Tag Archives: aging

Birth dearth in China => collapse? war?

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China passed us in life-expectancy in 2022, and also in fertility, going the other way. In China lifespan at birth increased to 77.3 years. In the US it dropped an additional 0.9 years, to 76.8. US lifespans suffered from continuing COVID and an increase in accidents, heart disease, suicide, drugs, and alcohol abuse. Black men were hit particularly hard, so that today, a black man in the US has the same life expectancy as he would in Rwanda. China seems to have avoided this, but should expect problems due to declining fertility and birth rates.

China passed us in life expectancy in 2022.

Fertility rates will eventually burden the US too, as US fertility is only slightly greater than in China, 1.78 children per woman, lifetime, compared to 1.702 in China. But China has far fewer people of childbearing ages, relatively, and only 47% are women. Three decades of one child policy resulted in few young adults and a tendency to abort girls. Currently, the birthrate in China is barely more than half ours: 6.77 per 1000, compared to 12.01 per 1000. And the proportion of the aged keeps rising. China will soon face a severe shortage of care-givers, and an excess of housing.

Years of low birthrate preceded the “Lost decades” of financial crisis in Japan and the USSR. Between 1990 and 2011, business stagnated and house prices dropped. China faces the same; few workers and more need for care: it’s not a good recipe.

Beginning about 1991, Japan saw a major financial collapse with banks failing, and home values falling. China seems over-due.

Few children also signals a psychic lack of confidence in the country, and suggests that, going forward, there will be a lack of something to work for. Already Chinese citizens don’t trust the state to allow them to raise healthy children. They have stopped getting married, especially in the cities, and look more to have fun.

Affluent women claim they can’t find a good man to marry: one who’s manly, who will love them, and who will reliably raise their standard of life. Women seem less picky in China’s rural areas, or perhaps they find better men there. However it goes, urban women get married late and have few children, both in China and here. China produces great, sappy, soap operas though: a country girl or secretary in a high-power job meets a manly, urban manager who lovers her intensely. A fine example is “The Eternal Love” (watch it here). It involves time travel, and a noble romance from the past. Japan produced similar fiction before the crisis. And a crisis seems to be coming.

While Japan and Korea responded quietly to crisis and “the lost decades,” allowing banks to fail and home values to fall, Russia’s response was more violent. It went to war with Chechnya, then with Belarus and Ukraine, and now with NATO. I fear that China will go to war too — with Taiwan, Japan, and the US. It’s a scary thought; China is a much tougher enemy than Russia. There is already trouble brewing over new islands that they are building.

Robert Buxbaum January 25, 2023. If you want to see a Korean soap opera on the Secretary – manager theme, watch: “What’s wrong with Secretary Kim”. (I credit my wife with the research here.) I suspect that Americans too would like sappy shows like this.

New Chinese emperor, will famine not follow

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For most of its 2300 year history, the Chinese empire has rattled between strong leaders who brought famine, and weak leaders who brought temporary reprieve. Mao, a strong leader, killed his associates plus over 100 million by his “great leap forward” famine. Since then, 30+ years, we’ve had some weaker leaders, semi-democracy, and some personal wealth, plus the occasional massacre, e.g. at Tiananmen square, and a growing demographic problem. And now a new strongman is establishing himself with hopes of solving China’s problems. I hope for the best, but fear the repeat of the worse parts of Chinese history.

Two weeks ago, Chairman Xi amended the Chinese constitution to make himself emperor for life, essentially. He’s already in charge of the government, the party, and the military. Yesterday (Tuesday), he consolidated his power further by replacing the head of the banks. The legal system is, in theory, is the last independent part of government, but there is hardly any legal system in the sense of a balance of power. If history is any guide, “Emperor” Xi will weaken the courts further before the year is out. He will also likely remove many or all of his close associates and relatives. It is not for nothing that Nero, Stalin, and Mao killed their relatives and friends — generally for “corruption” following a show trial.

China's Imperial past is never is quite out of sight. Picture from the Economist.

China’s past is never is quite out of sight. Picture from the Economist.

Xi might be different, but he faces a looming demographic problem that makes it likely he will follow the president of the stronger emperors. China’s growth was fueled in part by a one child policy. Left behind is an aging, rural population with no children to take care of the elderly. As top-down societies do not tolerate “useless workers,” I can expect a killing famine within the next 10 years. This would shed the rural burden while providing a warning to potential critics. “Burn the chicken to scare the monkey,” is a Chinese Imperial aphorism. Besides, who needs dirt farmers when we have modern machines.

Lazy beds (feannagan) use only half the soil are for planting. The English experts were sure this was inefficient and land-wasting. Plowing was imposed on Ireland, and famine followed

“Lazy beds” of potatoes were used in Ireland for a century until experts forced their abandonment in the mid 1800s. The experts saw the beds, and the Irish as lazy, inefficient, and land-wasting. Famine followed.

Currently about 40% of the country is rural, about 560 million people spread out over a country the size of Canada or the US. The rest, 60% or 830 million, live concentrated in a few cities. The cities are rich, industrial, and young. The countryside is old, agricultural and poor, salaries are about 1/3 those of the cities. The countryside holds about 2/3 of those over 65, about 100 million elderly with no social safety net. The demographic imbalance is likely to become worse — a lot worse — within the next decade.

What is likely to happen, I fear, is that the party leaders — all of whom live in the cities — will decide that the countryside is full of non-productive, uneducated whiners. They will demand that more food should be produced, and will help them achieve this by misguided science and severe punishments. Mao’s experts, like Stalin’s and Queen Victoria’s, demanded unachievable quotas and academic-based advice that neither the leaders nor the academics had ever tried to make work. Mao’s experts told peasants to kill the birds that were stealing their grain. It worked for a while until the insects multiplied. As for the quotas, the party took grain as if the quotas were being met. If the peasants starved, they starved.

I expect that China’s experts will propose machine-based modern agriculture, perhaps imported from the US or Israel: Whatever is in style at the time. The expert attitude exists everywhere to this day, and the results are always the same. See potato famine picture above. When the famine comes, the old will request food and healthcare, but the city leaders will provide none, or just opioids as they did to ailing Elvis. When the complaining stops the doctor is happy.

China's population pyramid as of 2016. Notice the bulge of 40-55 year olds.

China’s population pyramid as of 2016. Notice the bulge of 40-55 year olds. Note too that there are millions more males (blue) than females (pink).

In single leader societies, newspapers do not report bad news. Rather, they like to show happy, well-fed peasants singing the leaders’ praise. When there’s a riot too big to ignore, rioters are presented as lazy malcontents and counter-revolutionaries. Sympathizers are sent to work in the fields. American academia will sing the praises of the autocratic leader, or will be silent. We never see the peasants, but often see the experts. And we live in a society where newspapers report only the bad, and where we only believe when there pictures. No pictures, no story. As with Stalin’s Gulags, Mao’s famine, or North Korea today, there are likely to be few pictures released to the press. Eventually, a census will reveal that tens of million aged have vanished, and we’ll have to guess where they went.

I can expect China to continue its military buildup over the next decade. The military will be necessary to put down riots, and keep young men occupied, and to protect China from foreign intervention. China will especially need to protect its ill-gotten, new oil-assets. Oil is needed if China is to replace its farmers with machines. It will be a challenge for a wise American leader to avoid being drawn into war with China, while protecting some of our interests: Taiwan, Hong Kong, etc. As with Theodore Roosevelt, he should offer support and non-biassed mediation. Is Trump up to this?  Hu Knows?

Robert Buxbaum, March 21, 2018. The above might be Xi-nephobia, Then again, this just in: Chairman Xi announces that Taiwan will face punishment if it attempts to break free. Doesn’t sound good.

Fat people live longer, show less dementia

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Life expectancy is hardly affected by weight in the normal - overweight- obese range. BMI 30-34.9 = obese.

Life expectancy is hardly affected by weight in the normal – overweight – obese range. BMI 30-34.9 = obese.

Lets imagine you are a 5’10” man and you weigh 140 lbs. In that case, you have a BMI of 20, and you probably think you’re pretty healthy, or perhaps you think you’re a bit overweight. Our institutes of health will say that you are an “average-wight” or “normal-weight” American, and then claim that the average-weight American is overweight. What they don’t tell you, is that low weight, and so-called average weight people in the US live shorter lives. Other things being equal, the morbidity (chance of death) for a thin American, BMI 18.5 is nearly triple that of someone who’s obese, BMI 32. The morbidity of the normal-weight American is better, but is still nearly double that of the obese fellow whose BMI is 32.

Our NIH has created a crisis of overweight Americans, that is not based on health. They work hard to solve this obesity crisis by telling people to jog to work, and by creating ever-more complicated food pyramids. Those who listen live shorter lives. A prime example is Jim Fixx, author of several running books including “The complete Book of Running.” He was 52 when he died of a heart attack while running. Similar to this is the diet-expert, Adelle Davis, author of “Let’s eat right to keep fit”. She died at 70 of cancer — somewhat younger than the average American woman. She attributed her cancer to having eaten junk food as a youth. I would attribute it to being thin. Not only do thin people live shorter lives, but their chances of recovering from cancer, or living with it, seem to improve if you start with some fat.

The same patter exists where age-related dementia is concerned. If you divide the population into quartiles of weight, the heaviest has the least likelihood of dementia, the second heaviest has the second-least, the third has the third-least, and the lightest Americans have the highest likelihood of dementia. Here are two studies to that effect, “Association between late-life body mass index and dementia”, The Kame Project, Neurology. 2009 May 19; 72(20): 1741–1746. And “BMI and risk of dementia in two million people over two decades: a retrospective cohort study” The Lancet, Volume 3, No. 6, p431–436, June 2015.

Morbidity and weight, uncorrected data, and corrected by removing the demented.

Morbidity and weight, uncorrected data, and corrected by removing the demented. The likelihood of dementia decreases with weight.

Now you may think that there is a confounding, cause and effect here: that crazy old people don’t live as long. You’d be right there, crazy people don’t live as long. Still, if you correct the BMI-mortality data to remove those with dementia, you still find that in terms of life-span, for men and women, it pays to be overweight or obese but not morbidly so. The study concludes as follows: “Weight loss was related to a higher mortality risk (HR = 1.5; 95% CI: 1.2,1.9) but this association was attenuated when persons with short follow-up or persons with dementia were excluded.” As advice to those who are planning a weight loss program, you might go crazy and reduce your life-span a lot, but if you don’t go crazy, you’re only reducing your life-span a little.

In terms of health food, I’ve noticed that many non-health foods, like alcohol and chocolate are associated with longevity and mental health. And while low-impact exercise helps increase life-span, that exercise is only minimally associated with weight loss. Mostly weight loss involves changing the amount you eat and changing your clothes choices to maximize radiant heat loss.

Dr. Robert E. Buxbaum, October 26, 2017. A joke: Last week I was mugged by a vegan. You may ask how I know it was a vegan. He told be before running off with my wallet.

Seniors are not bad drivers.

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Seniors cause accidents, but need to get places too

Seniors are often made fun of for confusion and speeding, but it’s not clear they speed, and it is clear they need to get places. Would reduced speed limits help them arrive alive?

Seniors have more accidents per-mile traveled than middle age drivers. As shown on the chart below, older Canadians, 75+, get into seven times more fatal accidents per mile than 35 to 55 year olds. At first glance, this would suggest they are bad drivers who should be kept from the road, or at least made to drive slower. But I’m not so sure they are bad drivers, and am pretty certain that lower speed limits should not be generally imposed. I suspect that a lot of the problem comes from the a per-mile basis comparison with folks who drive long distances on the same superhighways instead of longer, leisurely drives on country roads. I suspect that, on a per-hour basis, the seniors would look a lot safer, and on a per highway-mile basis they might look identical to younger drivers.

Canadian Vehicle Survey, 2001, Statistics Canada, includes drivers of light duty vehicles.

Deaths per billion km. Canadian Vehicle Survey, 2001, Statistics Canada, includes light duty vehicles.

Another source of misunderstanding, I find, is that comparisons tend to overlook how very low the accident rates are. The fatal accent rate for 75+ year old drivers sounds high when you report it as 20 deaths per billion km. But that’s 50,000,000 km between fatalities, or roughly one fatality for each 1300 drives around the earth. In absolute terms it’s nothing to worry about. Old folks driving provides far fewer deaths per km than 12-29 year olds walking, and fewer deaths per km than for 16-19 year olds driving.

When starting to research this essay, I thought I’d find that the high death rates were the result of bad reaction times for the elderly. I half expected to find that reduced speed limits for them helped. I’ve not found any data directly related to reduced speeds, but now think that lowered speed limits would not help them any more than anyone else. I note that seniors drive for pleasure more than younger folks and do a lot more short errand drives too — to the stores, for example. These are places where accidents are more common. By contrast, 40 to 70 year olds drive more miles on roads that are relatively safe.

Don't walk, especially if you're old.

Don’t walk, especially if you’re old. Netherlands data, 2001-2005 fatalities per billion km.

The Netherlands data above suggest that any proposed solution should not involve getting seniors out of their cars. Not only do seniors find walking difficult, statistics suggest walking is 8 to 10 times more dangerous than driving, and bicycling is little better. A far better solution, I suspect, is reduced speeds for everyone on rural roads. If you’re zipping along a one-lane road at the posted 40, 55, or 60 mph and someone backs out of a driveway, you’re toast. The high posted speeds on these roads pose a particular danger to bicyclists and motorcyclists of all ages – and these are folks who I suspect drive a lot on the rural roads. I suspect that a 5 mph reduction would do quite a lot.

For automobiles on super-highways, it may be worthwhile to increase the speed limits. As things are now, the accident fatality rates are near zero, and the main problem may be the time wasted behind the wheel – driving from place to place. I suspect that an automobile speed limit raise to 80 mph would make sense on most US and Canadian superhighways; it’s already higher on the Autobahn in Germany.

Robert Buxbaum, November 24, 2014. Expect an essay about death on tax-day, coming soon. I’ve also written about marijuana, and about ADHD.