Measuring our Health

By Byron E. Conner, M.D.

“Dear friend, I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well”
3 John 2 (NIV)

A revealing way to measure the health of a population is to look at its “life expectancy”. That is how long a person would live from birth, assuming they are born in a certain location, or as a member of a certain subset of a population.

This can be applied to different nations and also populations within a nation. We can further refine this by looking at the number of years of ill health as compared with the number of years of good health of people to give a measure called the equivalent years of healthy life. (or DALE- the Disability Adjusted Life Expectancy). Despite the fact that we may spend a trillion or so dollars for health care in America, as a nation we do not enjoy the longest life expectancy in the world. In fact a surprising number of countries outrank us in life expectancy.

The longest healthy life expectancy in the world is found in Japan (74.5 years) looking at 191 countries. The lowest ranking country is the West African nation Sierra Leone (at 26 years).
We have found that years of life lost to disability are significantly higher in poorer countries. Things such as injury, blindness, paralysis, and the deadly effect of tropical diseases such as malaria, as well as the AIDS pandemic strike children and young adults.

Besides Japan the other top ten countries in regards to healthy life expectancy are in order: Australia, France, Sweden, Spain, Italy, Greece, Switzerland, Monaco, and Andora. The bottom ten countries were all in what is called sub-Saharan Africa where the HIV-AIDS pandemic is raging, and include (in ascending order): Sierra Leone. Niger, Malawi, Zambia, Botswana, Uganda, Rwanda, Zimbabwe, Mali, and Ethiopia.

Under this system of health assessment, the United States (ranked at 70 years adjusted life expectancy) was 24th in the world! Perhaps we may have thought we were number 1, but it is not so. The question is why? The World Health Organization gives these reasons why the United States ranks relatively low among wealthy nations:

  • In America, some groups such as Native Americans, rural African Americans, and the inner city poor have extremely poor health. In fact their state of health is more like that of those living in poor developing country than a rich nation such as ours.
  • The HIV epidemic causes a higher proportion of death and disability among young and middle-aged people, compared to other wealthy nations.
  • America is one of the leading countries for cancers related to tobacco especially lung cancer and chronic lung disease.
  • High levels of violence, especially homicides are prevalent in our country compared to other industrialized countries.
  • A high rate of coronary heart disease , which has dropped in recent years, but remains high.

Are you dismayed at these findings? We all should be, and we can say shame on us as a nation!

We need to do what we can to change things such as health disparities, poverty, poorer access to health care, violence and the scourge of diseases such as HIV/AIDS, heart disease, cancer, stroke, and diabetes.

In a future article we are going to look closer at the state of health of America and how we can improve it.

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