What is the measure of a country's health? How do you take the temperature of a population that sprawls across nine time zones, 50 states and a global rainbow of cultures and communities? One way is by taking a close look at yourself.
If you're like 67% of Americans, you're currently overweight or obese. If you're like 27%, your blood pressure is too high. If you're like a whopping 96% of the population, you may not be able to recall the last time you had a salad, since you're one of the hundreds of millions of Americans who rarely eat enough vegetables. And what you do eat, you don't burn off — assuming you're like the 40% of us who get no exercise. Most troubling of all, if you're like any parent of any child anywhere in the world, you may be passing your health habits to your children, which explains why experts fear that this generation of American kids may be the first ever to have a shorter life span than their parents do.
(Read the Year in Medicine 2008.)
By too many measures, America is a lot less healthy than a developed nation has any business being. But just how sick — or just how well — are we? Broad national averages are limited things — very good at telling you the what, but notoriously bad at telling you much more. Who are the one-third of Americans who don't have a weight problem, and how can the rest of us become like them? Why do some of us get our cancer screenings and make sure our kids are vaccinated while others don't? It's hard enough to get a thorough profile of any one person's health outlook. Now imagine putting 300 million of us on the examining table together. That's where TIME's inaugural national health checkup can help.
For this first annual feature, we've gone straight to the numbers to measure the vital signs of a 232-year-old nation that, let's be honest, has let itself go a little lately. The results of such a collective physical are something that should concern us all. If Americans get flabby and inactive together, we can also get fit and healthy together, and a look at the national fever chart is one way to learn not only where any one person needs to improve, but where any one family or entire region should too.
Even a cursory glance at the stats gives us reason for both hope and worry. Each decade since 1980, the Department of Health and Human Services (HHS) has compiled what it calls its Healthy People report, a sort of prospective census in which it sets goals in 28 health areas, from weight and diabetes incidence to cholesterol levels and cancer screenings, and keeps track of how well those targets are met over the 10 years that follow. We are approaching the Healthy People 2010 report, and in an interim assessment, hhs revealed that 59% of its objectives had already been met or were on their way to being met. The goal of vaccinating 80% of babies under age 3 with a core series of shots was surpassed in 2005, with 81% of infants receiving the recommended doses. Half of adults ages 50 and older received a colon scan, meeting the target for colon-cancer screening. Yet at the same time, in 20% of the tracked trends, we have actually retreated from the goals. Only 33% of adults in 2003-06 were at a healthy weight, half the number who ideally should be and 10% fewer than in 1988-94. The prevalence of diabetes, which health officials hope to cap at 25 cases per 1,000 people, is more than double that and has actually risen since 1997.
With a new Administration promising much needed reform in the way health care is accessed, delivered and reimbursed, legislators, health officials, doctors and patients see this as a rare opportunity, a sweet spot in which national need could meet national will and we could actually fix a system that seems to be costing us more and more but delivering less and less. The improvements can't come too soon. In spite of our gleaming hospitals and cutting-edge technology that can detect the tiniest tumors and repair the most complex organ, on some basic health measures the U.S. is starting to fall behind — far behind.
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