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Wake-Up Call


All of the detail in this report adds up to the stunning impression of an inferior quality of life.

Let’s look at it this way. The United States is less than 300 years old, which is hardly a blip on the screen of recorded history. Maybe we have time to recover.

This post was inspired by the recent findings of a panel of experts representing the Institute of Medicine and the National Research Council. Announced last week and titled “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” it represented a stunning collision with the reality of the quality of life here. To put it bluntly, there is nothing in this report to brag about.

As the authors summarized, among seventeen of the wealthiest countries in the world, “the United States ranks at or near the bottom in all indicators of mortality, survival, and life expectancy.”  Life expectancy here for men is at the very bottom, for women second-to-the-bottom. And another stunner: We have a “health disadvantage” that has been getting worse for three decades. The following are some of the more disturbing details:

1) Although we spend more on healthcare  than any other country, we lead in rates of obesity and diabetes, heart disease, lung disease, and arthritis.

2) We outstrip every other country in infant mortality, injuries, teen pregnancy, and sexually transmitted disease.

3) We have the highest poverty rate and the most violence. Our rate of firearm homicides was 20 times higher than any other country.

4) We exceed all other countries in years of life lost to drug-related deaths. These include deaths from alcohol and addictive drugs including opiates, cocaine, hallucinogens, psychotropic drugs, etc.

4) Even those who are advantaged–white, insured, college-educated, or upper income—are in worse health than their peers in other countries.

5) Other countries are outpacing the United States in the education of young people. (We are continually seeing statistics that show that students are lagging far behind other countries in reading, math and science.)

One looks at these facts and wonders, “Can this really be us?”

Because we are a young and very wealthy nation, a comparison comes to mind. We are kind of like an affluent teenager who has been given grades in private school he didn’t deserve because his parents were trustees. It made him think that he would graduate valedictorian, and now he’s realizing that he’s not only not valedictorian; he’s actually at the bottom of his class.

The issues are complex, but individual decision-making plays a huge role. We have access to an amazing array of foods, and we purchase huge quantities of those that are not good for us. Life is rather easy, and we make little effort to exercise. Dangerous behavior is common, leading to high death rates from car accidents caused by alcohol, drugs, and the refusal to wear seat belts.

All of the detail in this report adds up to the stunning impression of an inferior quality of life. How could things have gone so badly in a country that was so beautiful in its uninhabited state, so hospitable, and such a source of abundance? How can it be that we now appear to be in decline with a population that is apparently unhealthy in both body and mind?

But as I said, we’re a very, very young nation in the grand scheme of things. My comparison with the young teenager is comforting to me. I imagine him as bright and full of potential. He comes from good stuff; he’s just been overindulged. And as he looks at his position in the very bottom of his class, he becomes angry. “Somebody has not been telling me the truth.” Now that he knows, he will do what he has to in order to succeed in the real world.

And one final note: The prefrontal cortex, the seat of judgment in the human brain, doesn’t develop until late in the 20s, which is why we do so many dumb things when we’re young. We’re like a nation with an undeveloped prefrontal cortex. However, as in the case of every adolescent, if we survive, we have the potential to mature.


The sixteen other countries analyzed in the study are Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Portugal, Spain Sweden, Switzerland, and the UK.



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