It often appears that we Americans are obsessed with health. Media outlets trumpet the latest gene and drug discoveries, dietary supplements line shelf after shelf in the supermarket and a multi-billion dollar industry of magazines, videos and spas sells healthy "lifestyles." We spend more than twice what the average rich country spends per person on medical care.
Yet we have among the worst disease outcomes of any industrialized nation - and the greatest health inequities. It's not just the poor who are sick. Even the middle classes die, on average, almost three years sooner than the rich. And at every step down the socio-economic ladder, African Americans, Native Americans and Pacific Islanders often fare worse than their white counterparts.
Our international health status has fallen radically in the last few decades. In 1980, we ranked 14th in life expectancy; by 2007, we had fallen to 29th. Our infant mortality rate lags behind 30 other countries. And illness now costs American business more than $1 trillion a year in lost productivity.
Healthy behaviors, molecular research, and of course, universal health care are all important. But evidence suggests they miss the most vital factor of all: how the social circumstances in which we are born, live and work can get under our skin and disrupt our biology as surely as germs and viruses.