In many international sports America’s ranking may be #1, but writer,
educator and commentator Bill Mares notes that among all advanced
countries we come in a distant 17th – in health.
According to a recent study by the National Research council and
Institute of Medicine, across most health indicators, age and wealth
groups, people in the US have shorter lives and more illness than people
in other advanced countries. Even advantaged Americans – with health
insurance, college educations, higher incomes, and healthier behaviors –
appear to be sicker than their peers in other rich nations.
these countries, the U.S. is at or near the bottom in nine key areas of
health. These are infant mortality and low birth weight; injuries and
homicides; teenage pregnancies and sexually transmitted infections;
prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes;
heart disease; chronic lung disease; and disability.
appear to be a number of reasons for this, but perhaps chief among them
is our flawed health care system – one that leaves a relatively large
uninsured population with little or no access to primary care. Plus, the
US has a higher poverty rate, poorer general education system, and
poorer social safety net – while at the same time, Americans practice
unhealthy behaviors, from over-eating to drug abuse. The physical
environment dominated by the automobile discourages physical activity
and encourages obesity, not to mention increases in injury and death
when driving and alcohol mix. The study also found that Americans are
more likely to use fire arms in acts of violence. Our rate of homicide
by firearms is 20 times higher than in the other countries of the study.
To get a local perspective, I went to my Tuesday morning
walking buddy, pediatrician Joe Hagan, who’s been thinking about youth
health for his entire career. Among other things, Joe was an editor of
The Bright Futures Guidelines, the national standard for preventive
health care for children, incorporated by the affordable care act.
one morning as we walked along the Lake with temperatures huddled
around zero, Joe told me about a developing concept of health care,
called "life course," based on research documenting the important role
early life events play in shaping an individual’s health trajectory. The
interplay of many risk and protective factors, such as socioeconomic
status, toxic environmental exposures, health behaviors, stress, and
nutrition, influence health throughout one’s lifetime.
that prevention is "…about promoting health; it’s not just about
detecting disease. Promoting health means promoting healthy families,
both physically and emotionally. Preventing hunger, substance use and
family violence is promoting health. Promoting mental health of parents
promotes the health of children," he concluded.
It reminded me
of one of the points President Obama made in his recent Inaugural
Address, when he said that our commitments to each other through
Medicare, Medicaid and Social Security, "…do not sap our initiative,
they strengthen us. They do not make us a nation of takers; they free us
to take the risks that make this country great."
We may never be #1 in national health and health care, but surely we can do better than 17th.