Tag Archives: Death

No Generic City Effect

By Robin Hanson · May 26, 2011 1:50 pm · Comments (3)

This is my last post on results from Ken Lee’s excellent thesis.

People who in rural areas die consistently less than others, even after controlling for other death predictors. To study this effect, Lee tried interacting urbanity with many other predictors, including geography. That is, Lee looked at all combinations of whether someone lived in a city, suburb, or rural area, and in which of nine regions of the US they lived.

After controlling for his other usual predictors (age, race, gender, married, education, income), Lee found that eleven of the 26 interaction ratios were 5% significant, and six were 1% significant. It seems that there is just no such thing as a generic effect of living in a city, suburb or rural area, nor a generic effect of living in each region. Instead, each of the 27 different place combinations has its own distinct influence on health. Put another way, each of the nine US region has a different city, suburb, or rural effect. Here are the estimated death ratios of each place (relative to Middle Atlantic cities):

KenLeeLocations2

It is West North Central, New England, and Mountain rural areas that are good for health (adding a year or so of life), and it is South Atlantic cities that are the worst for health (cutting ~1.5 years of life).

FYI, these are the ratios and significance from Lee’s table 17: Continue reading "No Generic City Effect" »

GD Star Rating
loading...
Tagged as: ,

Jobs Kill, BIG Time

By Robin Hanson · May 25, 2011 7:20 am · Comments (39)

I’ve saved the most interesting result in Ken Lee’s thesis till today. The subject is how death rates vary with jobs. The big result: death rates depend on job details more than on race, gender, marriage status, rural vs. urban, education, and income combined! Now for the details.

The US Department of Labor has described each of 807 occupations with over 200 detailed features on how jobs are done, skills required, etc.. Lee looked at seven domains of such features, each containing 16 to 57 features, and for each domain Lee did a factor analysis of those features to find the top 2-4 factors. This gave Lee a total of 22 domain factors. Lee also found four overall factors to describe his total set of 225 job and 9 demographic features. (These four factors explain 32%, 15%, 7%, and 4% of total variance.)

Lee then tried to use these 26 job factors, along with his other standard predictors (age, race, gender, married, rural, education, income) to predict deaths in the 302,890 people for whom he had job data. Lee found that his standard predictors didn’t change much, and found these job factor risk ratios (Table 34, column 2):

KenLeeHugeJobEffects

Ten of the 26 estimates are 5% significant, and five are 1% significant – this isn’t random noise (*** p<0.01, ** p<0.05, * p<0.1). Each factor is scaled to range in value from 0 to 1 across the 806 occupations; its risk ratio is an estimated ratio of death rates when that factor has its max value of one, relative to death rates when that factor has its min value of zero. And these are huge risk ratios!

If you take all of Lee’s standard non-age predictors (race, gender, married, rural, education, income), and multiply together their risk ratios, you’ll find that a poor badly-schooled unmarried urban black male dies 17.7 times as often as a rich well-educated married rural asian woman (of the same age), with a lifespan roughly thirty years shorter on average. (A risk ratio of 1.57 costs roughly five years of life.)

Yet big as this effect is, the top five job factor risk ratios give a total ratio of 19.7, bigger that all the other non-age effects put together! And the top ten job factor ratios give a total risk ratio of over 100!  (All twenty six factors together give a total risk ratio of 563.) Jobs are clearly a huge and neglected influence on who lives and who dies.

If you cared about preventing death, rather than just signaling your concern, these results suggest you stop wasting your efforts on tiny effects like medical insurance, auto accidents, crime, recreational drugs, radiation, or food safety, and focus on: jobs. Yes a lot of job-death variation must come from different types of people doing different types of jobs, but a great deal of this variation is also likely causal – some jobs kill folks much more than others.

At the very least we should try to tell people about the huge life and death consequences of their job choices. Then workers could demand higher wages for more deadly jobs, which should induce employers to seek ways to substitute less deadly for more deadly jobs. Alas I suspect most folks will just shrug their shoulders – these sort of effects seem too abstract to elicit much concern. If you look at a person doing a job they don’t look like they are dying. Not like if snakes were killing people on planes …

FYI, here are some sample jobs rated high and low on the four overall job factors (from Table 49): Continue reading "Jobs Kill, BIG Time" »

GD Star Rating
loading...
Tagged as: ,

Death Cause Correlates

By Robin Hanson · May 24, 2011 1:50 pm · Comments (8)

Over the years I’ve seen many studies correlating overall death rates with other features, and also seen studies on correlates of particular causes of death, but until Ken Lee’s thesis I’d never seen how death correlates change with broad categories of death causes. Yesterday I pointed to one disturbing correlate: more med spending correlates with more cancer deaths, but not with more deaths from other causes.

That data also found injury deaths increasing more with alcohol use, which makes sense. While no population density estimates were significant, density’s most positive correlation with death was for “other” deaths, which contains most known contagious conditions. This also makes sense, as density increases contagion.

That was all from Lee’s chapter 2, where he looks at 50 states over 28 years. In chapter 3 Lee turns to a much larger data set, 367,101 adults from the National Longitudinal Mortality Study, followed over 11 years during which 9.1% of them died. Here are a few selections from Lee’s Table 14, where he breaks down deaths into cancer, heart attack, injury, and other:

KenLeeCauseCorrelates

If docs are especially bad at treating cancer, then we should expect those who use docs more to do worse at cancer. And in fact women, the rich, and the well educated do worse at cancer. Since there are many more dangerous objects in rural and poor lives, it also makes sense that such folks suffer injury deaths more.

If the main reason rural folks die less is that lower density reduces contagion, we’d expect the rural effect to be largest for “other” deaths, and that is what we find. Interestingly, that is also the kind of death which marriage best prevents – does married life prevent contagion compared with single life?

GD Star Rating
loading...
Tagged as: , , ,

What Is Em “Death”?

By Robin Hanson · April 29, 2011 5:00 am · Comments (32)

Yesterday I talked about one big change with ems (future whole  brain emulation robots) – they’d mostly be workaholics. Another other big change with ems, I think, is their concept of and attitude toward “death.” Ems would often agree to make copies of themselves, copies which they expected would only last for a limited time, such as one year. But they’d mostly be fine with this. Let me explain.

Imagine that you have lost all memories of some period of your life, say a period one year long. You still have pictures, letters, a diary, some video, memories in others you can talk to, etc. But while it all sounds like the sort of thing you might have done, you don’t additionally recall doing any of it. How much would this memory loss degrade the value of your overall life? I’d say it would be far worse to have not lived that year at all, say being put in suspended animation, than to merely have lost the memory of that year.

Now imagine that, because you had access to a time machine, this lost year happened at the same time as one of your other years. During 2006, for example, you were off experiencing 2005 all over again, but in another place, and then you forgot it all, expect for the pictures, etc. For me, this would not much degrade the overall value of my life. It would again be a bit sad not to remember that year, but its not a big deal when it happened.

Now imagine that you could use this time machine to both experience 2005 twice, forgetting one of the parts, and also to experience 2006 as usual. Here you’d be adding one more year onto your life, which I’d consider great. If the cost of having one more year of life were that you don’t fully remember that year, to me that would be a small price to pay.

For an em who shared my attitudes here, the option to spawn a new copy who only lasted a year would be much like the option to live another year longer, but without remembering it. Mostly a good deal, at least if you liked your life during that time. Yes the copy might be sad when his year came to an end, knowing his detailed memories of that year would not last. But he’d usually expect that “he” would continue to exist through other copies. He wouldn’t consider this harm to be remotely as large as what we call “death” — the end of anyone who remembers our life in some detail.

Ems would start as scans of humans, but not of random humans – the humans would be chose for their productivity and their acceptance of the em patterns of life, and “death.” As a result, ems would mostly be fantastically-capable workaholics who were not greatly bothered by “death” given the existence of other close copies. Since they seem to me quite “human” with lives well worth living, I consider the em revolution to be far more glorious than horrifying.

GD Star Rating
loading...
Tagged as: ,

Avoiding Death Is Far

By Robin Hanson · April 12, 2011 12:50 am · Comments (42)

Avoiding death is a primary goal of medicine. Avoiding side effects of treatment is a secondary goal.  So it makes sense that in a far mode doctors emphasize avoiding death, but in nearer mode avoiding side effects matters more:

The study asked more than 700 primary-care doctors to choose between two treatment options for cancer and the flu — one with a higher risk of death, one with a higher risk of serious, lasting complications. In each of the two scenarios, doctors who said they’d choose the deadlier option for themselves outnumbered those who said they’d choose it for their patients. … Two hypothetical situations were presented: one involved choosing between two types of colon cancer surgery; the less deadly option’s risks included having to wear a colostomy bag and chronic diarrhea. The other situation involved choosing no treatment for the flu, or choosing a made-up treatment less deadly than the disease but which could cause permanent paralysis. (more; HT Tyler)

As other people are far compared to yourself, advice about them is more far. Similar effects are seen elsewhere:

One study asked participants if they would approach an attractive stranger in a bar if they noticed that person was looking at them. Many said no, but they would give a friend the opposite advice. Saying “no” meant avoiding short-term pain — possible rejection by an attractive stranger — but also missing out on possible long-term gain — a relationship with that stranger.

Since fear of being laughed at for doing something weird is also near, far mode also seems the best place to get people to favor cryonics. A best case: folks recommending that other people sign up at some future date. How could we best use that to induce concrete action?

Added 11p: Katja offers a plausible alternative theory.

GD Star Rating
loading...
Tagged as: , ,

Deathbed Regret Is Far

By Robin Hanson · November 19, 2010 7:30 pm · Comments (38)

“No one on their deathbed ever wished they had spent more time in the office,” the saying goes. … I have my doubts. (more)

Ben Casnocha likes palliative care worker Bronnie Ware’s “top regrets … from her patients on their death beds” (HT Tyler):

  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
  2. I wish I didn’t work so hard.
  3. I wish I’d had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish that I had let myself be happier.

For ten years my wife has been a hospice social worker, supporting ten dying patients a week. And she can’t recall any of those 5000 patients ever spontaneously expressing a general life regret. She usually gives open-ended questions like “tell us about your life” and sometimes dying folk express apologies to particular people, or regret that a surprise early death prevents particular plans like visiting Europe. Sometimes patients say what they are proud of about their lives, or how they’d like to be remembered. But they just never give general regrets about their lives. Who would?

Ms. Ware said regrets are expressed “when questioned about any regrets they had or anything they would do differently”; my wife isn’t thrilled about this as a care technique.

Deathbed folks are usually far from their analytical peak – they are often in great pain, and rather muddle-headed. So why would we think their comments especially insightful? I suspect we attach unrealistic significance to deathbed words because we are terrified to think about death, and eager to show our devotion to the dead and dying.

But if deathbed regrets are less than reliable descriptions of reality, where might they come from? One theory is that they are like the famous interview question “What is your main fault?”, which evoke answers like “I work too hard” or “I’m too much of a perfectionist.” These are obviously attempts to brag about a good feature, but call it a “fault.” All but regret #4 above fit this directly – they basically say “I sacrificed so much for you people.” Regret #4 similarly declares how much the dying cares about others.

Another theory is that deathbed regrets arise from taking a far view of our lives. The far mental mode is more happy, social, and idealistic, and the above regrets express a commitment to the ideals of happiness, friend and family, and resistance to conformity pressures.

It may be good to take stock of your life and consider your basic priorities. And you might do well to listen to spontaneous comments by those experienced in life on the mistakes they’ve made. But what pain-pinned muddle-headed dying folks say when pushed to express regrets seems unlikely to be especially informative.

Added 9a: Stephen Smith suggests these regrets are the predictable result of opiate pain medication.

Added 24Nov: Andy McKenzie points to studies showing “as time since a decision grows, people tend to shift their regrets towards not making the hedonistic decision.”

GD Star Rating
loading...
Tagged as: , ,

Dissing Fear

By Robin Hanson · October 3, 2010 11:40 am · Comments (12)

Political pundits like to accuse opponents of a “politics of fear”, or of hate.  In contrast, folks go out of their way to emphasize that theirs is a politics of hope or compassion.  Yet when each of us notices that we are feeling fear or hate, this doesn’t usually make us reject the beliefs that lead to such feelings.  Why do we embrace and accept our own fears and hates, even as we suggest that others’ fears and hates are bad signs about them?

One obvious explanation: relative to low status folks, high status folks have less occassion to fear or hate.  Pretty pampered prestigious people encounter fewer dangers to fear, or powerful enemies to hate.  Therefore publicly showing fear or hate is a sign of low status.  Complaining that your opponents have a “politics of fear” or hate is really just complaining about their low status.  Politics isn’t about policy, after all.

GD Star Rating
loading...
Tagged as: , ,

Old Are Lazy, But Fit

By Robin Hanson · September 9, 2010 4:30 pm · Comments (24)

Many are concerned about how rich nation workers can pay for the rising costs of public pensions and other elderly benefits.  A graph from the latest Science clarifies.  While the ratio of folks over 65 to younger adults (OADR) will almost double in 45 years, the ratio of disabled to healthy adults (ADDR) will hardly change at all.  The ratio of folks with fifteen years left to live to younger adults will increase ~42%.

oldfolks

  • OADR, … people aged 65 or older, divided by … people of working age, 15 or 20 to 64. …
  • POADR, … people in age groups with life expectancies of 15 or fewer years, divided … people at least 20 years old in age groups with life expectancies greater than 15 years. …
  • ADDR, … adults at least 20 years old with disabilities, divided by … adults at least 20 years without them. (more)

There is no basic economic problem; we have plenty of capable workers. We instead have a political problem – old folks feeling entitled to more leisure at the expense of their juniors.  So just how much will rich nations be willing to tax their workers to pay for “promises” their elderly made to themselves long ago?

GD Star Rating
loading...
Tagged as: , ,

Ways To Pay To Exist

By Robin Hanson · September 3, 2010 6:30 am · Comments (47)

I’ve argued that if future tech and law enable a supply-and-demand economy of creature creation, it will enforce a good simple principle of existence:

Creature X should exist if it wants to exist [i.e., would want to exist if it existed] and it can pay for itself. … Most new creatures would have designs near the peak of factory profitability, and own little surplus relative to their cost. Residual control rights (e.g., “are they slaves?”) would rest in the hands of whomever could squeeze the most market value from them.

Control rights deal with a central conflict in factory-creature relations. Factories must pay up front to make creatures, but the value that creatures may create appears later. So how can factories assure they get paid? Some possible answers:

  • Slavery – Factories could take direct physical control of new creatures, or sell such control to others. This is a simple and robust approach, but it can also be wasteful, by reducing creature incentives to be productive.
  • Debt – A creature could be in debt for its creation costs, to be recycled or sold into slavery unless it repays via a set schedule. Inflexible payments can induce recycling needlessly often.  Such waste can be reduced by adjusting payments to market context. Debt holders may have some controls on activities or spending.
  • Stock – Others might own shares in a creature’s income, net of debt and certain specific expenses. Stock owners might voter to exercise limited control rights. Shares adjust more flexibly to changing conditions, and leave some creature incentives to find ways to be more productive.
  • Contract – A creature might be obligated by contract to work to achieve certain non-financial factory goals.  This requires goals that cannot be as well achieved by the factory itself, and requires relevant creature effort which can be monitored by courts.
  • Gratitude – A creature might have a strong preference for repaying its creator. This preference could be built into core values, or imprinted via something like education and acculturation, and encouraged via social norms.
  • Shared Goals – A factory might know how to make creatures that roughly shared certain of its broader goals. These might the creature’s core values or values imprinted via education or social norms. This approach requires factories with broad goals that can be better achieved by such delegates.
  • Reproduce – A factory may have a strong preference to make and support creatures like itself.  If it can actually make such, this process can be self-sustaining, and select for creatures who are effective at reproducing.

In practice, all of these approaches can be mixed, and I find it hard to say with much confidence which mixtures will be used more heavily, or be more profitable.  Mainly-slavery, however, seems pretty unlikely dominant long-run approach. I also find it hard to complain much about the ethics of using whatever turn out to be the most efficient mixtures. After all, using any other process would mean not creating creatures who could pay for themselves, or creating creatures who are a net burden to others.

While today’s creation practices include elements of all these approaches, we clearly lean most heavily on reproduction, and many of us are horrified at the prospect that future folk might not act similarly. For example, some libertarians tell me it is a basic ethical fact that no person should be born with debt, stock, or physical restraints. But I fear this is merely arrogant presumption that our ways must be best.

GD Star Rating
loading...
Tagged as: ,

Who Should Exist?

By Robin Hanson · August 30, 2010 6:00 pm · Comments (61)

The question of what people should exist seems complex and subtle, but basic economic theory suggests it may get a lot simpler in the future. Let me explain, via three possible questions.

1. First, consider the binary question, “should creature X exist or not?” Economically, creature X should exist if it wants to exist and it can pay for itself. That is, in a supply and demand world, if our only choice is whether X should exist, then an X that wants to exist should actually exist if its lifespan cost of resources used (including paying for any net externalities) is no more than the value it gives by working for others. To reject the existence of such a creature is to reject an efficiency gain, i.e., a way to potentially make everyone better off. (These costs and benefits are of course marked at market prices. A creature’s value might include donations from other creatures who valued its existence.)

2. Next, consider the question, “Which humans should be created today?” This question is complicated by the fact that each human likely to exist can be created by only one particular set of parents, and then only if the conception lottery goes a certain way.  Once a new human exists there remains the question of what resource endowment (positive or negative) the kid should get from its parents. Since this creation scenario is far from competitive, supply and demand doesn’t get us very far in analyzing it.

3. Finally, consider the question, “Which creatures should be created?” in a future where factories can make a wide range of creatures. This situation might arise with whole brain emulation, or advanced genetic engineering.  Imagine a supply-and-demand world where many similar competing profit-seeking factories can each make many possible creatures with great precision, endowing them with any preferred debts or rights, but aren’t overly limited by intellectual property rights. When creating creatures is such a competitive industry, supply and demand has strong implications.

All creatures would be created that could clearly pay for themselves (including intellectual property license fees minus existence donations). Since there are vastly more possible creatures than room for actual creatures, costs to exist would be prohibitively high. Most new creatures would have designs near the peak of factory profitability, and own little surplus relative to their cost. Residual control rights (e.g., “are they slaves?”) would rest in the hands of whomever could squeeze the most market value from them.  Yes a few would get lucky and become rich enough to have slack for leisure and existence donations; but theirs would be only a small fraction of total wealth. And in a supply and demand world, this distribution of existence, control, and wealth would be Pareto-optimal, economically efficient, and hence good for all the usual reasons.

Another exception to these creature patterns could be due to ancient legacies, of those who held large initial endowments before this competitive regime began. The designs of such ancient creatures, and of new creatures they favored with existence donations, might be unusually far from the peak of factory profitability. Other creatures might question the legitimacy of special creatures who would not exist if not for such legacy assets.  They might complain, “Why do such legacies get to be apparent exceptions to the general rule that creatures must pay their way to exist?” Of course if legacy assets were deeply entrenched in social institutions, yet represented only a tiny fraction of wealth, these might remain mere complaints.

Tin-pot dictators and supporting elites often keep their nations poor and inefficient out of (often valid) concerns that efficient economies might no longer tolerate their grabbing such large wealth fractions. Similarly, you might fear you would lose relative power in the above scenario of efficient future creatures. So you might prefer an inefficient legacy control scenario, where your generation coordinates to finely control of all future economies, to be tin-pot dictators of the future.  You might try to prevent the creation of these efficient creatures, in favor of creatures you decide should exist, serving you or not as you choose.

If asked what gives you the right to prevent the existence of creatures who could fully pay for themselves, you might respond that you need no right, if you have power and a will to use it.  Or perhaps you’ll say ethics assures you it is simply impossible to be unfair to creatures who don’t yet exist.  But wearing my efficient economist hat, I cannot support such naked selfish aggression, even if I thought it would work.  And knowing how hard is coordination, I have serious doubts re feasibility. If you can identify large negative externalities, I will help you to find ways to price them, to discourage the creation of creatures who cannot fully pay for themselves, and the theft of legacy assets.  But if not, I prefer to help creatures who can pay for their existence obtain that exquisite treasure.

Added 1Sep: Let “wants to exist” be “would want to exist if it existed.”

GD Star Rating
loading...
Tagged as: ,