What is Worse? This or That?

What’s Worse, This or That?

by Sean Kenniff, MD 

What is worse: being obese or suffering from anorexia nervosa? 

Statistics show anorexia nervosa has the highest fatality rate of any psychological disorder. Up to twenty-percent of those affected will die from the condition if left untreated, and roughly three-percent die even with therapy. Obesity also kills, but much more slowly. The mortality rate for people suffering from anorexia nervosa is higher, and they tend to die at much younger ages when compared to an obese people of the same age. For an obese twenty-five-year old woman the risk of dying is around 0.1%.

What is worse for parents with children: Having a gun in the house, or a swimming pool in the backyard?

In the book Freakonomics by economist Steven Leavitt, statistical analysis reveals that having a swimming pool is roughly 100-times more risky than having a gun in the house. According to Leavitt there are 6-million residential swimming pools in the U.S., and more than 500 children drown in them each year-so roughly one child drowns for every 11,000 swimming pools. Meanwhile there are more than 200-million guns in the U.S., but fewer than 200 deaths in children under the age of ten are due to firearms. Simple math tells you that the risk of having a gun in the home is just 1-child death for every 1-million guns.

What is worse: smoking marijuana cigarettes, or smoking tobacco cigarettes?

This question appeared in an editorial in the British Medical Journal in 2003. From a legal point of view marijuana is certainly worse. But when it comes to your health tobacco cigarettes are a much bigger risk. Two large studies failed to find an increased risk of death associated with cannabis use. While there are plenty of carcinogens in marijuana smoke, people do not tend to chain-smoke the drug-so the overall exposure to those carcinogens is much less. And most marijuana smokers cease smoking the drug in early adulthood. Cigarettes pose a much larger personal and public health risk. However this conclusion comes with a caveat: perhaps the main reason people stop smoking marijuana after a certain age is because of its illegality. As we age we are less likely to commit these kinds of criminal activities. Decriminalization of marijuana may lead to more prolonged smoking and perhaps more deaths. But overall cigarettes are much worse. In the United States tobacco use contributes to roughly 1-in-5 deaths.

What is worse: being married and miserable, or happy and single? 

Research shows happily married couples live longer than singles, and the health benefit of being in a happy marriage is more profound for men than it is for women. People in positive marital relationships have lower blood pressures and reduced levels of stress hormones when compared to unhappily married couples. And a recent study from BYU researchers found unhappily married people have a higher blood pressure, and higher stress hormones than happy singles and happily married folks. So being unhappily married appears to pose the biggest risk to your health. But before you think about heading to divorce court, several studies have shown divorce can increase the risk of death. So try to make your marriage a happy one. 

It’s also important to mention that overall never-married people face the highest risk of death (unhappy and happy singles combined). A study published in 2006 found never-married people faced 5-times the risk of dying from infectious diseases, were 38-percent more likely to die from heart disease, and faced twice the risk of dying from an accident, homicide, or suicide.

What is worse: air pollution or being exposed to second-hand smoke?

Air pollution from industrial pollutants and motor vehicles accounts for 3% of all U.S. deaths according to an article in the European Respiratory Journal. A study from University of Southern California in 2007 found children living near a major highway (within 500 meters) were more likely to have asthma, other respiratory diseases, and were more likely to have reduced lung function and reduced lung growth. Living close to a busy highway has also been associated with an increased risk of heart disease and some cancers. Air pollution alone causes between 22,000 and 55,000 deaths each year in the U.S. according to government statistics, but the National Resources Defenses Council says air pollution is responsible for 64,000 deaths each year. Particulate matter and benzene are thought to be playing the largest role in causing the health problems. 20-million Americans live under air pollution that contains more than 32 toxins at levels 100 times higher than the EPA deems acceptable. The World Health Organization says worldwide there are 2-million deaths due to air pollution each year. So how does second-hand smoke compare? The American Cancer Society estimates exposure to second-hand smoke causes roughly 3400 lung cancer deaths and between 22,000 and 69,000 deaths from cardiovascular disease each year in the U.S. There are approximately 21-million American children (35%) living in homes where they are exposed to second-hand smoke. So the numbers turn out to be roughly the same.