Van elke dollar die in de wereld aan gezondheid wordt uitgegeven komt 50 dollarcent door Amerikaanse handen. Tóch is het niet gezondste land met de hoogste levensverwachting in de wereld. Wat bepaalt de gezondheid van een volk?
In een artikel in de Centre Daily Times analyseert een medisch expert de situatie: in de landen in de wereld waar het grootste verschil is tussen arm en rijk is de gezondheidssituatie het slechtst. Ongezond gedrag als drinken, roken, weinig lichaamsbeweging en teveel eten laten evenwel geen enkele correlatie zien met de gezondheidssituatie van een land….
It is becoming clearer that at any given level of overall economic development for a country or region within a country, the populations of countries and regions with smaller gaps between rich and poor, in general, are healthier than the populations of countries and regions where the gap is larger.
These observations imply that the economic structure of a nation may be the most important determinate of the health of its people. To illustrate this, look at the health of people in the United States, measured by life expectancy. Fifty-five years ago, the United States was one of the healthiest countries in the world by this measure. Today, there are about 25 countries that are healthier than ours.
The United States has the highest infant-mortality rate, the highest child-poverty rate, the highest teen-pregnancy rate, the highest child-abuse death rate, and so on, among all rich countries. There are no indicators in which we excel, except in spending money on health care, for we spend half of the world’s total healthcare bill.
Japan has the highest life expectancy of any country in the world, yet there are twice as many smokers per capita in Japan than in the United States. To understand this phenomenon, we need to look at post-World War II Japan and the changes that occurred from 1945 to 1950, during the U.S. occupation: The first was demilitarization; the second was democratization, as U.S. policy-makers wrote the country’s constitution, providing for representative democracy, free universal education and the right of labor unions to organize and engage in collective bargaining; and the third “D” was decentralization, when the 11-family zaibatsu that ran the huge corporations controlling the country was broken up. The most successful land-reform program in history was carried out. What this did was bring down the economic hierarchy and leveled the playing field. The resulting rise in health in Japan is the most profound ever observed on this planet.
Studies have shown that even though these behaviors are considered bad for health, the excess smoking, drinking, heroin use and food consumption in conjunction with a lack of exercise, only explains about 10 percent of the reason that poorer people have poorer health. Learning this has been a revelation for me. I used to blame sick people for their behaviors that made them sick.