Michael A. Cohen

As worldwide health improves, America lurches backward

Shown are blighted and abandoned row homes in Philadelphia, Wednesday, Dec. 6, 2017. (AP Photo/Matt Rourke)
AP Photo/Matt Rourke
Abandoned row homes in Philadelphia.

Whenever I find myself feeling deeply pessimistic about the world around me, I have a simple way to turn that frown upside down: I look at global development data.

OK, that’s not completely true, but if you want feel that maybe things aren’t as bad as they seem and there is good reason to be optimistic about the future, it’s not the worst idea.

The fact is, over the past several decades, the planet earth has become an infinitely better place to live. One billion people across the globe have been lifted out of extreme poverty. More kids — particularly young girls — are in school, and literacy rates are near 90 percent.


Fewer people die in wars, and far more live in democratic societies. Tens of millions of people who would have died from treatable diseases are today alive. Perhaps most extraordinary of all, since 2000 global life expectancy rates have increased by five full years.

Get Today in Opinion in your inbox:
Globe Opinion's must-reads, delivered to you every Sunday-Friday.
Thank you for signing up! Sign up for more newsletters here

See, didn’t that make you feel just a little bit better?

Unfortunately, as is often the case, there’s a catch: at the same time that extraordinary progress is being made around the world in improving the human condition, America is moving in the opposite direction.

In 2016, for the first time in more than five decades, life expectancy in America declined for the second straight year. The proximate reason for this drop is the dramatic increase in opioid-related deaths.

But even before the opioid epidemic, life expectancy in America lagged two years below the average among other developed countries.


What is perhaps most stunning about these numbers is the scant attention they receive not just from politicians, but also from voters.

For all the sturm and drang that accompanies the latest terrorist attack in America, little concern is raised over the fact that the United States — the most powerful and richest country in the world — not only has the highest infant mortality rates in the developed world, but also, according to new study in the journal Health Affairs, American children face a far greater risk of death than children in other wealthy nations.

They are three times more likely to be born dangerously premature and are at 76 percent greater risk of dying in the first year of life than their counterparts in the developed world. For those who survive the first year they are 57 percent more likely to not make it to 20 years of age.

Make no mistake: these numbers are the direct result of decisions made — or not made — by generations of American political leaders. Indeed, the widespread improvement in global living standards is directly correlated to specific government investments in improving health, economic, and education outcomes. In America, it is the slashing of the country’s already inadequate social safety net that is responsible for our abysmal health and welfare numbers.

In America, of course, government is a four-letter world, which means that far too many women and girls, especially those mired in poverty, have limited access to health care and, in particular, prenatal care. It means we have youth poverty, obesity, and inequality rates that are the highest in the developed world. When it comes to basic access to water and sanitation, the United States ranks 36th. Indeed, it’s simply stunning to look at these numbers and then remind yourself that just a few months ago, Republicans were one senator’s vote short of taking health care access away from more than 20 million Americans.


Even more head-shaking is the fact that it’s been more than 100 days since the Children’s Health Insurance Program expired. Some states will start running out of money at the end of this month. Despite that, it’s still not clear if or when Congress will appropriate more money for the program. In 2016, practically every politician in America talked about the need to tackle the nation’s growing opioid epidemic, and yet congressional Republicans haven’t lifted a finger to tackle the issue — focusing instead on a $1.5 trillion tax cut that will disproportionately benefit those Americans who need the least amount of help from the federal government.

As the United Nations Special Rapporteur on Extreme Poverty and Human Rights recently concluded after a two-week tour of the some of the poorest communities in the United States, neither America’s “wealth nor its power nor its technology is being harnessed to address the situation in which 40 million people continue to live in poverty.”

At a time when practically every other country in the world is successfully investing in improving the health and welfare of their people, life in America is getting both worse and shorter — and few people in positions of power in Washington seem to care. If anything, they are actively working to make a bad situation worse.

This is reality of 21st century America: a country in precipitous decline, withalarming indifference to the extraordinary want that exists in our midst. A politician and a party truly interested in making America great again would make this growing health crisis their number one priority.

Michael A. Cohen’s column appears regularly in the Globe. Follow him on Twitter @speechboy71.