Americans Are Dead First

Americans Are Dead First

Stephen Bezruchka is a Senior Lecturer in Global Health and Health Services at the University of Washington. 

“To be or not to be” is the question Hamlet asked centuries ago. The answer in the United States is that not-being at too early an age is the reality we face. Let me explain.

Being requires us to be alive, rather than dead. If we re-frame that question as comparing our mortality to that in other nations, US mortality declines and even surpasses that of other rich nations only if we live considerably past retirement age. At all earlier ages, Americans are dead first.

People in as many as thirty plus other nations live longer lives than we do at every stage until the 80+ years range. The inequity starts in infancy: if we had Sweden’s infant mortality rate, 47 fewer babies would die every day in the US. For youth, ages 10 to 24, our mortality rates are more than twice as high as in some other rich nations. Mortality rates for women are actually increasing in about half of US counties, and we are one of only eight nations in the world that have seen increases of women dying in childbirth over the last decades. African American women in New York City have over ten times the chance of dying in childbirth than whites there.

Most of us are unaware of this carnage. Many presented with these facts say it doesn’t apply to them because they eat right, exercise, have a college education and make lots of money. Unfortunately, studies show that won’t exempt them from this trend. All of us die younger than we should, because of (and in spite of) living in the world’s richest most powerful country–one that spends close to half of all money spent worldwide on health care.

One part of the explanation for this shocking reality lies in policies that produce a consumer capitalist system with its cult of individualism. The pursuit of economic growth and working too hard to achieve the good life may be killing us. Inequality can be thought of as an odorless, colorless, highly toxic gas that somehow kills us from the usual diseases. It is more deadly than tobacco smoke was in the 1950s, when doctors recommended cigarettes to patients to help them relax.

The US neoliberal economic system produces great wealth for a few and misery for many. Why else would we consume half of all the world’s anti-depressants? Economic inequality has been causally linked to worse health. And not just early deaths, but to teen births, mental illness, homicides, incarceration rates, and school achievement test scores. More unequal societies have worse environmental outcomes and greater CO2 production. The social fabric of societies weakens. We don’t trust one another as much and prefer to live in gated communities. We have fewer friends to call on for support. In short, inequality kills.

Economic growth and acquiring more “stuff” hasn’t helped us achieve happiness, though we are in hot pursuit of it. Happiness levels have actually trended down in the US for the last forty years and the trend is more pronounced in women. Despite the constantly repeated phrase “have a nice day,” more and more in the US we are not having nice days.

Questioning the need for endless economic growth will lead us to a more promising land. Prosperity without growth is not only possible, but is necessary to save the planet from the inevitable consequences of decimating the environment. Answers lie in the precepts of degrowth (décroissance in French), in creating a society where endless economic growth is not the goal. Degrowth signifies a direction towards using fewer natural resources, embracing simplicity and conviviality, with caring and sharing the norm and reducing inequality the aim.

Degrowth is actually a win-win choice. We will all be better off and live longer and happier lives when economic growth is no longer the goal.


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