We are the only country that systematically collects data by race; race is not a biological construct, so what is race? So to compare the US with other countries you have to get at the question indirectly. Brazil, the United States and Cuba are countries in which the largest segment of the population is white, but each has a relatively large black population. There was a study done by a Harvard professor in the 1990s that looked at life expectancy differences among blacks and whites in each of those countries. The difference was about one year in Cuba, but six or so years in Brazil and also in the United States.
We have changed from a country that, in the 1950s, believed in economic justice. We had high tax rates on the rich, and we had welfare programs for other people. But we have changed from a community focus, or a collective focus, to one in which today we have to pursue our health as individuals.
I make two points about this. One is that early life — probably the first thousand days after conception, or up to around age 2 — is incredibly important for our health as adults. The risk for disease — heart disease, lung disease and others — is programmed in early life. You can’t give somebody a pill to redress childhood abuse and you can’t put a stent in a coronary artery to redress the stress resulting from the lack of support your parents gave in your early life. Every country in the world has a national policy that gives working moms paid time off work after they have babies, except for Papua New Guinea, Suriname, a few South Pacific Island nations and the United States. We also have the most child poverty of all rich countries in the world. We don’t invest in the part of life that really matters.
The other point is that healthier societies have a smaller gap between the rich and the poor than we do. That gap causes an enormous amount of stress in our society — road rage, air rage, stress at work, child abuse. I say stress is the 21st century tobacco. We have learned that inequality kills.
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