most traditional clothing, Amish clothing blocks most sunlight.
You'd have to be outside to get that "benefit". Sedentary people have sunlight blocked by their roof.
Sunlight kills bacteria and viruses, stimulates vitamin D production, and has a number of emotional/cognitive benefits. Being inside 24/7 is not good for you. For most of our history we spent every daylight hour outside hunting or farming, we're adapted to this situation.
HackerNews claims to be scientific and logical, but this paper comes out from old old data (1965!), and the ant-science, pro-RFK Jr come out of the woodwork to say how it's valuable for today.
Monks also probably live a longer live. I'm not sure it's worth it.
No alcohol or nicotine and sleeping for the same period every day can go a long way.
Might also avoid direct sun exposure, for good measure.
Are we talking about the same monks? Christian monks? The people developed champagne, chartreuse and many other alcoholic drinks?
Some also work outdoors.
Also disciplined breathing techniques, Om chanting strengthens the lungs and regulates O2 flows. FWIW they do get sunlight. People need some sunlight. More specifically Mitochondria need sunlight or artificial sunlight from 600nm -> 1200nm.
Monks seem to find fulfilment and happiness in their lives.
Do they?
From documentaries I've seen of Christian monks, there is no talk of personal benefits and emotions like a self-help book, instead it's spiritual motivations about being compelled to follow a path of devotion in service to their faith.
I get the impression that it's a hard life as such orders are dwindling and they report the deprivation of things they did since joining that we might find mundane like "going to buy music" (you can tell they joined pre '80s).
I recall reading the rules of a Buddhist monastery and it was basically a compendium of all the bad things monks have done, written down to make it ambiguous it's off-limits. It did not give the suggestion of fulfilled people. It had a lengthy chapter of all the things you can't put your penis in: people, children, animals, dead things, clay vessels, fabric dolls, trees, holes in the wall, holes in the ground etc. Feels like some desperate rules-lawyering had happened over the years.
Actually religious communities with single genders have shorter lifespans.
See also Eunuchs: https://www.bbc.co.uk/news/health-19699266
"Castration had a huge effect on the lifespans of Korean men, according to an analysis of hundreds of years of eunuch "family" records.
They lived up to 19 years longer than uncastrated men from the same social class and even outlived members of the royal family."
Same family is likely not a useful comparison because lifestyle would be different. Eunuchs would be expected to serve the royal family, which implies plenty of food - not as good as the royals, but still plenty of it unlike their families back on the farm who lived closer to starvation at best and a bad year would cause a lot of deaths.
At least that is what I'd expect, but I'm trying to extrapolate what I know of European history (acoup) to Korea. Anyone have better expertise able to talk about the experience of the different groups?
The report is linked. I guess it is a tricky study as they would have a job getting an RCT signed off.
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