Being American is hazardous to your health. We die younger and suffer more illness and injury than people in the world's other affluent nations and have the worst odds of living to age 50.
That "health disadvantage" can't be explained away by the usual suspects of poverty and race. It doesn't matter if you're white, insured, have a college education and earn a good living. It doesn't matter that the United States spends more per person on health care than any other nation. Even being young doesn't make you immune. The disadvantage exists from birth to age 75. And it's been getting worse for three decades. The way we live is killing us.
"We are struck by the gravity of these findings," said Dr. Steven Woolf, a professor of medicine at Virginia Commonwealth University and the chairman of the panel that compared life expectancy and health in the United States with data from 16 peer nations, including Canada, Japan, Australia and a number in Western Europe.
The United States fared worst, or close to it, in mortality rates, injuries and homicides, sexually transmitted infections including HIV and AIDS, drug-related deaths, obesity, diabetes, heart disease, chronic lung disease and disability. Over the past century, Americans' life expectancy and health have improved. But that improvement has lagged behind other nations.
So what is it about how we live that's killing, maiming and making us sick? No single factor can explain it. But it seems the freewheeling lifestyle we cherish enables behaviors that are bad for our health.
Americans are more likely to live in communities like Long Island that are built around automobiles. That frees us to live where we want, but it also discourages physical activity and contributes to obesity. Devil-may-care Americans are also less likely to use seat belts than motorists in other nations. And we have more traffic accidents that involve alcohol.
Americans notoriously eat more than people in other countries. More of us abuse drugs. And we do love our right to guns, which we're more likely to use in lethal acts of violence against others and sometimes ourselves.
Americans do enjoy some health advantages. We're less likely to smoke and we imbibe alcohol more judiciously than others. We have lower death rates from cancer and stroke. And lucky Americans who make it to age 75 can expect to live longer than people in other countries who reach that marker. But overall, the picture is pretty bleak.
Shorter lives and poorer health harm the nation's economy as health care costs rise and a sicker workforce compromises our ability to compete.
So, what to do?
Being academics, members of the panel recommend more data collection and study. And they call for an outreach campaign to alert the public to this health disadvantage and stimulate a discussion about its implications. That's sensible. The first step to solving a problem is knowing there is one.
Governments can help too. Tighter restrictions to keep guns out of the hands of violent people, like those to be debated soon in Congress, would help. So would tougher laws to keep chronic drunken drivers off the road. We may have to get over our aversion to "nanny-state" anti-obesity initiatives, such as taxes on sugary drinks. And we should invest more to expand mass transit to draw people out of their cars.
But, ultimately, changing lifestyle is personal. It's less an issue of figuring out what to do than of creating the resolve to do it.
Alvin Bessent is a member of the Newsday editorial board.