The National Research Council and Institute of Medicine yesterday released the results of a study addressing mortality in the United States as compared to other developed nations. The full report can be purchased here, where a summary also can be downloaded as a free pdf file. The press release on the study frames the questions addressed:
On average, Americans die sooner and experience higher rates of disease and injury than people in other high-income countries, says a new report from the National Research Council and Institute of Medicine. The report finds that this health disadvantage exists at all ages from birth to age 75 and that even advantaged Americans — those who have health insurance, college educations, higher incomes, and healthy behaviors — appear to be sicker than their peers in other rich nations.
“We were struck by the gravity of these findings,” said Steven H. Woolf, professor of family medicine at Virginia Commonwealth University in Richmond and chair of the panel that wrote the report. “Americans are dying and suffering at rates that we know are unnecessary because people in other high-income countries are living longer lives and enjoying better health. What concerns our panel is why, for decades, we have been slipping behind.”
From the summary, we have this long explanation of the causes of high US mortality, where I have added emphasis:
The panel’s inquiry found multiple likely explanations for the U.S. health disadvantage:
• Health systems. Unlike its peer countries, the United States has a relatively large uninsured population and more limited access to primary care. Americans are more likely to find their health care inaccessible or unaffordable and to report lapses in the quality and safety of care outside of hospitals.
• Health behaviors. Although Americans are currently less likely to smoke and may drink alcohol less heavily than people in peer countries, they consume the most calories per person, have higher rates of drug abuse, are less likely to use seat belts, are involved in more traffic accidents that involve alcohol, and are more likely to use firearms in acts of violence.
• Social and economic conditions. Although the income of Americans is higher on average than in other countries, the United States also has higher levels of poverty (especially child poverty) and income inequality and lower rates of social mobility. Other countries are outpacing the United States in the education of young people, which also affects health. And Americans benefit less from safety net programs that can buffer the negative health effects of poverty and other social disadvantages.
• Physical environments. U.S. communities and the built environment are more likely than those in peer countries to be designed around automobiles, and this may discourage physical activity and contribute to obesity.
No single factor can fully explain the U.S. health disadvantage. Deficiencies in the health care system may worsen illnesses and increase deaths from certain diseases, but they cannot explain the nation’s higher rates of traffic accidents or violence. Similarly, although individual behaviors are clearly important, they do not explain why Americans who do not smoke or are not overweight also appear to have higher rates of disease than similar groups in peer countries.
More likely, the U.S. health disadvantage has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions.
What stands out to me is that the list of reasons Americans die early overlaps significantly with the social goals of right-wing libertarians who worship Ayn Rand and John Galt. Continue reading
In a disgusting demonstration that for the NFL, money dictates that “The Show Must Go On”, the NFL never considered those who, like Dave Zirin, found it astounding that the NFL would encourage the Kansas City Chiefs to go ahead with their game barely 24 hours after Chiefs Coach Romeo Crennel and other Chiefs personnel witnessed Jovan Belcher kill himself with a handgun shortly after he had murdered his girlfriend, the mother of their three month old
son daughter. Zirin tweeted throughout the day on the coverage provided by the various networks as they continued broadcasting games, mostly as if the event had never happened.
But then, just at the close of halftime in the nationally televised Sunday night game on NBC, Bob Costas took the microphone for the minute and a half you see in the YouTube above. Costas started by slamming the cliche that the playing of the game somehow began the “healing” process for those affected by the tragedy, giving voice to the sentiment Zirin had stated earlier. But then Costas moved on to confront an even bigger taboo in the national debate, as he quoted this powerful column by Jason Whitlock, who dared to point out the way that our national sickness relating to guns contributed to this tragedy. From Whitlock:
I would argue that your rationalizations speak to how numb we are in this society to gun violence and murder. We’ve come to accept our insanity. We’d prefer to avoid seriously reflecting upon the absurdity of the prevailing notion that the second amendment somehow enhances our liberty rather than threatens it.
How many young people have to die senselessly? How many lives have to be ruined before we realize the right to bear arms doesn’t protect us from a government equipped with stealth bombers, predator drones, tanks and nuclear weapons?
Our current gun culture simply ensures that more and more domestic disputes will end in the ultimate tragedy, and that more convenience-store confrontations over loud music coming from a car will leave more teenage boys bloodied and dead.
In the coming days, Belcher’s actions will be analyzed through the lens of concussions and head injuries. Who knows? Maybe brain damage triggered his violent overreaction to a fight with his girlfriend. What I believe is, if he didn’t possess/own a gun, he and Kasandra Perkins would both be alive today.
Whitlock deftly destroys so many of the false narratives that our society has forced upon it regarding guns. As he states, this tragedy demonstrates that the second amendment actually threatens our liberty rather than protecting it. He goes on to state that although the second amendment is regarded by many as the last refuge by citizens against a government turned tyrannical, mere guns won’t protect against a determined government armed with “stealth bombers, predator drones, tanks and nuclear weapons”. Whitlock cleanly demonstrates that the pervasive nature of guns in our sickened society is what enables so many senseless deaths, pointing out that both Perkins and Belcher likely would still be alive if a gun had not been available during Belcher’s moment of extreme rage. Whitlock also alluded to the tragic murder of Jordan Davis in Jacksonville, Florida recently in a case that appears to possibly be headed once again into an inovcation of Florida’s “Stand Your Ground” law that many see as a license for murder.
Whitlock went directly in the face of the cliche, often pointed out by David Waldman on Twitter, that the immediate aftermath of a tragedy of this magnitude is “too soon” to enter into a discussion on the perils of society’s glorification of guns. Others would say that public discussion of guns on a rational basis is no longer possible because of the overwhelming power of the NRA.
The fact is, it is never “too soon” to discuss the role of guns in tragedies because the tragedies come at us so quickly that we would otherwise always be in the quiet period after one gun tragedy or another. But even more importantly, the myth of the power of the NRA has been completely destroyed. In the 2012 elections, Media Matters informs us that the NRA spent just under $12 million but only 0.42 percent of those funds supported winning candidates and only 0.39 percent opposed losing candidates.
Just as the latest round of elections and the current Kabuki over the “fiscal cliff” is poking a hole in Grover Norquist’s power over preventing tax increases, our society may actually be moving toward a more rational discussion on the sickness inherent in our gun culture. I don’t harbor any illusions that progress will be fast or that substantive improvements are even still possible, but if changes do finally take place, we may be able to point to the courage shown by Bob Costas last night as the turning point when we finally started a long overdue discussion.