Time For A Checkup: Class and Race in Health Care

by Merrill Goozner

TomPaine.com -- September 21, 2004

"What's the health care story no one's talking about
this election? The health effects of race and class in
America."

How is it that the richest nation in the world can
barely meet the health benchmarks set by former Soviet
Union countries? It's all about averages, says Merrill
Goozner of the Center for Science in the Public
Interest. There's a huge race- and class-based health
care disparity in the United States. And it's a problem
that's going to take more than promises of universal
health care to solve.

Merrill Goozner is director of the Integrity in Science
project at the Center for Science in the Public
Interest and a contributing editor to The American
Prospect. He has been a journalist and researcher for
more than 20 years.

The United States spends more on health care than any
country on earth - nearly 15 percent of its overall
economy. That's nearly a half again as much as other
countries and on a per capita basis, no one else is
even close. Yet if one looks at the performance of our
health care system, we're clearly not getting what we
pay for.

USA Today last week published a list of the top 50
countries in terms of life expectancy. The United
States ranked third from the bottom. That's right.
We're number 48. This year, Americans can expect an
average life span of 77.4 years, nearly four years
behind the Japanese.

Of course, our longevity has been rising every year by
a small amount. But many countries that spend nowhere
near our levels on doctors, hospital stays, drugs and
sophisticated tests are clearly getting a lot more for
their money.

Take the oppressed citizens of the British isles, for
instance. We're constantly told they are suffering
under the yoke of an incompetent national health care
system. Yet they live nearly a year longer on average
than Americans.

How about those beer-swilling, sausage-stuffing
Germans? They live 14 months longer on average.

Just over the border in Canada, the press constantly
claims that our northern cousins are suffering endless
waits for basic procedures that we take for granted.
Surely they must be dying off at a faster clip. Uh-uh.
They have two-and-a-half more years than the average
American. Perhaps they spend it waiting on lines for
their health care.

Among large industrialized countries, the life
expectancy leaders - all with an average life
expectancy over 80 years - were Japan, Switzerland and
Sweden. What do they have in common? They have national
health care plans. But more importantly, they have a
high degree of income and social equality across their
societies - which, more than any other single factor,
correlates with superior health outcomes.

A quick look at the Centers for Disease Control website
at health disparities in the United States gives a few
clues about why our health care system performs so
poorly despite outlandish costs. While the overall U.S.
life expectancy rate is 77 years, the rate for blacks
is about 72 years with black males at a Third World-
level of 68 years.

Infant mortality - a prime indicator of how well health
care services are distributed in a society - is another
area where the United States lags sadly behind its
industrialized rivals. The CDC rankings of selected
countries showed the United States at 28th out of 37
countries.

Who fell below us in safe and healthy childbirths and
infant care through the first year of life? Virtually
all the laggards (other than the United States) are
countries of the former Soviet Union and Eastern
Europe. How can it be that we not much better off than
Romania in this vital statistic? It's not middle-class
moms in suburban hospitals losing babies. It's poor
mothers without prenatal care. It's teenagers who hide
their pregnancies, deliver low birth weight babies and
have few support systems to help them care for their
newborns.

The health effects of race and class are America's
hidden health care story. Low-wage work leads to lousy
diets because the foods that are plentiful and cheap
happen to be the worst for you. Fear of unemployment
and economic decline defines America's large lower
middle class today and this produces tremendous psychic
stress - an unreported epidemic. We spend billions on
drugs to lower blood pressure, reduce cholesterol and
treat diabetes, but almost nothing on social programs
to offset the income-related lifestyles that lead to
these conditions.

In this election season, by all means let's have a
debate about how to provide health insurance to the 43
million Americans without it. But let's also talk about
who in this society suffers from ill health, why they
suffer and what can be done about the social and
economic disparities that lead to ill health. It will
take more than universal insurance coverage to tackle
those issues.

http://www.tompaine.com/articles/time_for_a_checkup.php

[TomPaine.Common Sense - a project of the Institute for America's Future ]

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