Did you know that, as an American, you're likely to have worse health and die younger than someone in virtually any other rich nation in the world? This is true regardless of who you are or what you do to live as healthy a life as possible.
This distressing news came last month in a remarkable report from the Institute of Medicine (IOM), titled "Shorter Lives, Poorer Health." The IOM was set up by Congress to advise the government on matters of health. It convenes panels of scientists, not politicians, and examines evidence, not opinions. The evidence is overwhelming that -- by any measure of health -- America is ailing and has been for many years. In a summary, the report states:
For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This disadvantage has been getting worse for three decades, especially among women. Not only are their lives shorter, but Americans also have a longstanding pattern of poorer health that is strikingly consistent and pervasive over the life course -- at birth, during childhood and adolescence, for young and middle-aged adults, and for older adults.
The United States is arguably the wealthiest and most powerful country in the history of the world. So why is America not a leader in health? "Shorter Lives, Poorer Health" addresses that question with a list of likely causes that work together to subvert our health and well-being, while other countries forge ahead. Our dismal health-care system and some individual behaviors such as drug and alcohol abuse play a part, as expected. But the report also emphasizes the causes that arise from our social problems: child poverty, educational deficiencies, rising income and wealth inequality, and unhealthy physical and social environments. The problem is more than health: It also reflects our national state of well-being.
What can be done about this problem? Important policy recommendations are included in the report, as well as by others commenting on it. A wide range of public health objectives already exist that focus on individual issues, such as smoking and teen pregnancy prevention. Those efforts should continue, but we also need to focus on interventions at earlier stages, such as support for health in early childhood, rather than waiting for health problems to begin. Yielding to current pressures to reduce spending on social programs would lead us in the wrong direction, and increase the gap even farther. The report also emphasizes the need to learn much more about how the other wealthy countries have attained and maintain their high levels of health, suggesting a special study of that question.
In the meantime, is there anything that we as individuals can do to change this inexorable decline in health? An important conclusion of the report is that it's critical for Americans to learn about the gap between our health and that of comparable nations. If something significant is to happen, "attention must be paid" -- not just to the death of one individual, but to these national trends in health and wellbeing.
Any important national problem requires attention from our leaders. President Obama needs to hear that we want the deterioration in America's health standing to be a key issue during his next four years, distinct from Affordable Care Act concerns. Take five minutes to let him and your congressional representatives hear from you via internet or a phone call, made easy from the presidential and congressional websites.
We also deserve to know what our public agencies were doing while our national health was declining compared to citizens from other countries. The institution responsible for public health in the U.S. is the Centers for Disease Control and Prevention in Atlanta, yet the CDC's extensive website makes no reference to the report or to the facts it exposes, which have been available for some time to anyone who was interested. What would happen if hundreds of people contacted the CDC and expressed concern (maybe even some outrage) that it seems to have ignored the several-decade decline in U.S. health? The CDC has a speaker's bureau. Why not request their presence at your organization's next meeting and ask for the CDC plan for addressing the recommendations in the report?
Professional associations of doctors, nurses, and public health workers also have been mostly silent about the relative decline in health of those they are meant to serve. Why didn't they know? Why didn't we?
Americans are great at spreading the news about something that's really important to us. I urge you to talk to someone -- do just one thing to publicize this report. It's time to expose this shameful secret.