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    editorial | Poor Public Health

    All Americans are at risk

    Statistics that show the United States ranking below other rich countries on health measures are often broadly attributed to the lack of public health resources and dangerous environments confronting Americans who are poor or members of minority groups. But while unequal access to health care remains a problem, a new report by the National Institutes of Health has a sobering message: Unhealthy and unsafe practices are leaving even well-off Americans with lower life-expectancies than their peers in other countries.

    For example, the study found that white Americans at every age level below 55 have either the highest or second-highest death rates among the 17 wealthiest countries. “Even relatively well-off Americans who do not smoke and are not overweight may experience inferior health,” the report said. There are many explanations for this: The United States has the world’s highest calorie consumption, the highest firearms ownership among wealthy countries, relatively high levels of teen pregnancy, a large percentage of people who lack reliable health care, and a tendency to design physical environments for automobiles instead of activity. Americans also have high rates of sexually transmitted diseases, HIV/AIDS, car crashes, and drug and alcohol abuse.

    Because of factors like these, life expectancy at age 50 has increased only 2.5 years in the United States since 1980, compared with 6.4 years in Japan and 5.2 years in Italy. Life expectancy for US women has fallen three to five years behind Japan, France, Switzerland, Italy, Spain, and Australia. “The tragedy,” the NIH report declares, “is not that the United States is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.”


    America’s relatively poor health saps productivity and drives up health care costs. It’s an economic problem as well as a potential tragedy for individuals who die earlier than they otherwise might. On the upside, the revelation that America’s risk factors affect all citizens, not just the poor and minorities, may point the way toward solutions.