U.S. health is lousy compared with peer nations, report says
Researchers said Wednesday that there were many reasons why Americans aren't as healthy as people in other wealthy countries. One possible reason: We spend too much time in our cars. (Genaro Molina / Los Angeles Times)
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Americans live shorter lives -- and are in generally worse health -- than citizens of other wealthy nations, according to an extensive report released Wednesday by the National Research Council and the Institute of Medicine.
The analysis of international health data, available here .. http://www.nap.edu/catalog.php?record_id=13497 , determined that American men had the lowest life expectancy among men in 17 countries, including wealthy European nations, Australia, Canada and Japan. U.S. women had the second-lowest life expectancy (only Danish women fared worse.)
The study listed nine health areas in which Americans came in below average: infant mortality and low birth weight, injuries and homicides, adolescent pregnancy and sexually transmitted infections, HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease and disability.
The U.S. earned relatively high marks for its low cancer death rates and success controlling blood pressure and cholesterol levels, the researchers said. But by and large, said panel chair Dr. Steven H. Woolf during a phone call with reporters Wednesday, the team was "struck by the gravity of our findings," which spanned the population.
"Even Americans who are white, insured, have college educations and seem to have healthy behaviors are in worse health than similar people in other nations," said Woolf, a researcher who directs the Center for Human Needs at Virginia Commonwealth University in Richmond, Va.
The disparities were pervasive across all age groups up to 75, Woolf told the reporters, and seemed to stem from a variety of wide-ranging causes, including U.S. car culture, the number of uninsured people in the country, and weaknesses in our outpatient healthcare system.
Gun use emerged as a factor: Americans were seven times more likely to die in a homicide and 20 times more likely to die in a shooting than their peers. In all, two-thirds of the mortality disadvantage for American men was attributable to people under the age of 50 -- and slightly over half of that resulted from injuries, said study collaborator Samuel Preston, a sociologist at the University of Pennsylvania.
It is possible that there's something about American culture, and the high value it places on individualism and personal autonomy, that results in its poor performance, the researchers noted. It also may be that the U.S. is ahead of the curve on a general trend, and that other nations will also start to experience the health problems that have been on the rise here since the 1980s, Preston said.
The panel called for further research, including coordination with other countries to see if any of their successful strategies or policies could be adapted to apply in the U.S. But Woolf stressed that Americans shouldn't wait for new reports to act to combat factors such as obesity. "We know what to do," he said. "It's a matter of our society finding the resources to act."
The report includes this interactive graphic .. http://nationalacademies.org/IntlMortalityRates , which allows readers to compare the U.S. ranking with the peer countries on specific causes of death.
Because we have such good imaginations, we can always envision things going smoothly, or even wonderfully. Therefore, we are constantly frustrated, constantly dealing with disappointment. There are a lot of good coping strategies for this problem. You can shrug; you can count your blessings; you can take setbacks as opportunities or lessons; you can laugh or blog or make art or hang out with a friend. There are also bad coping strategies, including using drugs, indulging impulsivity, and viciously blaming yourself for the setback.
Positive coping strategies generally require some ability to see yourself as just another person facing just another setback. This is difficult for some people most of the time and for everyone at least some of the time. Lao-tzu said that the sage sees people as straw dogs. Straw dogs were woven for a ceremony, treated ceremoniously during the event, and then unceremoniously discarded. I can’t help but notice that sages are people, so sages must see themselves as straw dogs, not just other people. Sages don’t get too attached to outcomes, or to themselves, so they don’t get too upset by setbacks and disappointments. You are a sage when you shrug or make a joke or get some perspective on yourself. It can be as small as the difference between saying “I am a failure” (which overstates the case) and “That didn’t go so well.”
It’s hard for some people to have perspective on themselves because, for reasons I won’t go into right now, they are overly impressed by evidence that they are the main character in this thing called life. After all, each of us is constantly hearing ourselves narrate earthly events, and each of us was present—on camera, if you will—whenever anything happened onscreen. And whenever anything happened off screen, we were the person who was being informed of the event. We feel our own feelings but only observe other people’s, so we have firsthand knowledge that we are flesh and blood but we have to infer this about others. It’s not hard to see why some people conclude that they are the main character not just of their own lives but of life itself. Such people are said to have a personality disorder.
One way of managing disappointment and frustration is to think you’re in a thriller, to assume that setbacks are obstacles put before the hero by nefarious forces. This way of managing setbacks is called paranoia. It has some serious drawbacks. It distances you from other people because, like the hero of a thriller, it’s an outlook that makes all your friends suspect. It makes you want to hole up and arm yourself either literally or with anger, and this drives other people away. It’s also exhausting and, exhausted, you stop questioning your assumptions. Paranoia also has some advantages. It focuses the mind wonderfully, making you alert and hyper-rational. It gives your situation a sense of purpose, makes the universe seem meaningful rather than random, and energizes you to set things right (because what is wrong is not just misfortune, but injustice).
When people get paranoid, they feel like you feel if you are engrossed in a really good action movie, which usually begins with a series of injustices perpetrated on the main character or innocent people. You hope for, relish, and cheer a burst of violence in the name of justice. Paranoid people differ from you in what they consider an injustice, who they think is to blame, and what steps they think are needed to rectify the situation—but the feelings are the same, even down to the point of not thinking that objects of one’s anger (movie characters for you, other people for the paranoid) are fully human. In the same way that a good thriller often ends in violence, a paranoid method of managing setbacks also often ends in an outburst of anger, or even violence.
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