I already raised the problem of distribution, so we would need to find statistics on the difference between differing levels of care. I’m not sure how to dig those numbers up, even substituting wealth as a proxy for quality of care. Especially with various confounders taken out like smoking rates, which themselves vary over time.
I do note that there are a lot more very very old people than there used to be.
Also, there is a large lag. For instance, if you got Polio as a young child 70 years ago, you’re still living with that damage. A simple cure for HIV would barely have shown up in US statistics if we’d developed it as recently as 2000.
And then of course we get down to the other side of the claim you were making: that it’s been ‘about to massively improve for the past 30 years’. What massive improvements were we expecting ‘any moment now’, 30 years ago?
Increased understanding and education is probably another factor.
The emerging concept of HIV transmission is that, for efficient transmission, the virus does not pass readily through intact skin but has to be “worked into” the tissue in such a way that it gets to its target cells for infection which are below the sin. Sex by nature involves friction and friction helps to work the virus into place to cause infection. If exposed to HIV, the probability of infection therefore varies with, among other things, the thickness of the skin involved (genital skin is thinner than the skin of many other parts of the body and the skin on the palms and soles are the thickest of all), and the amount of friction involved (thus there is more friction for rectal intercourse than for vaginal intercourse and more friction for vaginal intercourse than oral intercourse). These principles in turn are part of the reason that masturbation is always safe sex.
A man who has sex with men, for instance, could use these principles to inform the decision to partake in sex in a particular type of way, but not another
As for frottage. most frottage is really just a form of masturbation and therefore no risk.
“Massively better” implies obviousness and ability to see plainly without reliance on statistics that need to be dug up.
I do note that there are a lot more very very old people than there used to be.
Links?
The life expectancy for an 70-year old female in 1984 was 15.09 years, the same in 2014 is 15.6 years (source). I don’t see any massive improvement.
As to the promises of informatics for medicine, the main promise was personalized medicine—treatment based on your individual genetics and biochemistry with bespoke drugs made just for you. There’s certainly progress (e.g. gene sequencing became really cheap) but not much made its way into mainstream medicine yet.
You specifically asked for statistics! Then you blame me for looking for statistics? Or are you saying if my statistics need to be dug up (aren’t the simplest-to-get statistics) then that makes my claim wrong? No, it just makes my claim inconveniently-shaped for statistics, which is obvious by looking at it.
Then you use general-population statistics when I specifically said it was leading-edge stuff with minimal penetration. And of course much of that change is going to be swamped by population-health changes like smoking habits (better) and weight/sedentarism (worse).
You say ‘Personalized Medicine’ is a 30 year broken promise? It was first mentioned back in 1990 and then again in 2000. Link. This does not qualify as progress we’d been promised for 30 years, let alone a promise that was not delivered. Especially since, for the top-end cohort I was talking about, it HAS begun to be delivered. No one at all could get their genome sequenced 30 years ago, and if they had, no one would have had more than the slightest clue what to do with it. Now you can, and we’ve already found a bunch of useful things out. More are coming all the time. It’s too new to show up in statistics even for those who got it, since it’s mainly a way of looking ahead.
Endoscopic surgery was in its infancy in 1984, and has greatly improved in the mean time, meaning less trauma, shorter hospital stays, and improved outcomes. That’s even widespread now. Even outside of full-on endoscopic surgery, many conventional surgeries use much-shorter incisions (I have a 4 cm appendectomy scar).
Eye surgery went from only one procedure that sometimes fixed one problem, to common and able to reliably fix several problems. It’s not necessarily going to extend one’s life much directly, but that is a lot of QALYs.
Back in 1984, HIV was a death sentence. Sure, some of the improvement is from its evolving to be less aggressive, but we’ve worked out responses, when before there was effectively nothing.
Cancer treatments have far less side-effects now, and radiotherapy can reach deeper and so target more cancers. More QALYs again, though not so much an improvement in survival. Oh, and we have a vaccine for HPV which looks like it works well.
All sorts of tricks with bone marrow and blood stem cells came up only in the ’90s or later.
I already raised the problem of distribution, so we would need to find statistics on the difference between differing levels of care. I’m not sure how to dig those numbers up, even substituting wealth as a proxy for quality of care. Especially with various confounders taken out like smoking rates, which themselves vary over time.
I do note that there are a lot more very very old people than there used to be.
Also, there is a large lag. For instance, if you got Polio as a young child 70 years ago, you’re still living with that damage. A simple cure for HIV would barely have shown up in US statistics if we’d developed it as recently as 2000.
And then of course we get down to the other side of the claim you were making: that it’s been ‘about to massively improve for the past 30 years’. What massive improvements were we expecting ‘any moment now’, 30 years ago?
Increased understanding and education is probably another factor.
A man who has sex with men, for instance, could use these principles to inform the decision to partake in sex in a particular type of way, but not another
Whereas for anal, that’s the highest risk.
“Massively better” implies obviousness and ability to see plainly without reliance on statistics that need to be dug up.
Links?
The life expectancy for an 70-year old female in 1984 was 15.09 years, the same in 2014 is 15.6 years (source). I don’t see any massive improvement.
As to the promises of informatics for medicine, the main promise was personalized medicine—treatment based on your individual genetics and biochemistry with bespoke drugs made just for you. There’s certainly progress (e.g. gene sequencing became really cheap) but not much made its way into mainstream medicine yet.
You specifically asked for statistics! Then you blame me for looking for statistics? Or are you saying if my statistics need to be dug up (aren’t the simplest-to-get statistics) then that makes my claim wrong? No, it just makes my claim inconveniently-shaped for statistics, which is obvious by looking at it.
Then you use general-population statistics when I specifically said it was leading-edge stuff with minimal penetration. And of course much of that change is going to be swamped by population-health changes like smoking habits (better) and weight/sedentarism (worse).
Old folks? Numbers of very old people. Also, Centenarians is pretty suggestive.
You say ‘Personalized Medicine’ is a 30 year broken promise? It was first mentioned back in 1990 and then again in 2000. Link. This does not qualify as progress we’d been promised for 30 years, let alone a promise that was not delivered. Especially since, for the top-end cohort I was talking about, it HAS begun to be delivered. No one at all could get their genome sequenced 30 years ago, and if they had, no one would have had more than the slightest clue what to do with it. Now you can, and we’ve already found a bunch of useful things out. More are coming all the time. It’s too new to show up in statistics even for those who got it, since it’s mainly a way of looking ahead.
Endoscopic surgery was in its infancy in 1984, and has greatly improved in the mean time, meaning less trauma, shorter hospital stays, and improved outcomes. That’s even widespread now. Even outside of full-on endoscopic surgery, many conventional surgeries use much-shorter incisions (I have a 4 cm appendectomy scar).
Eye surgery went from only one procedure that sometimes fixed one problem, to common and able to reliably fix several problems. It’s not necessarily going to extend one’s life much directly, but that is a lot of QALYs.
Back in 1984, HIV was a death sentence. Sure, some of the improvement is from its evolving to be less aggressive, but we’ve worked out responses, when before there was effectively nothing.
Cancer treatments have far less side-effects now, and radiotherapy can reach deeper and so target more cancers. More QALYs again, though not so much an improvement in survival. Oh, and we have a vaccine for HPV which looks like it works well.
All sorts of tricks with bone marrow and blood stem cells came up only in the ’90s or later.
Edited to add: recent advances in prosthetics.