Smoke Gamble

Smoking is like a gamble. Your input is your health and money. This is not including those who might rely on you or family relationships that might suffer one way or another. The other link has gambling at its source and smoking goes along with the continuous risk taking or the belief to be able to master the risks involved with both forms of potential addictions. Research has accumulated evidence that in fact both smoking and gambling occur frequently in combination with each other. Taking risks against the odds of suffering losses, maybe only in the medium or longer run perspectives like for health seems acceptable for those people. Society has put rather high taxes on both activities to discourage people and invests in prevention of addictions. However, it does not have substantial effects on people as smoking remains around the same level and gambling (poker online) or betting on sports (Euro 2024) are rising rapidly. Vaping and internet gaming have broadened the spectrum of addictive behaviors mostly for younger persons and young adults. The risks are manifold and increasing in their addictive potential since the smartphone is always in some pocket just like the smoking device. The behavioral turn in the social sciences has been well understood by the industries as well. The stakes for human development are high in this endeavor to offer young people equal opportunities at entry into adulthood.

Avoidable Mortality

Mortality in many instances is avoidable. Estimates Mühlichen et al. (2023) for Germany are as high as 19% of all deaths in the years 2017 to 2019. For men the figure is as high as 24%, for women “only” 13%. The scientific interest in the concept of avoidable death originates in the interest to indirectly gauge the efficiency of health systems. In order to do this the authors estimated cause-deleted life tables in a fine graded regional fashion. Avoidable deaths are defined as deaths that occur before the age of 75 and are either classified as medically preventable or preventable through a different life style. The study applies a quasi-experimental design in comparing German speaking regions within Europe. This allows to measure the influence of health care systems on a general level within Germany, Austria, Switzerland and South Tirol in Italy. The study corrects for different age structures in these regions. For Germany avoidable deaths are substantially higher in the North than in the South. Additionally Eastern parts of Germany have higher avoidable deaths. Even the best performing regions in Germany have higher rates of avoidable mortality than Switzerland.
The differential to other countries health systems is worth a concern, because the expenditure in the German health system per 1000 population are among the highest in Europe (OECD 2021). Despite the high expenditure per head, avoidable mortality remains particularly high for German men and in the North and East of Germany. Lack of prevention of unhealthy life styles is most likely the decisive factor to explain the disappointing results. There might be another “unaccounted” risk factor that originates in the lack of sufficient preventative health care and environmental risks during the young age of the regional populations. 33 years of unification and a cut-off age of 75 mean that in East Germany the oldest people lived through 40 years of high pollution coal as primary heating system.  Similar to Northern and Western Germany little concern and careless use of risky fertilizers might drive higher mortality decades after exposure. Life style patterns might additionally contribute, but are harder to assess in comparison. Research to clarify these differentials are just at the beginning. A valid conclusion remains: prevention is key, but it has many facets.

Drowning

Drowning is a largely underestimated risk. 2.5 million people die of drowning in 10 years according to the WHO. low and middle income countries have the highest drowning rates. However, remedies like teaching how to swim and to assess drowning risks at an early age can make a huge difference. Flooding as natural disaster causes high numbers of casualties, but even in such extreme weather conditions survival strategies involve drowning prevention.

Even in the richest countries drowning is still a reality. Life guards cannot prevent the most irresponsible behavior like drinking alcohol, taking drugs and drowning risks. Overestimating one’s own swimming capabilities is yet another reason for drowning in wealthy countries. Try floating your body with as little movement as possible and you slowly enhance your capabilities to survive in dangerous water conditions. This increases your self-confidence to master tricky situations. Panic in water is surely not helpful. Learning how to help others in danger is for well-trained rescuers or professionals.