In large swaths of the nation, life expectancy slipped in the decade that ended in 2007, particularly for women, a shocking development in the world’s wealthiest nation. Some communities — primarily wealthy ones — have some of the longest life expectancies in the world, but others, particularly rural areas in Appalachia and the Deep South and some poor urban neighborhoods, fare worse than many third world countries.
This news comes at a time when the Republican candidates for president are universally denouncing a national health care reform law designed to reduce health inequalities and to remake a system that spends more than any other nation and gets worse results. Even the first lady’s efforts to convince people to eat healthier and exercise (obesity is a major driver of the nation’s poor health outcomes) is facing criticism as paternalistic.
People can complain about the government telling us what to eat, and they can make campaign trail sound bites about Obamacare destroying the best health care system in the world, but it doesn’t change the fact that every year, millions of people die years earlier than they otherwise would.
We can change these trends. Baltimore, a city that has had a series of activist and ambitious health commissioners in recent years, still lags the national averages in life expectancy, but it is catching up, thanks in large part to a focus on reducing infant mortality and violence and the adoption of policies designed to reduce health disparities. The city has a long way to go, but it is under no illusions about that fact and is making aggressive efforts to enlist community groups, businesses, hospitals, churches and every other segment of society in the effort.
We know what it would take for the United States to catch up to the rest of the developed world in its health outcomes. It doesn’t require miracle drugs or high-tech therapies. It just requires us to acknowledge that the way we do things isn’t inherently the best, that more health care isn’t necessarily better health care, and that we have developed a culture of unhealthy habits. Most of all, it requires that we treat the problem like our lives depend on it, because they do.
--Andrew A. Green