Tuesday, April 14, 2009

Effect of culture - A Nation's Culture, Not Its Health System Shapes Its Health Statistics

Medical care accounts for about 15% of the health status of any given population, life style for 20% to 30%, and other factors – poverty, education, income, and lack of social cohesion, for the other 55%.

D. Satcher and R. Pamies, Multicultural Medicine and Health Differences, McGraw-Hill, 2006

In these days of high blown health rhetoric about the virtues of single payer and superior health statistics of other developed nations compared to the U.S., it’s useful to keep in mind that two salient U.S. cultural factors – one, our high death rates on our highways from accidents and violence in our mean streets, and two, our explosively high rate of immigration, with one of five Americans being a recent immigrant or close relative of one – are decisive in shaping our statistics.


• Col. John Holcomb, the army’s top trauma surgeon, is fond of quoting the statistic, that, among U.S. civilians, trauma leads all diseases in terms of life-years lost, more than heart disease or cancer. That’s useful statistic to keep in mind when comparing national health systems, for if one takes trauma and violence into consideration, U.S. longevity statistics are comparable to any other country. There is little the medical care establishment can do about reducing the number of these deaths, other than heroic actions in emergency rooms and hospitals, often after it too late.

• The number of U.S. citizens born to illegal immigrants , mostly from Mexico, has exploded from 2.7 million to 4.0 million over the last 5 years. One of four illegal Mexicans, or 25%, went without health insurance, and experienced much higher rates of infant mortality among illegal Mexican mothers than infants of U.S. born mothers. Many of these deaths occurred in infants of Mexican mothers who were beyond the reach of our health system. Take into account also that Hispanics, which now comprise about 15% of our population, have an average life expectancy of 74.0 years compared to 81.0 years for American whites.

When outraged reformers say its poor health coverage.

That makes U.S. statistics worse, don’t take umbrage.

Show them figures on immigration and domestic trauma,

Tell them to plug that into their dramatic docudrama.

Those numbers may help assuage irrational outrage

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