Thursday, February 19, 2009

Smoking Death Rates: Rich vs Poor. You'd Be Surprised at The Outcomes.

How do the smoking death rates compare for the rich vs poor?  If you are a smoker, rich or poor, are you more likely to die younger than even a poor nonsmoker?  The answer is yes.  That's  what  long term research suggests.  If you're a man or a woman,  rich or poor, if you smoke, you will die prematurely compared with your nonsmoking colleagues.  So says long term studies done by the Scots.

Read the whole article. Some very telling details about how to think about the poor uninsured. Perhaps all this talk about being poor making you die sooner is washed up. Perhaps just a liberal myth for the bleeding hearts. Perhaps the futility attitude has blinded their reality. Perhaps the higher death rates of the poor have absolutely nothing to do with social/economic/political/religious/ or even academic variations of class warfare.

Perhaps it's just something as simple as smoking. Since poor people smoke more, more poor people die sooner. That's what this new long term data suggests. Perhaps the greatest way to create health equality between rich and poor, men and women is not to increase funding for health insurance. Not to increase works programs. Not to increase education funding. Not to fight crime. Perhaps the most effective way to decrease the health gap is to get poor people to quit smoking.

That's not to say that these programs things don't have other benefits. It just may not be a health benefit. It looks to me, reading this article that the poorest nonsmokers live longer than the wealthiest smokers.
That, to me, is compelling evidence that the best way to close the gap between the health of rich vs poor is to get poor people to quit smoking. Independent of doing any other intervention.

It's the smoking stupid. Perhaps we are being intellectually dishonest when we pound on the drums of economic inequality leading to poor health outcomes for the walking, uninsured poor. Perhaps the greatest determinant on the health of the poor is not their education or their crime. Maybe, just maybe, it's that they smoke more often.

What we need to do is make smoking terribly expensive for the poor. Price it out of their income. We need to make access to quitting therapies free for all. We need to prevent young poor smokers from starting. This is not rocket science.

Increasing access to health care insurance doesn't save lives. In fact, we know that people live longer during recessions, probably because they can't afford their cigarettes and all the toxic side effects of their medications.

How does money prolong your health? It doesn't. When poor nonsmokers outlive wealthy smokers, the argument is immediately shot down. Lifestyle choices prolong your health. Government intervention wont. Health insurance wont. Doctors wont.

Being poor won't kill you. Being poor and smoking will. Just as it does the wealthy. And why throwing more money for access to health care for the poor won't make them any better off unless and until they quit smoking.  And if you're poor you can even get Chantix for free.  UPDATE:  Chantix lawsuits, here we come.  
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7 Outbursts:

  1. Scotland is a small country that is mostly homogenous.

    Poor smokers in America probably die faster than rich smokers in America.

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  2. being poor won't kill you? no diagreement about the smoking factor but think you might have just oversimplified health issues and poverty...a healthy lifestyle is expensive in america...fresh fruits and vegetables are pricey compared to fast food deals plus limited grocery stores in such areas, very limited pcps and clinics in poor rural and urban areas usually without any public transportation. Jobs that pay poorly so insurance is either opted out of and not even offered. You might have just as well suggested not only to quit smoking but join a health club and the yuppie fruit and vegetable of the month club....get real dr. happy.

    ReplyDelete
  3. You are aware that people who are poor receive later diagnoses for breast cancer and start treatment at later staging?

    While smoking increases cancer incidence, lack of access to care is a bigger barrier. Studies already do consider lifestyle choices versus social factors. See the discussion at: http://www.medscape.com/viewarticle/576684

    More information can be found in the cancer journals and within the epidemiology statistics.

    ReplyDelete
  4. Lack of access to care may decrease mortality from unneeded interventions among the general population, but it's going to increase mortality among people with a specific illness that's then untreated (diabetes, cancer, etc.). Not treating cancer=death, otherwise nonintervention would be key.

    ReplyDelete
  5. More:
    30% of cancer deaths are caused by smoking, according to the ACS.
    http://www.medscape.com/viewarticle/523366

    70% of cancers are not caused by smoking. The average % of men who smoke is 22%, the smoking rate among poor people is 34% (I didn't find this divided by gender). I think it's logical to conclude that a substantial number of cancers in poor people are therefore also not smoking related, though there's increased incidence.

    However, early detection would save a lot of money over treating late stage disease. But: "minorities and the poor are less likely to be screened for cancer and,
    therefore, are more likely to have late-stage cancer when the disease is
    diagnosed. Here, the review finds that only 66 percent of American
    Indian/Alaska Native women 60 years or older have ever had a breast exam
    and only 36.5 percent of Hispanic women aged 50 plus have regular screening
    mammograms. At the same time, the report reveals that Asian American,
    Hispanic, low income and less educated women are less likely than the
    general population to get Pap smears, greatly increasing their risk of
    being diagnosed with invasive cervical cancer."
    http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/04-03-2008/0004785854&EDATE=

    Smoking is also twice as likely to kill poor people once they've been diagnosed with cancer.

    ReplyDelete
  6. when you have limited income .70/lb can be expensive...that is aproximately one tomatoe as far as i can tell and yes fast food is calorie dense and cheap...you have not shopped in a regular grocery store in a poor urban or rural area....4 boxes of mac and cheese for a buck versus maybe 2 bananas for the same price.Where I live the decent stores with good affordable produce are in the "nice" areas...that's just a fact of life. Doesn't a diet low in fiber and high in simple carbohydartes and sugars increase risk of some cancers also?

    ReplyDelete
  7. You checked out a price of Smokes lately? Thats why the cost conscious Poor Peoples have switched over to Meth or Crack...

    ReplyDelete

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