Health Olympics

We watch the Olympics with fascination as countries compete to win the most gold medals and be ‘the best.’ But surely athletics are not the only important area for comparing achievements.

Consider the Health Olympics, the ranking of countries by life expectancy – a measure of the health of a nation’s people. Born today, at today’s mortality rates, on average how long can an individual expect to live? Japan has won the Gold Medal since 1978 with the longest life expectancy: The lead is ever increasing and is now more than four years ahead of the US.

This translates into a huge health difference. If the US eradicated heart disease, our leading killer, and kept the other disease death rates unchanged, we still wouldn’t surpass Japan. Today the US ranks 27th among nations in health – about on a par with Cuba.

In 2000 at the last Olympic fete, we were 24th while last year we were tied for 26th. Fifty-five years ago the US was in the top five and Japan had an even more shameful performance than we do today. Yet Japan, among rich countries, wins the gold in the Smoking Olympics. About 55% of Japanese males smoke, compared to 26% of American men. How do they get away with winning both Gold Medals? What is loaded in Japan’s smoking gun?

What makes a population healthy are not the usual do’s and don’ts that make an individual healthy. Smoking isn’t good for you. But compared to other adverse health conditions, it isn’t that bad. What is worse for a population than smoking?

Research has shown that status differences between the rich and the poor may be the best predictors of a population’s health. The smaller the gap the higher the life expectancy. The caring and sharing in a society organized by social and economic justice precepts produces good health. A CEO in Japan makes ten times what an average worker makes, not the 531 times in the USA reported earlier this year.

When society structures egalitarian relationships among its people then Japan demonstrates that individual behaviors, such as tobacco use, are not so bad for health.

We commonly equate health with health care. We spend almost half of all money spent world-wide on health care to serve less than 5% of the planet’s people. Health care spending cannot be an important positive factor affecting a population’s health.

The US wins the Gold Medal in many other important ‘Olympic’ events. Among rich countries we capture the gold in the Non-Voter Olympics, the Homicide Olympics, the Incarceration Olympics, the Teen Birth Olympics, the Child Abuse Death Olympics, and the Child Poverty Games. Among countries studied so far, we have the highest rates of significant mental illness. We have a commanding lead in the Billionaire Olympics, with over five times the silver medalist’s score.

We will probably win the most gold medals in this year’s games, as we did in 2000. We host the greatest number of Nobel Prize winners. If the health of our citizens mattered we should set our eyes on the Health Olympics prize.

Plato remarked around the time of the first Games in his Laws that for a “state which is desirous of being saved from all plagues – not faction but rather distraction – there should exist among citizens neither extreme poverty nor, again, excess of wealth for both are productive of both these evils.” He suggested the limit of extremes of wealth to be no more than the richest having four times that of the poorest. In the world today the proportion is closer to a trillion to one. The plagues are upon us.

To better the health of Americans the President could announce the US standing in the Health Olympics or the Child Poverty Olympics in every State of the Union address. Such public awareness would lead to improved standing in the health rankings, instead of continuing our free fall over the last half century. We need a prescription whose ingredients are social and economic justice.

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