Being American Is Bad for Your Health
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Social factors: Stark income inequality and poverty separate us from other wealthy nations, who also have more generous safety nets and demonstrate greater social mobility than we do. In America, the best predictor of good or bad health is the income level of your zip code.
Physical and social environmental factors: Toxins harm us, but our pollution isn't notably worse than in other rich nations. The culprit may be our "built environment": less public transportation, walking and cycling; more cars and car accidents; less access to fresh produce; more marketing and bigger portions of bad food.
Policies and social values: To me, this is the richest, and riskiest, ground broken by the report, which asks whether there's a common denominator -- upstream, root causes -- that help explain why the United States has been losing ground in so many health domains since the 1970s:
Certain character attributes of the quintessential American (e.g. dynamism, rugged individualism) are often invoked to explain the nation's great achievements and perseverance. Might these same characteristics also be associated with risk-taking and potentially unhealthy behaviors? Are there health implications to Americans' dislike of outside (e.g., government) interference in personal lives and in business and marketing practices?
My answer is yes, but I'd plant the problem in recent history and politics, not in timeless quintessentials. Since the 1980s, in the sunny name of "free enterprise," there's been a ferocious, ideologically driven effort to demonize government, roll back regulations, privatize the safety net, stigmatize public assistance, gut public investment, weaken consumer protection, consolidate corporate power, delegitimize science, condemn anti-poverty efforts as "class warfare" and entrust public health to the tender mercies of the marketplace.
The epidemic of gun violence has been fueled by anti-government paranoia stoked by the gun manufacturers' lobby, the NRA. The spike in consumption of high-fructose corn syrup has been driven by the food industry's business decisions and its political (i.e., financial) clout. In the name of fiscal conservatism, plutocrats push for cuts in discretionary expenditures on maternal health, early childhood education, social services and public transportation. The same tactic that once prolonged tobacco's death grip -- the confection of a phony scientific "controversy" -- now undermines efforts to combat climate change, which is as big a danger to public health as any disease.
More accidents may be shortening our lifespans. But we're not getting sicker by accident.