In a call to action on the sorry comparative state of U.S. health, researchers at Columbia University's Mailman School of Public Health are urging President Obama to "remove the public veil of ignorance" and confront a pressing question: Why is America at the bottom? The report, published in the journal Science, appeals to the President to mobilize government to create a National Commission on the Health of Americans. The researchers underscore the importance of this effort in order for the country to begin reversing the decline in the comparative status of U.S. health, which has been four decades in the making.
This is not a challenge that can be left to private groups, no matter how well meaning. Drs. Ronald Bayer and Amy Fairchild, both Professors of Sociomedical Sciences, argue, "The health status of Americans is a social problem that demands social solutions." More is at stake than the U.S. healthcare system, which fails to provide needed care to millions of Americans. "There is a need for bold public policies that move beyond individual behavior to address the fundamental causes of disease," Bayer and Fairchild conclude.
A January 2013 report by the U.S. National Research Council (NRC) and Institute of Medicine (IOM) ranks the United States last among peer nations in health status and compares it unfavorably to 17 peer countries at almost every stage of the life course. The report, titled "U.S. Health in International Perspective: Shorter Lives, Poorer Health," emphasizes that socioeconomic causes are the drivers of these outcomes and details the categories in which the U.S. has the worst or next-to-worst results:
- The U.S. has higher rates of adverse birth outcomes, heart disease, injuries from motor vehicle accidents and violence, sexually acquired diseases, and chronic lung disease.
- Americans lose more years of life to alcohol and other drugs.
- The U.S. has the highest rate of infant mortality among high-income countries.
- The U.S. has the second highest incidence of AIDS and ischemic heart disease,
- For decades, the U.S. has experienced the highest rates of obesity in children and adults as well as diabetes from age 20 and up.
In an interview, Drs. Bayer and Fairchild said, "Too many studies, too many reports documenting the grave health inequalities within the U.S. have been published." Now, they noted, "not only are social inequalities greater than they have been in a century, but we see that the U.S. does more poorly than other nations. Echoing the sense of urgency expressed in the report, they concluded, "We fear that like earlier studies this most recent analysis will be consigned to the dustbin of history. Only determined action by the President can prevent such an outcome."
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"Confronting the Sorry State of U.S. Health," by R. Bayer, Science, 2013