by Dr. Stephen Bezruchka, Chair, WPSR Economic Inequity & Health Task Force
Most people are concerned with their health. We are bombarded with what to do to keep ourselves healthy as individuals. What if that is not sufficient? What if the society in which we live matters more for our health than what we do to keep ourselves healthy?
The health of people in a country can be measured by how long they live, life expectancy. Calculating this requires only that you know when someone is born and when they die. All rich countries and many not-so-rich calculate this yearly. Many mortality rates can similarly be calculated from this information.
This century, the United States stands with Syria as the countries where mortality is going up and life expectancy is going down. Last century this happened suddenly in Russia after the breakup of the Soviet Union, and in high AIDS-prevalent countries in Africa.
Since 2015 life expectancy has declined here every year instead of continuing to increase. If health had continued to improve as expected, the excess deaths we’ve experienced is equivalent to eradicating deaths from motor vehicle crashes, other accidents, and homicide. Our health decline is huge and yet Americans are mostly unaware of this carnage.
Maternal mortality, deaths of women from childbirth-related causes, has risen 50% in the last 15 years. Back in 1951-53, we had the lowest rates of such deaths in the world. Now almost 60 nations surpass us. Adult mortality, ages 25 to 64, is similarly rising for all racial-ethnic groups in this country.
Why is this happening? We are not at war. There is an opioid death epidemic but it explains only a small part of this seeming slaughter. Much evidence suggests our increasing income and wealth inequality is a major part of this process, similar to what happened in Russia after the breakup only here the increase has been gradual over decades rather than happening suddenly there. Our income inequality continues to increase despite many people saying this is not good for us.
The other finger points to a lack of support for early life. Only two countries in the world do not grant a working pregnant woman paid time off after she has her baby. One is, of course, the United States, and the other is Papua New Guinea. We have the most child poverty of all rich nations. Our government spends for remedial action on failing students, rather than putting resources towards early life. For example, Sweden, one of the world’s longest-lived countries, spends more government money in the first year of life than in any subsequent year. Early life expenditures have a great return on investment compared to those repairing broken men and women.
While access to good medical care is important, it is not the driver of these fatalities. We spend more on health care than the rest of the world combined. Similarly for many health-related behaviors. We have among the lowest rates of cigarette smoking of all rich nations. Japan, the longest-lived has more than twice as many men smoking per capita than we do.
Our health decline is not on the list of presidential issues that are being discussed and debated. This was also the case after the 2013 Institute of Medicine report with the title that said it all before our health decline. “U.S. Health in International Perspective: Shorter Lives, Poorer Health.” Things are considerably worse now. This needs to become a national issue. It is much more important than Medicare for All or other such discussed programs. Yes, universal health care needs to be enacted but it won’t treat our health decline.
WPSR, through it's Economic Inequity Program, is taking on the responsibility of bringing these ideas to light, to eradicate shortgevity and get us back on the road to a longer healthier life. Creating awareness of a problem is always the first step. Then we need to change the economic structure of our society so there is more economic justice, and in turn, better health.