Wealthy, not healthy


Health care is a national obsession, but not health. Americans apparently do a lousy job of taking care of themselves. The average citizen — white, black, Hispanic, rich, poor, fat, or skinny — can expect to die sooner than counterparts in affluent countries, even while spending the most per capita on health care. Odds are Americans also will experience higher rates of disease and injury.

Those findings by the National Research Council and Institute of Medicine aren’t just more rants about fast food, laziness, smoking, excessive alcohol consumption, or other unhealthy habits. They raise broad questions about social problems, budget priorities, and risky behavior on many fronts, from food choices to driving habits.

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Health care has become enormously costly in the United States — for individuals, businesses, and governments. But these findings suggest the nation could make significant gains in public health without spending more money.

The report found Americans 50 and under die younger and live in poorer health partly because they’re far more likely to succumb to shootings, automobile accidents, and drug addiction.

Moreover, any American from birth to age 75 is at greater risk of death or injury than same-age residents of Europe, Australia, Canada, and Japan.

Obviously, more than cheeseburgers and guns need to become part of the national debate. Public health and wellness advocates need a more holistic platform and, equally important, Americans need to listen.

This is a diverse country, racially and economically, where wealth gaps are widening and more of the middle class is slipping into poverty. Even so, Americans did poorly when compared to people of similar wealth, race, or ethnic backgrounds in other countries.

In fact, Americans who have health insurance, college educations, higher incomes, and healthy behaviors did not score as well as those with similar traits in other affluent countries.

That suggests Americans, for all of their obsessiveness, still have a lot to learn about safe and healthy behavior.

America scored worst in 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.

Many of those conditions disproportionately affect American children and adolescents, the report said.

On the plus side, Americans tend to have lower death rates from stroke and cancer, better control of blood pressure and cholesterol, and lower rates of smoking. Those who make it to age 75 also tend to live longer.

Diet and heredity could explain some differences in health and risk, but so could behavior, climate, the environment, and lifestyle. So too could stress, America’s heavy use of drive-through services, and the amount of time spent in automobiles.

Social conditions and cultural influences apparently put Americans more at risk, regardlss of how much they spend on health care.

We don’t have all the answers, but the report suggests Americans, by changing some habits and behaviors, can live healthier and longer without spending a lot more money.