"The longest-lived country in the world is Japan, has been since 1978. And when I learned that three times as many men smoke in Japan as in the United States, and yet they're the longest-lived people in the world, I had to change my mind about what really mattered." - Stephen Bezruchka
Unlock this critical interview for $4 a month
FEATURING STEPHEN BEZRUCHKA - Americans have higher rates of chronic illnesses compared to other wealthy nations. They also have higher death rates and shorter life spans. How does the world’s most expensive healthcare system result in such terrible outcomes?
Most progressives attribute this to our lack of a single payer healthcare system. According to a new book, it’s even bigger than that and can be traced back to inequality, including capitalism and individualism.
Stephen Bezruchka is Associate Teaching Professor Emeritus in the Departments of Health Systems & Population Health and Global Health at the School of Public Health, University of Washington. At UW he received the 2002 Outstanding Teacher Award, the 2008 Faculty Community Service Award, the 2017 Outstanding Faculty Mentor Award, and the 2018 Communicating Public Health to the Public Award. He spoke with Sonali Kolhatkar about his new book, Born Sick in the USA: Improving the Health of a Nation.
ROUGH TRANSCRIPT:
Sonali Kolhatkar: So, we certainly know that the US has terrible health outcomes, and as I mentioned, many of us attribute that to the lack of a single-payer healthcare system. Why do you say it is bigger than that in your book? You wrote a whole book about how our entire system, but it also seems as though our cultural approach to how we exist in the United States is all part of why we have such terrible outcomes. So lay out your thesis for us, please.
Stephen Bezruchka: So, healthcare really contributes very little to the health of a population. Studies in the United States from my medical school at Stanford said healthcare here averts about 10% of mortality. That leaves 90% to be explained by other factors. And I like to simplify things, so two factors really matter most.
One is the amount of attention we pay to early life, because as we go from the erection to the resurrection, about half of our health as adults is programmed in the first 1,000 days after conception. So healthier countries privilege that period in various ways.
One example is to give a working woman who's pregnant paid time off as a national policy after she has her baby. Only two countries in the world do not provide, as a national policy, paid leave. One is, of course, the United States, and the other is Papua New Guinea, half of a big island north of Australia. So while about eight states have a modest program of paid parental leave, California and Washington, where I am, being examples, it's only 12 weeks, and that's at the low end of all the other countries in the world.
