Howard Steven Friedman is a statistician and health economist for the United Nations and an adjunct professor at Columbia University’s School of International and Public Affairs. He also has a new book out called The Measure of a Nation: How to Regain America’s Competitive Edge and Boost Our Global Standing, which is sure to provoke controversy and become fodder for those who take critical examinations of our society as reflective of a “hate America first” mindset.
In the book, Friedman examines key indicators, or metrics, such as life expectancy, infant mortality, crime, education, income equality, democracy and others, from 13 select/competing nations and compares these with the same metrics from the United States.
The carefully selected, competing nations are all members of the Organization for Economic Cooperation and Development (OECD), had populations of at least 10 million, and per capita GDPs of at least $20,000.
The 13 qualifying nations are: Belgium, Canada, France, Germany, Greece, Italy, Japan, Portugal, the Netherlands, South Korea, Spain and the UK. All of them are members of the Organization for Economic Cooperation and Development (OECD); all have populations of at least ten million, and mean GDPs per capita of at least $20,000
Friedman rates top performing nations (for a given indicator) as “stars,” low performers as “dogs,” and those in the middle as “middle children” — the same labels used by former Mitt Romney employer Boston Consulting Croup to rate businesses.
Based upon our performance on nearly every metric, the U.S. would be rated a “dog” in nearly every category… which, in the language of business, would mean it is unworthy of continued investment.
I will herein focus on just three of these competing indicators (for more indicator rankings and details, see the link at the bottom of this post):
Shockingly, the US is so far behind here, that even if we expanded the list of top life expectancy nations to 20 (instead of 14), we would still not even make the top 20. As a comparison, in 1987, the US ranked 7th in the world for life expectancy. Why so dramatic a fall? Critics try to rationalize this by noting our tremendous ethnic diversity (e.g., Asian American women outlive African American males by 20 years) and great variation from state to state (Hawaii has the highest life expectancy of any state, at 81.5 years, while Mississippi ranks lowest, at 74.8).
Most likely, poor diet, drug abuse, and inequality in healthcare access are big contributing factors here.
According to the book, a key driver of low life expectancy is what’s known as “amenable deaths,” which are those deaths that could have been prevented with timely medical intervention.
According to Friedman (as quoted in the Truthout review):
“Ranked as of 2002-2003, our rate of amenable mortality was 109.7 deaths per 100,000 people — more than 50 percent higher than the best-performing countries of France (64.8 deaths per 100,000), Japan (71.2 deaths per 100,000) and Australia (71.3 deaths per 100,000). Another way to view this is to recognize that even if the United States had the lowest infant mortality in the competition, it would still have the lowest life expectancy.”
One can clearly see that many of these indicators are tightly inter-related; poverty and access to affordable healthcare influence so-called “amenable deaths,” and these in turn impact life-expectancy.
To drive the point home, Friedman notes that while we spend twice as much (and in some cases, four times as much) per capita on healthcare as the closest competing nation “the United States is the only country in the competition with a significant percentage of its population uninsured.”
I will quote directly from the Truthout article by Arthur Goldwag (see source link below):
In 1960, the US had the 12th-lowest infant mortality rate in the world. By 1990, it had dropped to 23rd and it was 38th in 2008. Some of this is driven, a little counter-intuitively, by the US’ leadership in pre-term births (a testament to advances in neo-natal care). By 2005, pre-term babies accounted for 69 percent of infant deaths. But that doesn’t remotely tell the whole story. Once again, geography and ethnicity are complicit. In 2005, African-American infants died at a rate of 13.63 per one thousand births, more than twice the national average.
Those numbers speak (loudly) for themselves.
And there are, of course, several other indicators in which the US earns a “dog” rating: education (teacher pay, and math performance), voter turnout (the lowest turnout amongst surveyed nations) and number of representatives (one representative per 581,000 persons; the average of all the other nations was 1 rep per 85,000), rate of imprisonment (the US imprisons its citizens more than 4 times its closest competitor; another metric grossly tilted by the rate of poverty)…and others.
But I will now cut to the chase and skip to the one indicator (and its subsets) where the US is both a “dog” and a “star.”
Some quick stats (skip to the high-lighted section if you know these already):
25% of total adjusted income in the US accrues to 1% of the population.
7.7% of (reported) US income went to the top .1% (which is higher by far than any other competing nation in the survey)
US minimum wage workers earn about 33 percent of GDP per capita, less than their Australian, Belgian, Canadian, French, Greek, Japanese, Korean, Dutch, Portuguese, Spanish, and British peers.
On the Gini index (a scale of wealth distribution; a 0.0 rank would mean complete income equality, while a 1.0 rank would mean all income accrues to 1 person), the US ranks .28 on adjusted income (again, the highest amongst the surveyed nations) while the Gini index for total wealth (stocks, bonds, real estate, income, etc.) in the US is .80 — much higher than any of the competing countries.
Income disparity looks even worse if one factors in race or gender.
But the one area where the US excels above all its competitors is….
BILLIONAIRES!… Yes, the US has almost twice as many billionaires per one million inhabitants as its next two closest competitors (Canada and Germany). Unsurprisingly, the US also has the lowest level of tax collection of the 13 nations surveyed.
So then, there you have it… let the right-wing pundits decry this as more anti-American/anti-Business “hate America first” propaganda from the liberal or socialist Left… but this independent-minded progressive believes that without such studies and critical studies, we as a society and nation cannot truly reflect upon our current direction, and thus cannot make the necessary adjustments to keep ourselves from falling further behind the rest of the ‘developed’ world and maintain any (non-military) claim to global “leadership”… but more importantly, without critical examinations such as is offered by this book, we cannot truly (if ever) fulfill the basic promise of America… for all but a privileged few.
For more national/global metrics and reports, visit the Human Development Index (HDI) website.
Source material and quotes for this blog post came from: “‘The Measure of a Nation’ Challenges Illusions of American Superiority” by Arthur Godwag (on Truthout.org)
Top photo: (from Occupy Seattle rally, Oct. 8, 2011) M. Ricciardi