# How unhealthy is the United States really? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 3, 2017, 5:28am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849 "2017-10-03T05:28:57Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [October 7, 2017, 2:25pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/41 "2017-10-07T14:25:15Z")
This is truly the Trumpian era. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [October 7, 2017, 3:04pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/42 "2017-10-07T15:04:22Z")
[Cuba](http://www.commonwealthfund.org/publications/blog/2016/nov/fidel-castros-health-care-legacy) is in fact a fine example of how much can be accomplished cost-effectively … given having absolute authority to implement your plans. > [@](#): > > … By almost all accounts, Cuba’s health care achievements directly reflect the decisions of Fidel Castro. The Cubans we met consistently reported that Castro personally prioritized two services: education and health care. While these reports may reflect the Cuban party line, there is objective evidence reflecting these investments. Cuba’s literacy rate is 99.8 percent (some health care personnel actually complained, tongue-in-cheek, of how knowledgeable and demanding their patients are). The nation’s commitments to health care are also widely apparent. > > Cuba spends about 10 percent of its GDP on health care. Services are free and funded by the state. Its delivery system prioritizes primary care and public health, and extends into virtually all the island’s communities. The system operates at three levels. At its base is a network of almost 13,000 local family practices and 451 polyclinics that offer general and specialty care. Family practices consist of a physician and a nurse who live in the communities they serve. Each practice is responsible for between 1,000 and 1,500 patients, and physicians are required to visit every patient in their home at least yearly (or more often if indicated). For specialty services family practitioners send patients to the polyclinics, which also organize public health services. > > The next level of service is the island’s 151 community hospitals that dispense secondary services. A third level of service consists of 12 institutes that offer highly specialized care, and participate in teaching and research. > > Cuba’s investments in health care go beyond direct services and reflect Castro’s evident belief in health and biomedical science as long-term mainstays of the Cuban economy. Cuba has trained a surplus of physicians in its 13 medical schools, and sends 50,000 health professionals, including 25,000 physicians, abroad annually to provide care in developing countries. Recently, it has begun charging for these services, making health care an export equivalent and a source of scarce foreign exchange. > > Cuba has also invested in biomedical research … medical products and services, including physicians practicing abroad, pharmaceuticals, and medical tourism, account for 70 percent of Cuba’s export revenues. … > > … Cuba has demonstrated that a poor country can dramatically improve the health of its population through long-term, consistent investments in primary care and public health. Even if those investments depended on the authoritarian rule of a long-reigning communist dictator who made many other errors, Cuba’s example shows what very basic health care services can accomplish when the political will to apply them exists. It also I think provides some further support for the simple point I was making. Cuba has very little wealth inequality compared to the United States and for many reasons, including its size, does not have the structural factors that lead to health inequities either. Inequalities in health care contribute to and perpetuate wealth inequalities and very much so [wealth inequalities result in health outcome inequalities](https://inequality.org/facts/inequality-and-health/), more to the downside than the up. > [@](#): > > … many health outcomes — everything from life expectancy to infant mortality and obesity — can be linked to the level of economic inequality within a given population. Greater economic inequality appears to lead to worse health outcomes. … People live longer in nations with lower levels of inequality … In 2012, nations with the smallest income gaps between households at the 90th and 10th percentiles had significantly fewer infant deaths than other nations. … What’s true on the international level also holds true within the United States: People live longer in the nation’s more equal states. … Our path to dealing with this will certainly not be the path of Cuba (nor would many us want it to be), probably not even that of Finland or Iceland’s social democracies, [“the Nordic model”](https://en.wikipedia.org/wiki/Nordic_model) (that perhaps more would like see us emulate some aspects of). But clearly our consistently slightly less than our wealth based peers healthcare outcomes data is embedded in structural factors that are large in scope and magnitude. Frankly given those structural factors we should be doing worse. ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [October 7, 2017, 5:55pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/43 "2017-10-07T17:55:48Z")
Frankly, you are comparing the USA with a third world nation as if that’s normal in any sense. Is that what the USA aspires to do - to achieve better outcomes than in the developing world? There are thousands of these out there - variations on a theme - but here’s just one. In 2016 this chart would have continued to climb for all other countries and actually turned south for the USA. Frankly: [‘This chart is a powerful indictment of our current health-care system’](https://www.washingtonpost.com/news/wonk/wp/2017/03/08/this-chart-is-a-powerful-indictment-of-our-current-healthcare-system/?utm_term=.79ada321ca5d) ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [October 7, 2017, 6:30pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/44 "2017-10-07T18:30:19Z")
> [@Balthisar](#): > > giving people everything they want for free is a terrible disincentive towards taking care of themselves. This is one of those things that bugs me. No one is asking for ‘free stuff’. We’re asking that We The People ‘promote the general welfare’ of our fellow citizens, and provide for those who cannot provide for themselves. The way one side talks, they would gladly stop working if they got ‘free stuff’. Meanwhile, others believe that there is virtue in being productive and would work – and contribute to the well-being of the country and its citizens – even if they didn’t have to. Yes, there are freeloaders. There are people who game the system. But why project prejudices onto the majority for the failings of a few? Keeping citizens healthy and productive is good for the country, and brings such huge benefits that the freeloaders are just a cost of doing business. Unlike some politicians who want free money, and want to spend money we don’t have on things we don’t need, others want to buy things we need and they explain how they would be paid for. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [October 7, 2017, 7:26pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/45 "2017-10-07T19:26:40Z")
> [@up\_the\_junction](#): > > … comparing the USA with a third world nation … Actually it brings up an interesting aside: what does “third world” mean today? Anything? What did it mean? [Looking it up](http://www.npr.org/sections/goatsandsoda/2015/01/04/372684438/if-you-shouldnt-call-it-the-third-world-what-should-you-call-it) it seems that how I had thought of it was completely wrong and that it actually came out of The Cold War in reference to the nonaligned nations, neither “Western” nor part of the Soviet bloc. Cuba even then was not “Third World.” > [@](#): > > More than half a century ago, the Cold War was just starting. It was Western capitalism versus Soviet socialism. But there was another group of countries. Many of them were former colonies. None of them were squarely in either the Western or the Soviet camp. Thinking of these three factions, French demographer Alfred Sauvy wrote of “Three worlds, one planet” in an article published in L’Observateur in 1952. > > The First World consisted of the U.S., Western Europe and their allies. The Second World was the so-called Communist Bloc: the Soviet Union, China, Cuba and friends. The remaining nations, which aligned with neither group, were assigned to the Third World. > > The Third World has always had blurred lines. “Although the phrase was widely used, it was never clear whether it was a clear category of analysis, or simply a convenient and rather vague label for an imprecise collection of states in the second half of the 20th century and some of the common problems that they faced,” writes historian B.R. Tomlinson in the essay “What was the Third World,” published in 2003 in the Journal of Contemporary History. > > Because many countries in the Third World were impoverished, the term came to be used to refer to the poor world. > > This 1-2-3 classification is now out of date, insulting and confusing. Who is to say which part of the world is “first”? And how can an affluent country like Saudi Arabia, neither Western nor communist, be part of the Third World? Plus, the Soviet Union doesn’t even exist anymore. > > And it’s not like the First World is the best world in every way. It has pockets of deep urban and rural poverty, says Paul Farmer, co-founder of the nonprofit Partners in Health and a professor at Harvard Medical School. “That’s the Fourth World,” Farmer says, referring to parts of the United States and other wealthy nations where health problems loom large. … In sloppy usage use of the archaic term has meant the least socioeconomically developed countries. If that is the use being meant then Cuba and its healthcare system is NOT on the list. Actually [it gets placed in the “high human development”](https://en.wikipedia.org/wiki/List_of_countries_by_Human_Development_Index) grouping. Its number 68 position of 188 is well below the United States’ number 10 position to be sure and in less archaic than “Third World” terminology it would still place it the uppermost portion of “developing countries” (along with China and Brazil, and above both of them). In any case, what is “normal” to do in any sort of analysis is to look at the examples that fall out of the expected patterns and try to figure out why. Why does the U.S. not do _quite_ as well as one would expect if one only looked at its wealth and expenditures? Why does Cuba do much better than one would expect looking only at those factors? Is there anything to learn from countries that have punched outside their socioeconomic weight class on these measures? ---
**Author:** ![WildBlueYonder](https://avatars.discourse-cdn.com/v4/letter/w/ce7236/32.png) [@WildBlueYonder](https://boards.straightdope.com/u/WildBlueYonder)\ **Post date:** [October 8, 2017, 6:11pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/46 "2017-10-08T18:11:20Z")
So if we’re dying earlier, “we’re” definitely concerned much-we’re meaning the US government Its no wonder we’re getting fat. Every day there is some fast food place adding yet more calories to their already high calorie foods. The latest I saw was a pancake with ice cream or something on top. Come on! Glad I dont like that combination and glad I dont have the money to go out for meals that often. Maybe once a year. Now pizza comes home, we dont eat at wherever we get it from! But that I am doing well at avoiding. The trick is not to asked the husband if that is what he wants for dinner!!:eek::eek: ---
**Author:** ![Eyebrows\_0f\_Doom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eyebrows_0f_doom/32/3119_2.png) [@Eyebrows\_0f\_Doom](https://boards.straightdope.com/u/Eyebrows_0f_Doom)\ **Post date:** [October 8, 2017, 6:37pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/47 "2017-10-08T18:37:06Z")
A pancake with ice cream, my god how crazy and new and not something that has been served at every diner and breakfast place for as long as I can remember. ---
**Author:** ![Mangosteen](https://avatars.discourse-cdn.com/v4/letter/m/6a8cbe/32.png) [@Mangosteen](https://boards.straightdope.com/u/Mangosteen)\ **Post date:** [October 9, 2017, 1:14am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/48 "2017-10-09T01:14:10Z")
“Keeping citizens healthy and productive is good for the country”. But how exactly could this be accomplished? After eating too much fat and sugar for 60 years, the human body begins to break down. These people then go to the doctor or hospital and want to be “cured”. The problem is the “cure” is eating less and better food and exercising on a regular basis, but people don’t want to hear that. They want a pill to take so they can get back to their ice cream and easy chair. Probably close to 90% of the people that live in the USA don’t really care what they are eating and don’t bother to exercise at all. Which is easier, going out for a run or sitting on the sofa watching TV and drinking a beer? Which tastes better, a spinach salad or a hamburger smothered in bacon? People are free to choose either option and there is no way the government can influence their decisions. Everyone _already_ knows they should eat right and exercise. Education is not the answer. Don’t blame the government, the health care industry or anything else but the individuals who freely choose not too take care of themselves. And don’t blame the Food Industry. Supermarkets are full of fresh fruits and vegetables and other foods that are good for people. ---
**Author:** ![Balthisar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/balthisar/32/2825_2.png) [@Balthisar](https://boards.straightdope.com/u/Balthisar)\ **Post date:** [October 9, 2017, 1:22am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/49 "2017-10-09T01:22:22Z")
> [@Johnny\_L.A](#): > > This is one of those things that bugs me. No one is asking for ‘free stuff’. We’re asking that We The People ‘promote the general welfare’ of our fellow citizens, and provide for those who cannot provide for themselves. This isn’t about “those lazy people over there”; this is about the most simple of economic incentives. The same incentive is why the insurance industry is such a mess, and why there’s no transparency in medical pricing. Right now, people who have insurance have the same incentive to overspend needlessly, because they don’t have to pay; it’s free!, and covered by insurance! I didn’t quote the entire chain, but my complaint isn’t even about giving “free” insurance to people, but about the incentives for poor behavior that leads to obesity and self-inflicted type 2 diabetes. Just giving everyone free (no copays, no penalty) insurance is a horrible incentive towards a healthy lifestyle. And proper incentives already exist; look at all of the “wellness” plans offered by employers. Quit smoking, and halve your deductible. If you’re overweight and agree to free WeightWatchers, halve your deductible. When you propose free everything, you combine the already-horrible incentives of our current insurance system (for those who are insured) with the lack of any type of control over self-inflicted harm. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [October 9, 2017, 3:01am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/50 "2017-10-09T03:01:15Z")
> [@Mangosteen](#): > > “Keeping citizens healthy and productive is good for the country”. > > But how exactly could this be accomplished? > > After eating too much fat and sugar for 60 years, the human body begins to break down. These people then go to the doctor or hospital and want to be “cured”. The problem is the “cure” is eating less and better food and exercising on a regular basis, but people don’t want to hear that. They want a pill to take so they can get back to their ice cream and easy chair. > > Probably close to 90% of the people that live in the USA don’t really care what they are eating and don’t bother to exercise at all. Which is easier, going out for a run or sitting on the sofa watching TV and drinking a beer? Which tastes better, a spinach salad or a hamburger smothered in bacon? People are free to choose either option and there is no way the government can influence their decisions. Everyone _already_ knows they should eat right and exercise. Education is not the answer. > > Don’t blame the government, the health care industry or anything else but the individuals who freely choose not too take care of themselves. > > And don’t blame the Food Industry. Supermarkets are full of fresh fruits and vegetables and other foods that are good for people. That is a very simplistic approach to health. Poor diet and lack of exercise are bad for your health, but so are a hundred other things. Poor sleep is bad for health. Social isolation is bad for health. Chronic anger is bad for health. The life expectancy gap between someone who weighs 400+ lbs and someone of a healthy bodyweight is about the same as the life expectancy gap between rich and poor, between smokers and non-smokers, or between college graduates and high school graduates, or between white women and black men. For each comparison group the gap is about ~10 years. There are a lot of things that affect health and at the end of the day 90% of people die from complications of old age. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [October 9, 2017, 7:43am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/51 "2017-10-09T07:43:00Z")
> [@Balthisar](#): > > This isn’t about “those lazy people over there”; this is about the most simple of economic incentives. The same incentive is why the insurance industry is such a mess, and why there’s no transparency in medical pricing. > > Right now, people who have insurance have the same incentive to overspend needlessly, because they don’t have to pay; it’s free!, and covered by insurance! > > I didn’t quote the entire chain, but my complaint isn’t even about giving “free” insurance to people, but about the incentives for poor behavior that leads to obesity and self-inflicted type 2 diabetes. Just giving everyone free (no copays, no penalty) insurance is a horrible incentive towards a healthy lifestyle. And proper incentives already exist; look at all of the “wellness” plans offered by employers. Quit smoking, and halve your deductible. If you’re overweight and agree to free WeightWatchers, halve your deductible. > > When you propose free everything, you combine the already-horrible incentives of our current insurance system (for those who are insured) with the lack of any type of control over self-inflicted harm. I am rather doubtful about this. We don’t have to extrapolate what happens when the economic barriers to healthcare are removed. That is the default condition in the western world. It does not appear to lead to a significantly more unhealthy lifestyle than the US. Money is nice, but if you are not incentivized by the risk of strokes, impotence, loss of limbs or heart attacks, a few more bucks are not going to do it. ---
**Author:** ![WildBlueYonder](https://avatars.discourse-cdn.com/v4/letter/w/ce7236/32.png) [@WildBlueYonder](https://boards.straightdope.com/u/WildBlueYonder)\ **Post date:** [October 9, 2017, 1:42pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/52 "2017-10-09T13:42:17Z")
> [@Eyebrows\_0f\_Doom](#): > > A pancake with ice cream, my god how crazy and new and not something that has been served at every diner and breakfast place for as long as I can remember. Is u’s being sarcastic? Anyway, I was not sure what it was they put on top but I shall be sure to remember it when I see it again > [@Mangosteen](#): > > After eating too much fat and sugar for 60 years, the human body begins to break down. These people then go to the doctor or hospital and want to be “cured”. The problem is the “cure” is eating less and better food and exercising on a regular basis, but people don’t want to hear that. They want a pill to take so they can get back to their ice cream and easy chair. They’ve got pills for so many other bad habits. I’d like to go cold turkey from food but I cant because of my diabetes. I’d be glad to take some other type of pill to keep my hunger down and keep my sugar normal Cant afford to buy all the fresh vegetables in season or out. There are families that are economically unable to eat healthy. Of course the same families may not care. More exercise. Some things are just so depressing ☹ ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [October 9, 2017, 2:24pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/53 "2017-10-09T14:24:25Z")
> [@Wesley\_Clark](#): > > That is a very simplistic approach to health. > > Poor diet and lack of exercise are bad for your health, but so are a hundred other things. Poor sleep is bad for health. Social isolation is bad for health. Chronic anger is bad for health. The life expectancy gap between someone who weighs 400+ lbs and someone of a healthy bodyweight is about the same as the life expectancy gap between rich and poor, between smokers and non-smokers, or between college graduates and high school graduates, or between white women and black men. For each comparison group the gap is about ~10 years. > > There are a lot of things that affect health and at the end of the day 90% of people die from complications of old age. I just came back from Italy. My traveling companion and I both noticed that even though the cuisine was a little on the heavy side (lots of carbs, lots of dairy, lots of oil), people weren’t as overweight as Americans. We also noticed that there were a lot of smokers, despite [health statistics being more favorable towards Italians than Americans](http://www.nationmaster.com/country-info/compare/Italy/United-States/Health). Could the key be in the fact that Italians practice better [sleep hygiene?](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981826/) Does the Italian [siesta](https://www.huffingtonpost.com/marta-mondelli/quality-of-life-the-itali_b_152715.html) confer stress management benefits? It is also true that [Italians](https://well.blogs.nytimes.com/2010/10/19/the-pedometer-test-americans-take-fewer-steps/) are more active than Americans, even when [socializing](https://livelikeanitalian.com/2015/06/03/relax-like-an-italian-the-art-of-the-passeggiata/). Maybe all of these things combined mitigate the negative health consequences of a pasta-laden, nictotine-rich lifestyle. It probably also helps that Italians have better access to medical care, enjoying twice the number of physicians per capita as Americans at much less cost (see the first link). ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [October 9, 2017, 2:46pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/54 "2017-10-09T14:46:31Z")
> [@Mangosteen](#): > > “Keeping citizens healthy and productive is good for the country”. > > But how exactly could this be accomplished? Education - the USA has to do something about sugar, for example it’s insane how much people consume in just soft drinks and fruit juices. The body won’t have it - any more than a can a standard can a day and all additional sugar converts straight to stored fat. What chance a public health campaign? Zero, I’d imagine. Politicians bought and paid for again. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [October 9, 2017, 10:26pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/55 "2017-10-09T22:26:27Z")
> [@monstro](#): > > I just came back from Italy. My traveling companion and I both noticed that even though the cuisine was a little on the heavy side (lots of carbs, lots of dairy, lots of oil), people weren’t as overweight as Americans. We also noticed that there were a lot of smokers, despite [health statistics being more favorable towards Italians than Americans](http://www.nationmaster.com/country-info/compare/Italy/United-States/Health). > > Could the key be in the fact that Italians practice better [sleep hygiene?](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981826/) Does the Italian [siesta](https://www.huffingtonpost.com/marta-mondelli/quality-of-life-the-itali_b_152715.html) confer stress management benefits? It is also true that [Italians](https://well.blogs.nytimes.com/2010/10/19/the-pedometer-test-americans-take-fewer-steps/) are more active than Americans, even when [socializing](https://livelikeanitalian.com/2015/06/03/relax-like-an-italian-the-art-of-the-passeggiata/). Maybe all of these things combined mitigate the negative health consequences of a pasta-laden, nictotine-rich lifestyle. It probably also helps that Italians have better access to medical care, enjoying twice the number of physicians per capita as Americans at much less cost (see the first link). I honestly don’t know. I did some research, apparently in Japan nearly 30% of men smoke, but life expectancy for men is 80.5 years. Thats four years higher than men in the US. I’m not sure what all factors play a role in it. I just feel like there are probably dozens of lifestyle factors that all play a role in health, and we should be focusing on whatever ones we can that people can incorporate into their own lives. Supposedly the Mediterranean diet is arguably the best diet for prevention of vascular disease, so that may play a role in Italy’s health. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [October 9, 2017, 10:30pm UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/56 "2017-10-09T22:30:25Z")
Smaller food portions might be a factor, too - American portions are huge in comparison to other places. ---
**Author:** ![jtur88](https://avatars.discourse-cdn.com/v4/letter/j/e9c0ed/32.png) [@jtur88](https://boards.straightdope.com/u/jtur88)\ **Post date:** [October 10, 2017, 1:10am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/57 "2017-10-10T01:10:00Z")
The USA has the most affordable and most nutritious food in the world. Unfortunately, it also has the most affordable junk food in the world – everyone can afford it, and many (most?) live entirely on it. ---
**Author:** ![WildBlueYonder](https://avatars.discourse-cdn.com/v4/letter/w/ce7236/32.png) [@WildBlueYonder](https://boards.straightdope.com/u/WildBlueYonder)\ **Post date:** [October 10, 2017, 10:45am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/58 "2017-10-10T10:45:45Z")
> [@monstro](#): > > I just came back from Italy. My traveling companion and I both noticed that even though the cuisine was a little on the heavy side (lots of carbs, lots of dairy, lots of oil), people weren’t as overweight as Americans. We also noticed that there were a lot of smokers, despite [health statistics being more favorable towards Italians than Americans](http://www.nationmaster.com/country-info/compare/Italy/United-States/Health). > > Could the key be in the fact that Italians practice better [sleep hygiene?](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981826/) Does the Italian [siesta](https://www.huffingtonpost.com/marta-mondelli/quality-of-life-the-itali_b_152715.html) confer stress management benefits? It is also true that [Italians](https://well.blogs.nytimes.com/2010/10/19/the-pedometer-test-americans-take-fewer-steps/) are more active than Americans, even when [socializing](https://livelikeanitalian.com/2015/06/03/relax-like-an-italian-the-art-of-the-passeggiata/). Maybe all of these things combined mitigate the negative health consequences of a pasta-laden, nictotine-rich lifestyle. It probably also helps that Italians have better access to medical care, enjoying twice the number of physicians per capita as Americans at much less cost (see the first link). How much junk food with sugar is there available there as here in the US? Also do they eat the food and not junk? How about desserts? Do they eat between meals? Do the mothers all work so they have to pick up take out on the way home from work? > [@up\_the\_junction](#): > > Education - the USA has to do something about sugar, for example it’s insane how much people consume in just soft drinks and fruit juices. Education is the right thing, especially the younger crowd. Sometimes the craving for sugar just is too much. Availability will always be there, I guess > [@up\_the\_junction](#): > > Politicians bought and paid for again. Oh so sad but true… > [@Broomstick](#): > > Smaller food portions might be a factor, too - American portions are huge in comparison to other places. oh boy how true! ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [October 10, 2017, 11:17am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/59 "2017-10-10T11:17:52Z")
> [@WildBlueYonder](#): > > Sometimes the craving for sugar just is too much. For Americans in particular it’s not sugar per se it’s HFCS; best we understand atm is it coats receptors that send signals from the lower gut to the brain. But you can do your own research on that if interested. Except for one chart that tells the story 🙂 > **[How much high-fructose corn syrup does the average American consume per year?...](https://www.quora.com/How-much-high-fructose-corn-syrup-does-the-average-American-consume-per-year-How-does-that-compare-to-other-countries)** > > Answer: Extremely high. > > Understanding the difference between sugar and high-fructose corn syrup (HFCS), both are natural but HFCS causes more starch development as it contains more fructose (fruit sugar) from the starch of corn or other... ---
**Author:** ![Balthisar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/balthisar/32/2825_2.png) [@Balthisar](https://boards.straightdope.com/u/Balthisar)\ **Post date:** [October 10, 2017, 11:46am UTC](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849/60 "2017-10-10T11:46:54Z")
> [@Broomstick](#): > > Smaller food portions might be a factor, too - American portions are huge in comparison to other places. People say this all the time, but I’ve never seen it, excluding places like Olive Garden, Red Robin, or other crappy chain places where they deliberately try to make you feel “value” by loading you up with unlimited quantities of cheap carbs. Dining in, say, hotel restaurants or local, non-chain restaurants all over the world has been pretty consistent for me, quantity-wise. [Previous page](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849.md?page=2) [Next page](https://boards.straightdope.com/t/how-unhealthy-is-the-united-states-really/797849.md?page=4)