Affluent educated Asians in America
Life expectancy in Hong Kong is 85.3, which is the highest in the world. The US comes in at 79.1, which is well down the list.
But one group within the US exceeds even Hong Kong residents in life expectancy. Asian-Americans have a life expectancy of 85.7. Of course there are many types of Asian Americans, and I suspect that life expectancy within that group varies by class. More specifically, I suspect that highly educated Asian Americans have a life expectancy that is absolutely off the charts. (Let me know if anyone has data on that question.)
I recently ran across the following graph in the Orange County Register:
Orange County doesn’t have any poor towns (Laguna Woods is a retirement village), but it is split between upper middle class and working class towns. Focus for a moment on the three biggest towns, affluent Irvine and working class Anaheim and Santa Ana. Notice that the Covid death rate is 6 times higher in the two working class towns. That’s a lot, especially, considering that the age profile is fairly similar. And while the income difference is substantial, it’s not exactly gigantic. So what’s going on?
When I first moved to the OC, I was struck by the fact that Irvine seemed like a sort of paradise. It’s a rather boring place, but everything there is kind of perfect. Irvine also stands out in that it’s roughly 50% Asian, an unusually high percentage for such a large suburb. I suspect that its demographics have something to do with its unusually low Covid death rate (quite similar to the low Covid death rates observed in . . . you guessed it . . . East Asia.)
On the other hand, Westminister is also roughly 50% Asian, and has a relatively high Covid death rate, similar to Santa Ana and Anaheim, which are heavily Hispanic. BTW, the life expectancy of America’s Hispanics is higher than for whites.
So what’s going on here? Westminister’s Asians are mostly Vietnamese while Irvine’s tend to be Chinese, but can this actually explain such a large difference? I suspect that class plays a role. Irvine’s Asians tend to be highly educated professionals, whereas Westminister is more working class and small business.
This website suggests that Asian Americans living in states like Massachusetts and New Jersey have an unusually high life expectancy, roughly 89 years. Asians in those states tend to work in fields like science and finance. The estimated life expectancy of Asian females in Massachusetts (91.6) is the highest I’ve ever seen for any group. This estimate may be biased due to various factors, but it’s also likely measuring something real. (Full disclosure, my Chinese-American wife worked in Boston’s biotech industry–so I’m very familiar with their lifestyle.)
Some of the Asian American advantage is likely due to factors such as lower rates of obesity. But I also suspect that the same cultural attitudes that allowed highly educated Asians to live longer even before Covid, contributed to higher rates of vaccination, mask wearing, social distancing, etc.
Irvine also has geographical advantages. During Covid, it was possible to dine outside almost year around. When I moved here from Boston, I found the grocery stores here to be dramatically less crowded. In Boston, you must squeeze between shoppers. At a Gelson’s in Irvine, you can shop for 30 minutes in a spacious grocery store and never come close to another person, even when going though the self checkout.
All this leads me to believe that America’s relatively low life expectancy has nothing to do with our health care system. (I believe our system is awful, but mostly because it is absurdly expensive, and is a (the?) primary cause of slow growth in median real incomes.) Indeed the high quality of our hospitals might help to explain why our Asians live even longer than Asians in East Asia.
Instead, America’s low life expectancy seems to be due to lifestyle choices.
PS. Orange County’s Covid death rate (236) is a bit below California’s 250 and well below the national figure of 339.
PPS. Westminister’s Asians lean Republican and Irvine’s lean Democratic.
PPPS. I wonder if our federal bureaucrats are working for Trump:
A federal agency may look to ban gas stoves over concern about the release of pollutants that can cause health and respiratory problems, according to a new report.
A ban on gas stoves would cause America’s Asian American community to shift over to the GOP.
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10. January 2023 at 15:50
Lifestyle choices meaning diet?
10. January 2023 at 16:01
ee, Among other things. Crime and violence, drug use, mask wearing, vaccine use, reckless driving, smoking, exercise, etc. etc.
10. January 2023 at 17:40
Black Americans 90 years old or older have greater life Expectancy that white Americans 90 years old or older, so I think your right.
10. January 2023 at 19:15
Floccina, Interesting. I’d guess that a much smaller percentage of black Americans reach age 90. So there may be a selection effect.
10. January 2023 at 22:20
By age 65, Americans have comparable lifespans to Hong Kongers and Japanese. Why?
Because infant mortality, traffic deaths and homicides are the primary reason for lower life expectancy in the U.S. By age 65 those factors have less impact on mortality.
At 65 if you normalize for obesity, Americans live substantially longer than their peers in Japan or Hong Kong. Why?
Much better medical care in the U.S.
10. January 2023 at 22:22
As for Westminster, Vietnam did not start BCG vaccinations until 1990. I.e. after the diaspora and recently enough not to protect the age group most vulnerable to Covid mortality.
11. January 2023 at 00:43
If you want to grill bloody beef steaks each day, and wash it down with beers, then what’s the problem?
My grandmother was affluent. A lot wealthier than you. She inherited most of her 50 million from her father who owned a shipping company. She also went to Harvard. She was also one of the most disgustingly obese people I’ve ever seen in my life and she lived until she was 88.
These are just nonsensical ponderings, unless your goal is to enact legislation to prevent others from eating what they want, because you’re guided by some false misonception that the only thing that matters is the “common good”.
Vaccines and masking clearly have nothing to do with eating, and everything to do with information received from virologists who disagree. If X scientist says don’t take the vaccine, and Y scientist says it’s wonderful, then normal people with an impartial brain — i.e, people not easily duped by mass media and so-called experts, will begin to wonder whether it might be smart to wait a bit more until the raging debate is over. And how long you wait for the debate to play out might have something to do with how nasty the disease is, how old you are, your preexisting conditions, your immune system, etc, etc. Especially when the data, particularly now that we have more of it, doesn’t look good for those who ran out to get double and tripple vaxxed.
There is nothing “cultural” about masking and vaxxing. People just look at the data and draw different conclusions.
11. January 2023 at 01:29
I’m going to eat a big steak right now just to make Sumner and the left angry. Keep rearing those cattle cowboys. The left hates you, but I love you.
#supersizeme
11. January 2023 at 05:28
Fascinating post, thanks Scott.
“A ban on gas stoves would cause America’s Asian American community to shift over to the GOP.”
Talk about unintended consequences!
11. January 2023 at 05:42
dtoh,
Could smoking rates be an additional factor in the case of Japan? Roughly 20% in Japan, roughly 10% in the US and Hong Kong.
11. January 2023 at 06:30
HT DTOH. The big mysteries of demographics are pretty explainable with just a little knowledge and largely a result of behavior – but there are some things we’re just not supposed to know. Like: why are certain groups in the US perpetually poor? Bcz they have 3x the teen pregnancy rate of whites and a whopping 10x that of Asians (who have by far the lowest teen pregnancy rates in the US). I’m sure we could calculate the risk of poverty, the incarceration rate, expected level of education and life expectancy based on teen pregnancy rate alone, and probably a COVID mortality rate too, as all of these factors contribute to household crowding.
11. January 2023 at 08:53
dtoh, Don’t agree with the first part of your post, but this:
“At 65 if you normalize for obesity, Americans live substantially longer than their peers in Japan or Hong Kong. Why?
Much better medical care in the U.S.”
Just repeats what I said. Although I doubt that US medical care has “much” impact, just a little. Longevity is mostly lifestyle.
The BCG theory has been pretty much discredited, as countries once cited as examples (with little Covid) later shot up to very high death rates.
Sara and Edward, LOL, you guys are so dumb you think I’m ADVOCATING a healthy diet. I eat meat. Ever heard of the is/ought distinction?
Kangaroo, Correlation . . . causation . . .
But yes, lifestyle choices have consequences.
11. January 2023 at 19:34
@peden
Smoking is probably a factor. Also high rates of heart disease in certain parts of Japan where they eat lots of (high salt) pickled foods. Also high rates of stomach cancer because of the prevalence of H. pylori.
@scott
Yes it is mostly medical care. Specifically much higher mortality rates for many types of cancer because of the 8 year average delay in approving new cancer drugs. And a much higher mortality rate for heart attacks and strokes because of exceptionally bad trauma care including the fact that ambulances do not provide medical care (only transport) and the lack of emergency and trauma centers.
And check your facts. The first part of my post is correct. And countries with BCG vax programs did not have very high death rates.
11. January 2023 at 23:54
Not sure if you addressed this: wouldn’t you need to compare against Hong Kong’s most educated part of the population, instead of their whole population, it you pick a subset of the US, too?
12. January 2023 at 09:11
dtoh, At age 65, life expectancy is still far higher in Japan than the US:
https://data.oecd.org/healthstat/life-expectancy-at-65.htm
So it’s not stuff like murder and accidents. Obesity is a factor, as you say, but that’s consistent with my post.
There’s very little evidence that health care quality has much effect on life expectancy.
I recall you pointing to countries with low Covid death rates due to BCG, and then later on their death rates shot up dramatically. I’ve given up on that theory.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062527/
Matthias, Yes, that’s true. I don’t have data for Hong Kong by class status.
12. January 2023 at 10:36
The numbers for median age of death seem screwy. I couldn’t find data for median age at death from covid for the US, but the data in this table https://www.cdc.gov/mmwr/volumes/71/wr/mm7117e2.htm#T1_down make it pretty clear the median age can’t be in the thirties. For the UK, the median age of death from covid was 83
https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/meanandmedianageofdeathsfromcovid19
12. January 2023 at 10:38
Say what, I recall that in the US roughly 75% of Covid deaths were people over 65, so I suspect the median was about 75.
12. January 2023 at 14:52
There’s a strong association between income and life expectancy. For example, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866586/
The cited agency said yesterday that it has no plans for a ban on gas stoves.
12. January 2023 at 17:05
The Census doesn’t publish data on Jews as a category, but they are another contender for longest lived American ethnicity: e.g., Steven Spielberg started working on his autobiographical movie The Fabelmans in the 1990s but decided to postpone it until both of his parents had died. His mother then lived to be 97 and his father 103.
12. January 2023 at 18:55
Scott,
Look at the data over time. For women there’s a bigger gap, but for men, the gap had shrunk from 8 years at birth to roughly 1 year at at age 65…. pre-covid.
After Covid the life expectancy gap between American and Japanese men at age 65 nearly tripled because while life expectancy continued to climb in Japan during Covid, life expectancy for 65 year old American men fell by over a year. (That’s what happens when you don’t have BCG vaccinations.)
12. January 2023 at 18:57
Scott,
“There’s very little evidence that health care quality has much effect on life expectancy.”
If you are going to have this discussion, you need to at least understand that there is a huge difference between medical care and health care and not treat them interchangeably.
Also see…
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33326-3/fulltext
for differential survival rates for cancer.
12. January 2023 at 19:39
foosion, You said:
“The cited agency said yesterday that it has no plans for a ban on gas stoves.”
Thanks, glad to hear my post had an impact.
Steve, That seems plausible.
dtoh, With BCG, I prefer to look at evidence. It doesn’t fit.
On Japan, I wonder why you adjust for obesity but not smoking? You can play around with numbers all you want, but health care simply doesn’t have much impact on life expectancy. Cancer survival rates depend on when the cancer is diagnosed.
13. January 2023 at 02:05
Scott,
What evidence. The evidence showing the strong negative correlation between BCG vaccinations and Covid mortality that you refuse to read?
Read the Lancet study. It’s normalized for when the cancer is diagnosed.
14. January 2023 at 08:05
dtoh, Just look at the map of countries with the BCG vaccine. Remember when we we told the death rate in Eastern Europe was low because of the BCG vaccine? South America? Portugal? What happened?
14. January 2023 at 23:45
Scott,
Suggest you read the actual studies, not the fourth grade level maps created by 23 year old “journalists.”
15. January 2023 at 08:28
dtoh, But you were the one that told me to look at those countries! You were the one who suggested they had low Covid rates due to the BCG vaccine. It’s not a list I came up with.
15. January 2023 at 08:34
BTW, I linked to a published academic study, not a news article written by journalists.
It’s always a game of whack a mole “Those countries now have high Covid rates? I changed my mind, they never had the BCG vaccine”