Read an article today about why Americans think alcohol has health benefits and it's apparently another "well the French are healthy and they do X so it's healthy to do X."

So here's your periodic reminder that France (and Italy, and Sweden, and Japan, and basically every country you've seen in a "this country is so healthy, what's their secret?" headline) has universal health care.

The secret is access to health care. It's always access to health care.

And of course access to health care goes hand-in-hand with other social safety nets. Turns out people are healthier when they are food and housing secure, have better labor protections, have better support in early childhood and better support as parents of young children, etc.

The thing is that those things rather by definition are not consumer products that can be sold in the US market, so they don't get media campaigns and catchy headlines about how you can buy them for $20.

Right so this thread is getting some "well actually it's the thing you just said," and a metric fuckton of "well actually it's my personal pet cause," so time to mute. Enjoy arguing about bike infrastructure, processed foods, sugar, and breast milk amongst yourselves (it's still access to health care and a strong social safety net but y'all have fun).

Really wish we had an option to close/limit replies; comes in real handy when a post goes viral.

@Annalee it’s a package. Health care is definitely critical. But the average diet is also way more healthy in these country. Public support to sport activities beyond school age also helps. Now, conservative policies are hitting this hard everywhere.

@Annalee

First of all, I'm not sure how well you actually know France.

Secondly, access to health care is a good reason but by far not the only one.

Please stop making such wild claims.

@Annalee

I recently read that this is the origin of the idea that breastfeeding is healthier than formula: people who can afford to stay home and breastfeed can afford other nice things too. I felt really stupid for never having realized that before.

(I'm prepared to feel stupid again if it was you who mentioned that before and I'm explaining it back to you now...)

@Annalee

I don't know if there's a name for this specific cognitive error, where it's easier to attribute an effect to a thing you're consuming than to other stuff that correlates with consuming that thing, but it's a darn good one.

@nuthaven It's called confounding bias, but it doesn't apply here AFAIK. Breast milk is healthier for many reasons such as that it contains maternal antibodies that help protect the baby against infections. Do you know of studies disproving this ?
@curiousmind It can still be confounding bias, even if the confounding factor just exaggerates the effects
The known health benefits of breastfeeding are amplified in studies by the factors mentioned by Evan
A good study would correct for that though
@nuthaven
@nuthaven
I think the origins of breastfeeding promotion also came in part from conservatives who liked the sexist idea that woman's place was in the home.
@Annalee
@nuthaven @Annalee it's the same as "people who drink expensive red wine are healthier than people who drink cheap booze, so clearly red wine is healthy and the other stuff is harmful"
@nuthaven @Annalee Feeding a baby is the most important thing of course. But there are real biological differences between breast milk and formula. Foremost being that babies have immature immune systems and that mother pass antibodies to their babies via breast milk. Apparently kissing is a way of sampling a baby's microbial exposure and mothers can produce antibodies specifically tailored to that microbiome.
@BeneCal @nuthaven second request to tag me out of breast milk discourse.
@nuthaven
It has been extremely well experimentally verified in studies across cultures controlled for confounding variables like income etc that breastfeeding is healthier than formula, but yes people who can afford to stay home and breastfeed or have accommodating jobs for pumping breast milk can afford tons of other nice things too and those are also incredibly significant. And the way breastfeeding as a parent is treated by the culture has almost nothing to do with the science.
@nuthaven
Women who for whatever reason don't breastfeed get shamed like crazy for misogynistic and racist/classist reasons in a way that almost exactly mirrors the way women were who breastfed when the medical establishment was claiming (without evidence) that formula was much healthier. At that time people who used formula were more affluent and whiter and could afford tons of other nice things too. It's bigotry justifying itself through prevailing beliefs regardless of whether they're true.
@nuthaven
But yeah there is significant benefit to breastfeeding, and actually benefits to continuing breastfeeding a kid to ages where women get shamed like hell for it now. And stuff like friends and family sometimes breastfeeding each other's kids is practically considered child abuse even though that's been shown to benefit health.
@nuthaven
Almost nobody formula feeds without good reason in the US now and it's a lifesaving technology we're lucky to have that shouldn't have any stigma associated with it. And high quality formula absolutely should be provided free. And they need to do controlled trials on things like free donated milk banks for non-nursing parents so their kids get key benefits of nursing, which seem to be significant early for infants even if some breast milk is just supplementing a primarily formula diet.

@nuthaven @Annalee used to be the other way around. Rich people got formula, less rich would breastfeed.

It's a tangle of politics. Women* had to fight for the right to breastfeed at all, especially in public, and the right not to, and they only achieved this by proving it was good for the child, in societies that didn't value what's good for the mother. So some literature massively overflates the difference for political reasons, both for or against

* non-women too

@nuthaven @Annalee I recall the main reason for health benefit of breastfeeding is hygiene. In countries with poor water quality, the "fresh" breast milk has far less risk of being polluted one way or the other. Plays a role in developing countries ( not sure to include USA here?)
@Annalee Unfortunately, because I agree that helping the poor is way more valuable than a glass or two of wine a day, those programs cost WAY more than $20.

@Annalee

"They" always complain about "big" government, but the big came when they decided (under Reagan) it was better to hire and manage private companies to do jobs instead of just hiring people to do them.

That then created layers of bureaucrats to deal with the layers of subcontractors, all under the illusion that "government doesn't create jobs", in spite of how that's exactly what FDR did with the CCC etc, and what the military has been for 200 years.

@Annalee EXACTLY. Honestly, better healthcare, better labor protections, and better protections in general (infrastructure repairs, consequences for environmental damage etc) should be bare minimum everywhere.
@Annalee I wouldn't dismiss that the quality of food (and drink) is also a factor. But this cannot be reduced to red wine (which some claim has certain benefits when consumed in moderation). I am convinced nutrition is a major health factor. Fresh vegetables, moderate amounts of meat, a varied diet is beneficial. Highly processed food, sugared cereals for breakfast, burgers and fries, pounds of (red) meat, carbonated sugared soft drinks less so. @isotopp
(shared to me today, 1 reply shown)

@Annalee

There are some other factors at work, but the healthcare system is a huge part of the problem.

The other side of the physical health issues is how our infrastructure demands that people use cars to do nearly everything and oftentimes it's dangerous for people to walk and bike places.

@IzabelaKaramia @Annalee Also in Europe we generally have better workers rights and holiday pay, resulting in less stress based illness.

@toni

It's really no great mystery why average life expectancy in America here has declined 2 consecutive years. The remarkable thing maybe is how there are so many factors involved and trying to figure out what causes what although there can be vicious cycles going on between some of the factors.

I won't be surprised at all if there is going to be a 3rd consecutive year of decline in life expectancy.

And that's disturbing and perhaps indicates America may be in decline towards failure.

@IzabelaKaramia @toni

From afar, there's no "may" or "perhaps" involved. I worry about my friend who lives there, and I'd consider him privileged. I can't begin to imagine what it's like for underprivileged people in the USA.

@IzabelaKaramia @toni since 5 years I am not counting USA with the civilised countries anymore.
Rich, yes, if you average out earning. But not civilised in law, in democratic behaviour, in wise or generous attitude, it any other sense of that word.
@IzabelaKaramia @toni Well we are still in the middle of an epidemic, and policy amongst most nations these days is to let it rip.

@Annalee

And public transit, more walking areas, and generally less refined sugar.

@Annalee Conversely, our lack of universal health care is a good reason to drink.
@Annalee I don't know. The actual "secret" seems to be, that it is better to drink controlled.
That's a human issue, neither depending on being a US-American, French or Martian.
@Annalee There are so many stories in my life of friends who have been hurt or died because of no insurance, or insurance companies denying treatment.

@Annalee Certainly health care plays a big role, but other contributors:

1) lack of a social safety net
2) perpetuated deep resource inequities along racial, gender and socioeconomic lines
3) a culture of stress-induced unhealthy behaviors embedded within an economic system that profits from those behaviors
4) social fragmentation and isolation that keep us from caring about one another's health and well-being
5) guns and other instruments of violence
6) poor physical and chemical environment

@[email protected] I suspect the biggest difference between US/UK and French health habits is the consumption of ultra processed food. The French still cook in the real sense of the word. ie. from scratch. They take pleasure in eating real food.

Access to universal healthcare certainly does them no harm either.

But last time I checked they were comparatively big smokers…https://worldpopulationreview.com/country-rankings/smoking-rates-by-country

Smoking Rates by Country 2025

Discover population, economy, health, and more with the most comprehensive global statistics at your fingertips.

worldpopulationreview.com
U.S. food additives banned in Europe: Expert says what Americans eat is "almost certainly" making them sick

One expert says most Americans likely don't realize how many additives they're eating that European regulators shun β€” and it's "almost certainly" making them sick.

@Annalee Every second the United States exists while people's insurance is tied directly to their employer marks this country as a threat to its citizens and a failed nation.
@Annalee
There is so much more to health than healthcare. Access to healthcare is a byproduct of social justice and social welfare.
@anildash

@Annalee nutrition studies are suffering from the same biases than social studies.
It all depends on what you’re looking for.

Want to find if alcohol is good for heart and lowers the risks of having a cancer? You will.
Want to find if alcohol is bad for heart and can cause cancer? You can do that too.

After all the way the body processes food is really complex, so an isolated ingredient can’t really be good or bad in itself (if not poisonous)

@MrRaptor @Annalee
The thing is that alcohol is actually poisonous.
@Annalee universal health care and an equitable society. Being poor kills you.
@Annalee the lack of guns is a bit of the answer as well.
@Annalee Rich Americans are healthy. They have access to health care. QED.
@Annalee their secret. Good health care. And exercise. Simple.
@Annalee This topic was covered excellently in an episode of Maintenance Phase last year: https://maintenancephase.buzzsprout.com/1411126/11389837-the-french-paradox
The French Paradox - Maintenance Phase

How an early-'90s newsmagazine show convinced a generation of Americans to start drinking red wine. For the antioxidants! Special thanks to Susanne Stolpe and Alexander H. Sandtorv for helping us fact-check this episode! Support us: Hear bonus epi...

Buzzsprout
@spacehobo @Annalee oh oop, came to post this reply. Loved this ep!!
@Annalee - Better play it safe and have universal heath care *and* wine.
@Annalee It’s certainly not boozing!
@Annalee If only logic and facts could ever win out over social and cultural forces.
@Annalee This times a million plus they get longer vacations and just generally a better work-life balance.
@Annalee of course the Americans will solve the healthcare issue the only way they know how: with thoughts and prayers 😈
@Annalee eh, this widespread belief is because it was the subject of a well financed sham research and marketing effort by the alcohol industry to distort data and spin a compelling narrative about French (and Italian) longevity being a result of wine consumption so that North Americans would buy more wine. No one came to this conclusion on their own or from observing the French, it was a decades-long corporate lie.
@Annalee ~"Of course. That's why selling health care isn't illegal in the US. Your point is?"~

@Annalee

Indeed France has a spectacularly good universal healthcare system - they also have a world renowned treatment facility for cirrhosis of the liver and liver disease in general in one their hospitals in Paris - that says something about what the French lifestyle/alcohol culture does for your health. Having lived and worked in France, I can say from experience that life in France revolves almost entirely around the consumption of alcohol.