Introduction: A Wake-Up Call for Change

In late January, a committee of medical experts under the auspices of NIH released a report on the health of Americans relative to citizens in the rest of the industrialized world. It should be read by every hospital CEO and public official in this country. In fact, it should be studied by everyone interested in quality of life. I believe it demonstrates a need to rethink the nature of health. Obviously, how we view health has consequences for the way we organize our health systems—and much more.

Here is a one-sentence summary of the stark findings from the NIH expert panel: People living in the United States die sooner, get sicker and sustain more injuries than those in all other high-income countries.

How Are We Doing? Not So Well

Health status is worse in America in no fewer than 9 out of 11 categories than it is the 17 leading industrialized nations. In the other two categories, we’re doing better: We’re only next to worst. Anyone who considers Americans healthy might be shocked to discover what the NIH report indicates to the contrary. The fact is we are at the bottom rank among our peer nations. We are last in regard to how we’re doing in life expectancy, obesity, infant mortality and low birth rate, heart disease, diabetes, chronic lung disease, homicide rates, teen pregnancy and sexually transmitted diseases.

The chairman of the study panel, Dr. Steven Woolf, a professor of medicine at Virginia Commonwealth University, said: We were stunned by the propensity of findings all on the negative side – the scope of the disadvantage covers all ages, from babies to seniors, both sexes, all classes of society. If we fail to act, life spans will continue to shorten and children will face greater rates of illness than those in other nations.

If all this does not seem akin to a mass die off of proverbial canaries in a coal mine, then consider this statement in the report: Advantaged Americans – those who are white, insured, college-educated, upper income – are in worse health than similar individuals in other countries. Even Americans who do not smoke or are not overweight have higher rates of disease than similar groups in peer countries.

What’s Going On? How Did This Happen?

The NIH report offers no single sweeping answers or simple solutions. Many factors are discussed. The key factors cited include mostly lifestyle-related dynamics, such as dreadful diet and exercise levels. Much attention is devoted to our unprecedented obesity rates, our dependency on a physical environment built around the automobile rather than the pedestrian, tens of millions without access to proper medical services, adverse economic/environmental and social conditions, values and public policies.

One panel member added this: The bottom line is that we are not preventing damaging health behaviors.

The report was designed to alert the American public about the extent of the nation’s health disadvantage and to stimulate a national discussion about its implications.

Educating the American people about becoming and staying well might warrant as much priority as delivering high-tech, costly care for chronic medical conditions. The situation is dire. It could be that a Marshall Plan-level commitment to REAL wellness is in order.

What to Do? Look on the Bright Side and Shift Gears

In a strange way, this watershed report could represent tidings of great joy, so to speak. However, that would only be the case if it sparks a reassessment and reawakening essential for a seismic shift from treating symptoms and consequences of mediocre lifestyles to organizing for a healthier society.