Posts Tagged ‘Inequality’
April 7 is World Health Day, an annual event sponsored by the World Health Organization (WHO) to promote greater awareness of global health issues. Conferences and activities all over the world address diverse topics like life expectancy, infant mortality, spread of diseases, access to clean drinking water, healthcare infrastructure, to mention a few. This year’s main focus is on the growing threat of foodborne illnesses.
Life expectancy, in particular, has long been considered a leading indicator for progress or decline of public health, and many changes have taken place in this regard over time. However, the gap between the richest and poorest parts of the world in terms of health status and longevity remains wide and may not significantly narrow in the foreseeable future. For example, most African populations still fall many years short behind their European and North American counterparts.
An outlier turns out to be Qatar, which is now rated the healthiest country in the world, followed by Norway and Switzerland. Why Qatar? Although this relatively small country with a population of just over 2 million has no national healthcare system, easy and affordable access to medical services seems one of the distinguishing factors. With more than three physicians per 1,000 people, the country is better staffed with healthcare professionals than most others. By comparison, the United States has less than two and a half doctors per 1000 inhabitants, while Canada has about two.
Yet, the US is well known for having the highest medical expenditures in the world. According to Forbes, the annual per capita spending on healthcare here is well over $8,000. Canada spends a bit more than half as much.
What do Americans get in return for that kind of money? Unfortunately, a lot less than one would expect. Among 10 of the most developed countries, the US comes in dead last, behind Canada, Australia, New Zealand, and most European nations.
The most striking deficiencies are related to a convoluted healthcare system that is less efficient and less affordable for large parts of the population.
Inequality is a particularly pressing problem. According to the report on healthcare spending and based on data by the WHO, the US ranks clearly last on measures of equal access to healthcare.
“Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs. On each of these indicators, one third or more lower-income adults in the US said they went without needed care because of costs,” it said in the report.
By contrast, Canada was generally lauded for its universal healthcare system but also faulted for its high costs as well as timeliness and efficiency of care. High marks were given to Australia for quality and cost efficiency.
To turn things around, WHO experts recommend that policymakers in the respective healthcare systems combat first today’s fastest spreading health threats like lifestyle-related chronic diseases, a.k.a. non-communicable diseases (NCDs), including cancer, heart disease, and lung disease, largely through preventive measures like reducing tobacco use and dietary improvements.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com. For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).
The United States of America have often been called a divided nation, separated by race, class, political affiliation, values, you name it. Now, one study has found that we are also drifting apart in terms of life expectancy. While the better-off can hope to live longer than ever, the rest falls behind and may even die at a younger age than their parents.
Educated white males seem to have the edge on longevity. Conversely, the least educated and often poorest Americans, regardless of gender or race, are moving in the opposite direction. The average life expectancy for them has fallen by four years since 1990.
The disparities are most dramatic between highly educated white men and the least educated black men, about 14 years, according to Dr. S. Jay Olshansky, a professor of epidemiology at the University of Illinois at Chicago School of Public Health and lead author of the study report.
These widening gaps within our society have lead to “at least two Americas, if not multiple others, in terms of life expectancy, demarcated by level of education and racial-group membership,” said Dr. Olshansky.
The causes behind these trends are not altogether clear, although unhealthy lifestyles like alcohol and drug abuse, smoking, poor diets, obesity and lack of health care coverage are among the most likely factors.
A separate study predicts that obesity, along with multiple related diseases, will continue to rise across the nation, but especially in states with the poorest populations. The report, sponsored by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), concluded that the numbers of diet and lifestyle-related illnesses could increase tenfold by 2020 and double again by 2030.
Currently, more than 25 million Americans suffer from diabetes, 27 million from chronic heart disease, 68 million from hypertension and 50 million have arthritis. Every year, almost 800,000 have a stroke, and about one in three deaths from cancer are related to weight problems, poor eating habits and physical inactivity.
While many Americans are becoming more health-conscious, the majority continues on a dismal path. “This study shows us two futures of America’s health,” said Dr. Risa Lavizzo, president and CEO of RWJF. “At every level of government, we must pursue policies that preserve health, prevent disease and reduce health care costs,” she said. “Nothing less is acceptable.”
Treating obesity and related diseases already costs an estimated $147 to $210 billion annually in health care, and these numbers will increase by another $48 to $66 billion if current trends persist, according to TFAH. The only way to change course is “to invest in obesity prevention programs that match the severity of the problem,” said Jeff Levi, TFAH’s executive director, at a news conference for the study release. The report included a series of policy recommendations such as swift implementation of existing legislation (e.g. the Healthy, Hunger-Free Kids Act) as well as creation of additional prevention strategies and action plans.
Government can definitely play an important role in the fight against the obesity epidemic, said Dr. Thomas A. Farley, Commissioner of the New York City Department of Health and Mental Hygiene. Government regulations are a justifiable option when they lead to preventing excess calorie consumption and obesity-related health problems and deaths, he wrote in an article for the Journal of the American Medical Association (JAMA).
In this country, we have long treated lifestyle choices as personal matters that should not be regulated or interfered with, even if they produce undesirable results. It’s a part of our individualistic culture. There is much to be said for that, but, as it is becoming increasingly apparent on so many levels, our attitudes have consequences, and sometimes they make the difference between life and death.
Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.