The American Patient

Woolf_StevenAccording to Dr. Woolf the actors that appear on movies and television are not typical of how most Americans look. Americans have the highest rate of obesity in the world. Those are not the kind of people who get jobs as actors.

We talked to Dr. Steven Woolf from the Virginia Commonwealth University.

Dr. Steven Woolf : The problem that we uncovered was so broad it involves so many diseases and so many different causes of injuries that it’s hard to blame it on one problem. We found problems with life expectancy in general. We found problems with birth outcomes. We found problems with violence and car crashes. Americans have higher rates of obesity and diabetes. It is hard to blame all that on one thing. We looked at multiple explanations. We looked at differences int he health care system because the health care system in the United States has problems, behaviors of Americans. We considered the role of social factors like poverty. We thought about hte environment at with Americans live.

Peter Zentai: What do you mean by environment?
The conditions at which people live. Both physically in terms of air pollution or the ability to walk and get exercise. Many American cities are designed for cars and it’s actually difficult to go for a walk and get activity.

If you watch American movies what you see is that people do exercise.
Well, the public health message in the United States emphasizes the importance of healthy diet and exercise. The actors that appear on movies and television are not typical of how most Americans look. Americans have the highest rate of obesity in the world. Those are not the kind of people who get jobs as actors.

Okay, but you really can’t criticize the mass media for their message.
That is precisely the point. The messages that people receive in school and in public health advertisements and the messages they get from their doctors are all the same. In the US we have a lot of cities where large areas of the city has no access to a store that sells fruits and vegetables. So the doctor may say, eat lots of fruits and vegetables but f you cannot find a store that sells them then you are going to turn to other food sources, like fast food restaurants.

On the other hand there is a pressure on people; they have to look happy all the time.
Well, stress is a very important factor and there is plenty of it in this country. People who experience stress are more likely to smoke cigarettes or drink alcohol or no other unhealthy things to cope with their stress. There is increasing evidence that stress causes changes in the body that are harmful to health, that could affect heart disease.

You’re a doctor. Do you think that many people hide their angst?
I am not a social psychologist and I don’t know that we have a good data to say that Americans hide their stress more than other countries but I know that a lot of people do, I know that it’s quite unhealthy. The bottom line is that if people are experiencing a lots of stress it’s going to come out one way or another in an unhealthy way. We have in this country high rate of violence, crime problems and high rates of drug abuse compared to other countries. You can easily imagine that stress is playing some role in that.

What have you proven with your research? What is the most important message?
When we began the analysis we knew there was a problems with Americans over age 50 having worse health than people in other countries. One of the main findings of our report is not only that the problem exists in younger Americans but it’s probably even worse. We were very surprised by how bad the problem is. The problem is not a mixture of good news and bad news but primarily bad news across many different conditions. That had never really been reported before.