The article says the drop is due to people in their 20s and 30s are dying but why? The article states there is a big increase in overdose deaths but in percentage terms. Is this significant? Are deaths from fentanyl up from 1,000 to 2,000 or 100,000 to 200,000?
I also didn't find the word "obesity" anywhere in this article and I have to wonder how much this is a factor too.
As much as people might take this as "see how much life is better in [country X]", you still see people desperate to come here. Even in the EU, legal and illegal immigrants are much more likely to be headed to the UK and Germany.
I'm Australian but I've now lived in the US coming up on 9 years. The reason? As a software engineer, you can squeeze what would be a lifetime of savings in Australia into 10 years or less and that's hard to ignore.
The US is a pretty terrible place to live if you're poor however. And that goes far beyond life expectancy (but it of course plays into it).
Actually, if you're poor enough in the US and you live in a state like California you'll qualify for the best free healthcare in the world via Kiaser. Zero copay, pick your own doctors, specialists, eye exams, medication, etc. at zero cost. Then as soon as you get another job and start earning more than $1,400 a month(IIRC) you'll be kicked back into the regular system where no amount of money will ever buy you back into that awesome top tier that you got with the free plan.
Kaiser is fine for acute issues, or prescription drugs. For chronic issues, you have to yell at them repeatedly to get a decent doctor. I left that mess long ago and never looked back. Insurance is more, but I actually get semi-competent doctors now.
A lot of young adults are graduating and finding zero hope of getting a full time job with benefits. Also they have large amounts of non-dischargeable student loans. In addition if they have any health problems they are no longer on parent's insurance and suffering disproportionately. I'm not surprised to see issues with drug use and suicide bringing down life expectancies. I also don't expect the trend to get much better in the next few years.
The median student loan payment is $220 per month, for the minority of young people who even have student loans. (Only a third of millennials have any student loans, and the median amount is less than $25,000.) People are killing them selves over a car payments worth of debt? Or are you trying to shoe horn these mortality statistics into a pre-constructed narrative?
It's ~17,000 --> ~70,000 in the last twenty years.
Also, since a lot of these deaths happen early, they have a greater impact the life expectancy rate. One person dying 55 years earlier from a heroin OD has the same impact as 11 people dying 5 years earlier.
> The US is a pretty terrible place to live if you're poor however.
That's simply not true. The poor in the US have one of the world's most expensive welfare states. It's the next ~20%-25% or so above the bottom 25%, that have it worst. Those people don't get free access to healthcare because they earn too much.
The US has a very advanced welfare state and safety net for the poor. The US spends more of its economy on its welfare state than either Canada or Australia, and is in the upper half of the OECD in that regard. The US welfare state is also rapidly growing, whereas most other developed nations are seeing their welfare states shrinking.
The US poverty and homelessness rates are both superior to Canada and France. The US provides free healthcare for the bottom 25%, along with countless other massive programs involving food and shelter for the poor.
You talk about absolute costs as if that means much.
Surely a conclusion can be reached where you’re spending more than any other country, yet so inefficient at distributing the wealth that you’re spending, or funnelling it into broken feedback loops that keep people in the welfare system.
surely if that were the case then it doesn’t matter how much you’re spending in absolute terms, you’d still not be enriching the lives of the poor or helping social mobility.
Folks, the equation is quite simple: the US is a high-risk, high (financial) reward society. Unlike the EU, it's optimized for the upside: you have many opportunities to create wealth for yourself (and sometimes for others). The EU, conversely, is optimized for the downside: you may not have too many opportunities to climb high, but even if you are the bottom, life can still be relatively comfortable.
So, for the averaghe person, the European system is likely (almost definitely) better.
For risk-craving entrepreneurs, the US is better (although some other places may have even more and bigger high-risk opportunities nowadays).
For you? You decide!
> So, for the averaghe person, the European system is likely (almost definitely) better.
I would strongly dispute this. According to the OECD, median household disposable income (adjusted for purchasing power) in the US is $10,000 per year, more than 20% higher than Germany, and $12,000 per year higher than the OECD average.
Health care and educational expenses don’t come close to wiping out that difference for the median person. The median American household has no student loan payment, and spends just a couple of thousand per year on out of pocket health care costs: https://www.kff.org/health-costs/press-release/interactive-c...
> For example, a person with employer coverage earning $50,000 annually spends on average $5,250, or roughly 11% of her income, on health care. This includes $800 per year in out-of-pocket costs, a $1,400 premium contribution, and $3,050 in state and federal taxes to fund health programs.
(The OECD disposable income statistic is after taxes, so the $3,050 in taxes above should be excluded from the comparison.)
The US system is optimized for the top 60%, and further optimized so the middle 40% doesn’t have to pay EU-level taxes to bankroll a safety net for the bottom 40%. It’s optimized at maximizing material comfort for the majority of people who never get seriously ill before they’re eligible for Medicare, as opposed to optimizing for raising the floor for people who get unlucky.
That's not actually true at all. The US has lower social mobility than most wealthy European countries. Thus, there are actually fewer opportunities for most people to create wealth for themselves compared to countries with more equality. It's hard to start a business, if, like the vast majority of people, you don't have a bunch of excess money sitting around.
Quintile graphs obscure absolute magnitudes. Most of the people that have a realistic chance of making it into the upper income/wealth quintiles come from relatively high social strata already (either within the U.S or, if they're an immigrant, within their home countries), but they want that high percentile to mean more in absolute terms.
In other words, if you come from the upper end of the distribution, income inequality is a feature not a bug.
I think this has to do with the Great Recession. Prolonged economic insecurity is associated with a poor mental health. And that is in turn associated with self medication with things like alcohol and opioids.
I'm curious why the broad result is also showing up in UK as another example (the opioid deaths in the US are making its situation even worse). There must be something in common occurring:
"Life expectancy progress in UK 'stops for first time'"
The UK has "enjoyed" nearly 10 years of post 2008 austerity, destroying services, reducing spending on health, education, social care, everything really. Health waiting lists have risen to the highest levels for decades, mental health care has essentially become dysfunctional. The resultant effect on life expectancy isn't surprising.
For the UK at least, it's policy.
The main alternative political party spends more time making itself unpopular than opposing the government, or we may have voted in a change years ago.
Growth on Wall Street isn't growth on main street, and huge corporate and big investor profits (and associated cash hordes) haven't meant economic recovery in the places and communities hardest hit by the opioid epidemic.
> The US has been having it’s longest continuous period of economic growth ever.
Cost of living and healthcare costs are skyrocketing and have outpaced inflation for decades. Wages are stagnant, and benefits are rare for those who are working.
Yes, if you have significant investments, you're benefiting handsomely.
If you have thousands of dollars of student debt, can barely afford health insurance and are making much less than your parents did at your age, things don't look so good from that perspective.
I see some people talking about Germany and France offering far better and cheaper healthcare.
But can you afford to look only at Germany and France? They operate in a broader framework of EU.
If you are going to compare services/living standards then must also directly compare Romania or Bulgaria to the US because Germany and France are able to provide cheap healthcare because their healthcare staff are willing to accept lower prices and how does it work? By importing labor from cheaper European countries. Presently, many doctors and nurses from Romania work in Germany without them good luck being able to maintain "cheap" healthcare.
If you cut off Germany and France from rest of the EU, the healthcare cost will likely shoot up far more than what it costs in US now.
There is downward pressure on wages in whole EU and this is why Europeans come to states for better employment opportunities, and better pay which can and does buy you better living standards if you are willing to spend the money you make but it seems not many want to do that, they want free healthcare in addition to taking large proportion of their wages home.
I am from Portugal, a country that has many people working in richer EU countries, but I don't think this is true.
Romanian or Portuguese nurses and doctors working in France or Germany or any other country will have the same wages as a french nurse or doctor. Or most of the time at least.
My wife is a nurse and we did some research on this a few years ago.
I am not saying they are accept lower wages then their German or French counterparts, what I am claiming is that because they are available in the market, their availability puts downward pressure on the wages and that's why German or French doctor/nurses can't charge more than what they'd pay to a worker from any other country.
I don't know specifically wages but often there are re-certifications needed even within the EU (currently a friend's wife who is an M.D. is trying to switch from Estonia to the UK and has to jump through several administrative hoops and get certifications in English and a few other things)
There is still the possibility of increased worker availability reducing wages, you have less bargaining power if theres readily someone else to take your place.
It's not like North America doesn't have its share of immigrant doctors. However, at least in Canada, their diplomas are often not accepted. I know a dentist operating a daycare, for example. Is it any different in the EU?
Lack of a stable career, terrible health insurance, high premiums, lack of community involvement, isolation from people, increased screen time and media consumption, hopelessness from always on sensational news, hopelessness in the face of global catastrophe to be coming near you due to ever worsening climate problem, student debt, not being able to afford a home, lack of healthy food options, diet and exercise misinformation, overprescribed medication, always on notifications never allowing you to relax, binge watching Netflix no time for brain to relax, shortened sleep cycles disrupting circadian rhythm.
I wonder what could possibly make people feel like shit and wanting to end it all...
I'm open the idea of various forms of drug legalization, but someone pointed out that the opioid epidemic (which is behind the decline in life expectancy) is arguably an experiment with legalizing heroin. The analogy isn't perfect, but that gave me pause.
Decriminalization (which is subtly different than legalization) of drugs isn't in conflict with preventing addiction and abuse by treating these as health problems, which is what they actually are.
The opioid epidemic was in significant part pushed forward by the unscrupulous marketing of prescription opioid manufacturers, and further catalyzed by the declining socioeconomic conditions in the areas most affected by the epidemic.
> Decriminalization (which is subtly different than legalization) of drugs isn't in conflict with preventing addiction and abuse by treating these as health problems, which is what they actually are.
It is when you hold the belief that addiction is a moral failing. Most parts of the US seem to be digging out from under that misconception, though. Finishing it off for good could be the one good thing to come out of the opioid epidemic.
It isn't legalizing heroin, or else we'd have nationwide formal public health strategies for harm reduction. What we have is a strategy that seems like it was custom-built to maximize harm to public health.
We should hand over the reins of drug policy to the Public Health Service Commissioned Corps and task them with minimizing harm, instead of the abject failure we have now with police running the show.
The main point of drug legalization to me is to get people out jails and into proper support networks where they can get the medical treatment they need for an addiction without throwing their life away.
> I'm open the idea of various forms of drug legalization, but someone pointed out that the opioid epidemic (which is behind the decline in life expectancy) is arguably an experiment with legalizing heroin. The analogy isn't perfect, but that gave me pause.
Not in the slightest, because presumably heroin that you get from your pharmacist at Walgreens wouldn't be contaminated with fentanyl.
Heroin dealers are mixing in fentanyl because it’s extremely dense (in terms of doses per mass) and therefore easy to smuggle. People are ODing on fentanyl because those same properties make it hard to dose accurately. None of this would happen if opioids were legal.
No, it's not. Throwing addicts in prison does nothing to help addiction rates, and proper support systems to help addicts can't be created easily if heroin is illegal.
Two weeks, I had open heart surgery in my mid-20s in the US.
My main takeaway is this: those of us who work in tech or companies with decent health insurance are extremely fortunate.
In total (knock on wood that this doesn’t go up), I spent around $10k out of pocket.
This included more than surgery itself:
- multiple ER visits because of my deteriorating valve
- a LOT of dentist work (cleanings, fillings, wisdom teeth removal); these things increase your risk of stroke/heart attack after heart surgery.
- multiple visits with cardiologist and surgeon consultations
- pre-operation
- six days in the hospital recovering
To be honest, that’s a lot less than I expected to pay. However, I can’t help but think of people in less fortunate positions that would 1) get fucked by the bills if they had no insurance or 2) still go into debt despite having insurance. When you really think about it, all options are ridiculous for an operation that is literally do-or-die.
I’d also like to add a note on specialized vs ‘routine’ care here in the US. Or my experience with it, anyway.
All specialized treatment I received (dentist, heart surgery, cardiologist) was outstanding.
Routine cafe was awful, and ER visits were nothing short of ridiculous. I went in with chest pain/shortness of breath (that I now know was very serious). I waited for 6 hours. They gave me some blood work and an ekg and sent me on my way. I went again the next week, because my symptoms were getting progressively worse. Once again, I waited about 6 hours in the waiting room before getting an ekg and some blood work. Both visits were a complete waste of time. Luckily, I saw a cardiologist shortly after who gave me an echocardiogram and identified the valve issue.
This (the shortness of breath, dentist visits, surgery) was all done within the last two months. Were I in a less fortunate financial position, I probably would have hesitated to even go to the cardiologist. Especially after having thrown money at the ER for nothing.
It’s unfortunate how our healthcare system mirrors some sort of class-based hierarchy: If you can afford it, great! Else, get fucked.
Medicaid is only expanded via the ACA in 36 states. In the remaining states that denied Medicaid expansion via the ACA, Medicaid is not available based on income at all.
In the states that expanded Medicaid, it is only available to individuals making less than 100-138% of the federal poverty level. The FPL for a single individual in 2019 is $12,490.
Individuals making more than 138% of the FPL, which is $17,236, are not eligible for Medicaid.
I'd argue that making slightly more than 138% of the FPL is still poverty level income, however Medicaid is not available to these individuals.
Nope! Just told me to reach out to a cardiologist if things didn’t get better, and suggested it’s probably anxiety. I suppose I can’t blame them given my age, but it makes me wonder how many cardiac deaths (#1 source of deaths in the US [1]) are preventable.
> It’s unfortunate how our healthcare system mirrors some sort of class-based hierarchy: If you can afford it, great! Else, get fucked.
It's not widely known in the upper/upper middle classes but healthcare is more or less free if you're poor in the US (even for major things like cancer treatment). It's really the middle class that has it the worst as they don't qualify for free health care.
Edit:
Some additional information to back up my assertion:
> healthcare is more or less free if you're poor in the US
If you qualify for Medicaid, you have government-provided insurance available, but that doesn't mean care is free even then, because Medicaid rules allow state plans to incorporate either or both of premiums and beneficiary cost sharing as part of the state Medicaid plans.
Also note that many people (particularly adults) that would meet many definitions of poor are not qualified for Medicaid, because several states don't cover adults (especially non-parents) with Medicaid above a small fraction of the federal poverty level (and sometimes not at all for non-parents).
I was on Medicaid just a few years ago. It was definitely a lifesend, but the network is very tiny and, as a result, scheduling visits with specialists (in my experience, so anecdotally) took about three months.
I am very grateful I was not on Medicaid during the past few months. But I am happy it’s an option.
Emergency healthcare is free. Cancer treatment might be free, but good luck seeing the specialists needed to get that treatment without some very explicit charity.
Free or reduced cost stuff is all the rage these days. Yet we refuse to look in the mirror, where at least a partial explanation for the costs may be found. Quite unfortunate.
There are some other interesting tweaks that can be done as well, sin taxes on things like sugar, tobacco, and booze are all likely to have major impacts on increasing the overall life expectancy
"Cancer Research UK says bowel, kidney, ovarian and liver cancers are more likely to have been caused by being overweight than by smoking tobacco. It says millions are at risk of cancer because of their weight and that obese people outnumber smokers two to one. But its new billboard campaign highlighting the obesity-cancer risk has been criticised for fat-shaming."
[..] "NHS England chief executive Simon Stevens said: "The NHS can't win the 'battle against the bulge' on its own. "Families, food businesses and government all need to play their part if we're to avoid copying America's damaging and costly example.""
Readit News
I also didn't find the word "obesity" anywhere in this article and I have to wonder how much this is a factor too.
As much as people might take this as "see how much life is better in [country X]", you still see people desperate to come here. Even in the EU, legal and illegal immigrants are much more likely to be headed to the UK and Germany.
I'm Australian but I've now lived in the US coming up on 9 years. The reason? As a software engineer, you can squeeze what would be a lifetime of savings in Australia into 10 years or less and that's hard to ignore.
The US is a pretty terrible place to live if you're poor however. And that goes far beyond life expectancy (but it of course plays into it).
Also, since a lot of these deaths happen early, they have a greater impact the life expectancy rate. One person dying 55 years earlier from a heroin OD has the same impact as 11 people dying 5 years earlier.
https://www.drugabuse.gov/related-topics/trends-statistics/o...
That's more than traffic fatalities.
you still see people desperate to come here.
Yes, mostly Mexicans, Chinese and Indians. If I hailed from such a country I would be desperate too.
That's simply not true. The poor in the US have one of the world's most expensive welfare states. It's the next ~20%-25% or so above the bottom 25%, that have it worst. Those people don't get free access to healthcare because they earn too much.
The US has a very advanced welfare state and safety net for the poor. The US spends more of its economy on its welfare state than either Canada or Australia, and is in the upper half of the OECD in that regard. The US welfare state is also rapidly growing, whereas most other developed nations are seeing their welfare states shrinking.
The US poverty and homelessness rates are both superior to Canada and France. The US provides free healthcare for the bottom 25%, along with countless other massive programs involving food and shelter for the poor.
Surely a conclusion can be reached where you’re spending more than any other country, yet so inefficient at distributing the wealth that you’re spending, or funnelling it into broken feedback loops that keep people in the welfare system.
surely if that were the case then it doesn’t matter how much you’re spending in absolute terms, you’d still not be enriching the lives of the poor or helping social mobility.
What poor in Canada can afford in terms of food, shelter and healthcare, and what poor in US can afford.
Which figures for homelessness in the US and in France are you using please?
I would strongly dispute this. According to the OECD, median household disposable income (adjusted for purchasing power) in the US is $10,000 per year, more than 20% higher than Germany, and $12,000 per year higher than the OECD average.
Health care and educational expenses don’t come close to wiping out that difference for the median person. The median American household has no student loan payment, and spends just a couple of thousand per year on out of pocket health care costs: https://www.kff.org/health-costs/press-release/interactive-c...
> For example, a person with employer coverage earning $50,000 annually spends on average $5,250, or roughly 11% of her income, on health care. This includes $800 per year in out-of-pocket costs, a $1,400 premium contribution, and $3,050 in state and federal taxes to fund health programs.
(The OECD disposable income statistic is after taxes, so the $3,050 in taxes above should be excluded from the comparison.)
The US system is optimized for the top 60%, and further optimized so the middle 40% doesn’t have to pay EU-level taxes to bankroll a safety net for the bottom 40%. It’s optimized at maximizing material comfort for the majority of people who never get seriously ill before they’re eligible for Medicare, as opposed to optimizing for raising the floor for people who get unlucky.
https://www.forbes.com/sites/aparnamathur/2018/07/16/the-u-s...
https://www.economist.com/graphic-detail/2018/02/14/american...
In other words, if you come from the upper end of the distribution, income inequality is a feature not a bug.
Take this scenario:
1. You go from 1st quintile (10K EUR) to 5th quintile (100K EUR) in Europe.
2. You go from 1st quintile ($10K) to 4th quintile ($110K) in the US.
By this measure, Europe has better mobility, but the person in the US ends up with a higher income.
If all countries are the same then you're out of luck.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741013/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151244/
"Life expectancy progress in UK 'stops for first time'"
https://www.bbc.com/news/health-45638646
"Life expectancy falls by six months in biggest drop in UK forecasts"
https://www.theguardian.com/society/2019/mar/07/life-expecta...
"Why is life expectancy faltering?"
https://www.theguardian.com/society/2019/jun/23/why-is-life-...
For the UK at least, it's policy.
The main alternative political party spends more time making itself unpopular than opposing the government, or we may have voted in a change years ago.
Cost of living and healthcare costs are skyrocketing and have outpaced inflation for decades. Wages are stagnant, and benefits are rare for those who are working.
Yes, if you have significant investments, you're benefiting handsomely.
If you have thousands of dollars of student debt, can barely afford health insurance and are making much less than your parents did at your age, things don't look so good from that perspective.
But can you afford to look only at Germany and France? They operate in a broader framework of EU.
If you are going to compare services/living standards then must also directly compare Romania or Bulgaria to the US because Germany and France are able to provide cheap healthcare because their healthcare staff are willing to accept lower prices and how does it work? By importing labor from cheaper European countries. Presently, many doctors and nurses from Romania work in Germany without them good luck being able to maintain "cheap" healthcare.
If you cut off Germany and France from rest of the EU, the healthcare cost will likely shoot up far more than what it costs in US now.
There is downward pressure on wages in whole EU and this is why Europeans come to states for better employment opportunities, and better pay which can and does buy you better living standards if you are willing to spend the money you make but it seems not many want to do that, they want free healthcare in addition to taking large proportion of their wages home.
Romanian or Portuguese nurses and doctors working in France or Germany or any other country will have the same wages as a french nurse or doctor. Or most of the time at least.
My wife is a nurse and we did some research on this a few years ago.
I wonder what could possibly make people feel like shit and wanting to end it all...
The opioid epidemic was in significant part pushed forward by the unscrupulous marketing of prescription opioid manufacturers, and further catalyzed by the declining socioeconomic conditions in the areas most affected by the epidemic.
It is when you hold the belief that addiction is a moral failing. Most parts of the US seem to be digging out from under that misconception, though. Finishing it off for good could be the one good thing to come out of the opioid epidemic.
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We should hand over the reins of drug policy to the Public Health Service Commissioned Corps and task them with minimizing harm, instead of the abject failure we have now with police running the show.
Not in the slightest, because presumably heroin that you get from your pharmacist at Walgreens wouldn't be contaminated with fentanyl.
My main takeaway is this: those of us who work in tech or companies with decent health insurance are extremely fortunate.
In total (knock on wood that this doesn’t go up), I spent around $10k out of pocket.
This included more than surgery itself:
- multiple ER visits because of my deteriorating valve
- a LOT of dentist work (cleanings, fillings, wisdom teeth removal); these things increase your risk of stroke/heart attack after heart surgery.
- multiple visits with cardiologist and surgeon consultations
- pre-operation
- six days in the hospital recovering
To be honest, that’s a lot less than I expected to pay. However, I can’t help but think of people in less fortunate positions that would 1) get fucked by the bills if they had no insurance or 2) still go into debt despite having insurance. When you really think about it, all options are ridiculous for an operation that is literally do-or-die.
I’d also like to add a note on specialized vs ‘routine’ care here in the US. Or my experience with it, anyway.
All specialized treatment I received (dentist, heart surgery, cardiologist) was outstanding.
Routine cafe was awful, and ER visits were nothing short of ridiculous. I went in with chest pain/shortness of breath (that I now know was very serious). I waited for 6 hours. They gave me some blood work and an ekg and sent me on my way. I went again the next week, because my symptoms were getting progressively worse. Once again, I waited about 6 hours in the waiting room before getting an ekg and some blood work. Both visits were a complete waste of time. Luckily, I saw a cardiologist shortly after who gave me an echocardiogram and identified the valve issue.
This (the shortness of breath, dentist visits, surgery) was all done within the last two months. Were I in a less fortunate financial position, I probably would have hesitated to even go to the cardiologist. Especially after having thrown money at the ER for nothing.
It’s unfortunate how our healthcare system mirrors some sort of class-based hierarchy: If you can afford it, great! Else, get fucked.
https://en.wikipedia.org/wiki/Medicaid
In the states that expanded Medicaid, it is only available to individuals making less than 100-138% of the federal poverty level. The FPL for a single individual in 2019 is $12,490.
Individuals making more than 138% of the FPL, which is $17,236, are not eligible for Medicaid.
I'd argue that making slightly more than 138% of the FPL is still poverty level income, however Medicaid is not available to these individuals.
[1] https://www.healthline.com/health/leading-causes-of-death#ca...
It's not widely known in the upper/upper middle classes but healthcare is more or less free if you're poor in the US (even for major things like cancer treatment). It's really the middle class that has it the worst as they don't qualify for free health care.
Edit:
Some additional information to back up my assertion:
72.5 million people are covered by Medicaid: https://www.medicaid.gov/medicaid/eligibility/index.html
The vast majority of medical services are available for free to Medicaid members: https://www.medicaid.gov/medicaid/benefits/index.html
If you qualify for Medicaid, you have government-provided insurance available, but that doesn't mean care is free even then, because Medicaid rules allow state plans to incorporate either or both of premiums and beneficiary cost sharing as part of the state Medicaid plans.
Also note that many people (particularly adults) that would meet many definitions of poor are not qualified for Medicaid, because several states don't cover adults (especially non-parents) with Medicaid above a small fraction of the federal poverty level (and sometimes not at all for non-parents).
See, https://www.kff.org/health-reform/state-indicator/medicaid-i...
I am very grateful I was not on Medicaid during the past few months. But I am happy it’s an option.
I’d imagine life expectancy would go up a bit too.
"Cancer Research UK says bowel, kidney, ovarian and liver cancers are more likely to have been caused by being overweight than by smoking tobacco. It says millions are at risk of cancer because of their weight and that obese people outnumber smokers two to one. But its new billboard campaign highlighting the obesity-cancer risk has been criticised for fat-shaming."
[..] "NHS England chief executive Simon Stevens said: "The NHS can't win the 'battle against the bulge' on its own. "Families, food businesses and government all need to play their part if we're to avoid copying America's damaging and costly example.""
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