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Happy and Healthy

By now you’ve probably had numerous people, either in person or in Christmas cards, wish you a “happy and healthy New Year.” Happy is perhaps an elusive quality to measure, but healthy can be assigned a number of metrics which is what the United Health Foundation has done for the past twenty-five years. The report for 2014 offers reason to be encouraged about the state of our health in the US, along with significant warning signs for the future. Here are a few of the positive highlights:

  • Since 1990, the percentage of adults in the US who smoke regularly has decreased by 36% from almost 30% to 19%
  • The incidence of violent crime is 37% lower than it was in 1990, and 49% lower than it was at its peak in 1993
  • Air pollution has continued to improve with a 30% decrease in the average amount of fine particulates in the air
  • Occupational fatalities have declined in the last 8 years from 5.3 to 3.8 deaths per 100,000
  • Infant mortality decreased by 41% over the 25 years
  • Cancer deaths have declined by 4% and cardiovascular deaths by 38%

We are arguably a healthier society due to a combination of behavioral changes, the impact of public policy, particularly on the environment, and the benefits of medical research.

But the report also shows that improvement is not spread evenly across the US population. It still matters where you live and what your race and income are. And the US still lags behind many other developed nations in several categories. The Affordable Care Act should begin to have an impact on at least some of these factors as millions of Americans join the ranks of the insured. But other concerns persist.

  • Obesity is increasing at an alarming rate – 153% - from 11.6% of adults in 1990 to 29.4% in 2014. Almost a quarter of US adults report no meaningful physical activity.
  • Nearly 20% of children live in poverty, up from the 23 year low of 15.8% in 2002
  • State public health spending has dropped for the last four years in a row
  • Comprehensive immunization coverage for children remains low, at only 70.4%
  • Over the last 20 years the prevalence of low birth weight has increased from 7.1% to 8 %
  • There has been a steady upward climb in the incidence of diabetes, with 9.6% of adults now reporting they have been told they have diabetes

It is interesting to note that the challenges identified in the report have very little to do with the impact of things beyond our control. Improved lifestyles, enlightened public policies with accompanying funding, and a serious commitment to end poverty would make a significant impact on each. It’s a matter of national will and personal life style changes, not a set of dreaded afflictions for which we have no medical solution. Viruses, bacteria, and cancer are not our biggest threats. We are.

As they have done for centuries, churches have an important role to play. Wellness programs in local churches, support for quality local health care for all, advocacy for national policies in support of public health, research funding, and improved nutrition, and a consistent prophetic voice on behalf of the poor can all support continued progress in the annual health care report card. But there are strong countervailing forces as well – continued attempts to eviscerate the Affordable Care Act, further plans to reduce public spending affecting both basic research and public health programs, the captivity of federal nutrition policy to the food industry, to name just a few, all threaten the gains of the last quarter century. It’s not often that we see a report card so encouraging. But if the good news is to be shared by all, and if momentum is to be continued, we need to do much more than simply wait and hope for the next big medical breakthrough. A healthy new year depends on good citizenship and lifestyles far more than simply on good fortune.

John H. Thomas
January 8, 2015

For the full report, see:


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