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Doing It Right
If Americans have been slow to realize the worrisome state of our collective health, we have — as individuals and as a nation — at last begun to wake up. Take our long and almost always unhappy battle with weight. In recent years, the scale has been telling not just a distressing tale, but also a truly shocking one. Between 1980 and 2004, the prevalence of obesity in the U.S. doubled among adults, surging to 72 million, or one-third of people ages 20 and older. Worse, the percentage of overweight or obese kids rose to 17%. If all those numbers could be cut by even a third, the ripple effect would in turn slash rates of hypertension, heart disease, diabetes, cancer, joint damage and more, not to mention the myriad costs associated with fighting these illnesses.
And indeed, there may be flickers of hope. From 2005 to 2006, the percentage of women and children who are overweight appeared to stabilize, while the rate for men increased only slightly. "That's good, but it's not as if it's flattening at a good level," notes Cynthia Ogden, an epidemiologist at the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. Still, the improvement is no accident, and for women and particularly children, it can be traced to aggressive nutrition and exercise messages promoted in schools, hospitals, community groups and churches — precisely the kind of low-cost, high-impact measures health experts love.
Similar preventive methods may help cap soaring cholesterol levels. Since the late 1960s, the average serum-cholesterol level of adults has continued to drop, from a high of 220 mg/dL down to 199 mg/dL in 2006. That cut the percentage of Americans with high cholesterol to 17%, precisely the goal set by the Healthy People 2010 targets — and it was reached four years ahead of schedule. Routine blood tests for low- and high-density lipoproteins, or bad and good cholesterol — as well as the use of cholesterol-lowering medications when needed — have played a major role in powering those improvements.
The same principles of education, prevention and early treatment can apply to mental health as well. One in 20 Americans over age 12 reported feeling depressed in 2006, with non-Hispanic blacks making up the largest percentage. Although 80% of Americans admitted that their symptoms interfered with their ability to work, only 29% had contacted a mental-health professional. Recent improvements in screening at primary-care facilities, one of the goals set by Healthy People 2010, may help address this problem: while 62% of primary-care facilities provided treatment for mental disorders in 2000, 74% do so now.
It took the U.S. health-care system a long time to get as broken as it is, and it will take a long time to set it right. A big, diverse land like ours may never be able to put up the glittering health numbers of smaller, more homogeneous countries. But we're not in the game to compete with the Swedens and Norways of the world. We're in the game to make America the healthiest place it can be. At the moment, we're nowhere near the goal, but slowly, we're edging closer.