Thursday, January 10, 2013

We're wealthy but unhealthy -- Jan. 10, 2013 column


It hardly seems fair.

Even though the United States is the wealthiest nation on earth and spends the most per capita on health care, we’re sicker and die earlier than people in other high-income countries, a new report has found.

Surely, you say, our health status lags because so many millions lack health insurance, and the Affordable Care Act -- a.k.a. Obamacare -- will save the day.

Sorry, it won’t. 

Nor is our health disadvantage the result of America’s high poverty rate, our racial and ethnic diversity, or our immigrant population. Recent immigrants are in better health than the native-born, says  “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” released Wednesday by the National Research Institute and Institute of Medicine.

The report goes beyond others that have chronicled our broken health care system to look at diseases, injuries and behaviors throughout life. It’s a 378-page wake-up call about our big, fat, stressed American lifestyle, available for reading from the National Academies Press,

“Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries,” the report says. We lag behind: Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom.  

It’s shocking to think that people in other countries enjoy longer, healthier lives than we do, and, says Dr. Steven H. Woolf, professor of family medicine at Virginia Commonwealth University, it’s unnecessary.

 “Americans are dying and suffering at rates that we know are unnecessary because people in other high-income countries are living longer lives and enjoying better health,” says Woolf, who led the panel that wrote the report.

The report recognizes that we have more people who are uninsured and in poverty and that our health care system is fragmented. It also suggests as possible factors for the health gap the pressured work and child care schedules of American families, our car-oriented neighborhoods, and traffic congestion that leaves us little time or energy to exercise or to shop for nutritious food.  

Even the rugged individualism that made America great may be to blame. Fiercely independent Americans are more likely than our foreign counterparts to engage in risky behaviors. We drive with seatbelts unbuckled, ride motorcycles with the wind in our hair, eat tons of fatty food, occupy the couch, keep our arsenals of guns unlocked, abuse drugs and have unprotected sex.

And so we die earlier even though we’re now less likely to smoke and may drink less than people in other high-income countries.

Our life expectancy is lower because we lose so many people before age 50. Once Americans hit 75, though, they live longer and are less likely to die from cancer and stroke than their foreign counterparts.

Most Americans have no idea that we long have had the highest infant mortality rate among high-income countries or that American adolescents have the highest rates of death from traffic accidents and homicide.

The United States is at or near the bottom in such key health areas as teen pregnancy and sexually transmitted infections, prevalence of HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease, and disability.

Wealth and education do not guarantee good health or long life. Our “haves” are sicker and die sooner than “haves” in other developed countries. Non-Hispanic whites in the United States who are well educated and have health insurance lag comparable groups in other affluent countries.

The report calls for more research, more public awareness and a national discussion of the American health disadvantage. We already know what we need to do, but sometimes we need a nudge. 

Higher taxes on cigarettes re-enforced a lot of individual resolve to stop smoking. Efforts by government to rein in our “rights,” such as to purchase giant soft drinks, elicit cries of “nanny state” but may curb sales.

First lady Michelle Obama harvested too much criticism along with the vegetables from her White House garden. We should stand behind her efforts to get kids moving.

It won’t be easy to change behavior. Even the 2010 federal health law explicitly supports the Second Amendment right to own guns and prohibits health providers from collecting or disclosing information related to gun ownership.  

Our national discussion on health must go beyond laws to individual behavior. It can start when President Barack Obama delivers his State of the Union address. We haven’t a life to waste.

(Marsha Mercer writes from Washington. You may contact her at
© 2013 Marsha Mercer. All rights reserved.


1 comment:

  1. Ms. Mercer brings us some very interesting but disturbing info about our health, as compared with other advanced nations. I agree, we need to work on this issue and the trick is to improve our life expectancy without impinging on our freedom to behave as we like. For example, we may live longer if we stop driving cars or eating hamburgers, but is it worth it? Surely there are some things we can do, as Ms.Mercer points out, that we can all elect to do on our own and not rely on government control. Let's do it.