Paul Krugman: Our Sick Society

For those who missed it, also reprinted from the Progressive American:

Is being an American bad for your health? That's the apparent implication of a study just published in The Journal of the American Medical Association.

It's not news that something is very wrong with the state of America's health. International comparisons show that the United States has achieved a sort of inverse miracle: we spend much more per person on health care than any other nation, yet we have lower life expectancy and higher infant mortality than Canada, Japan and most of Europe.

But it isn't clear exactly what causes this stunningly poor performance. How much of America's poor health is the result of our failure, unique among wealthy nations, to guarantee health insurance to all? How much is the result of racial and class divisions? How much is the result of other aspects of the American way of life?

The new study, "Disease and Disadvantage in the United States and in England," doesn't resolve all of these questions. Yet it offers strong evidence that there's something about American society that makes us sicker than we should be.

The authors of the study compared the prevalence of such diseases as diabetes and hypertension in Americans 55 to 64 years old with the prevalence of the same diseases in a comparable group in England. Comparing us with the English isn't a choice designed to highlight American problems: Britain spends only about 40 percent as much per person on health care as the United States, and its health care system is generally considered inferior to those of neighboring countries, especially France. Moreover, England isn't noted either for healthy eating or for a healthy lifestyle.

Nonetheless, the study concludes that "Americans are much sicker than the English." For example, middle-age Americans are twice as likely to suffer from diabetes as their English counterparts. That's a striking finding in itself.

What's even more striking is that being American seems to damage your health regardless of your race and social class.