Americans are probably not sicker than the rest of the world -
- they are just more knowledgeable about their sickness. With
advances in medical technology making more sensitive
detection of abnormalities in the body possible at
increasingly lower cost, a lot of minor problems are being
found — and treated — that would probably have
gone unnoticed — and without any ill consequences.
According to a recent article in the New York Times
("If You've Got a Pulse, You're Sick," May 21, 2006),
Americans look much harder than anyone else to find out
whether they are sick — and they detect many problems.
However sometimes those problems could have literally been
lived with.
In a paper in the Journal of the American Medical
Association, Dr. H. Gilbert Welch of Dartmouth University
reported that the incidence of thyroid cancer in the United
States had increased by 250 percent over the last two
decades. But the death rate from it remained the same. This
is a tipoff that a lot of thyroid cancer that has been newly
discovered was not life-threatening. The serious cases, from
which people died, were discovered more than twenty years
ago. What changed is that a lot more non-threatening cases
came to light with better detection technology.
Another example that seems to be indicative of the same
phenomenon is another paper that was published in the
Journal of the American Medical Association comparing
the health of Americans and the health of Britons. They found
that "Americans are much sicker than the English." Almost all
specific diseases were more prevalent among Americans than
among the British.
However, the New York Times pointed out that most of
these results come from the reports of the respective people.
However there is one objective statistic that is considered
reliable, and that is life expectancy at birth. These are
very close in the United States and Britain: 77.6 years in
Britain; 77.1 in the United States. Despite this, more than
twice the proportion of Americans say they have cancer as
Brits, and 50 percent more say they have heart disease.
Some researchers say that this just reflects the American
interest in testing. People are very eager to have all the
latest tests done, and then once they find something, they
demand that the doctor do something about it. But often the
conditions are subclinical and never pose any danger. Massive
public screening programs turn up conditions at early stages
that would be much harder to treat if found later, but they
also find small problems that might never have otherwise
turned up. Autopsies have found that people often have such
diseases without being aware of them.
One medical expert said that if everyone had all the
recommended tests for blood cholesterol, blood sugar, body
mass index and diabetes, maybe 75 percent of the adults in
the United States would be diagnosed as diseased.
For example, more Americans say they have high blood pressure
than British, but when researchers compared actual
measurements of blood pressure in British and American
populations ages 40 to 70, there was no difference.
What is the bottom line?
With all our modern technology and increased knowledge and
understanding of how things work, the scientific approach has
its limits.
"Everything is miraculous and there is no "nature" or "way"
of the world, . . . rather if one does the mitzvos their
reward will bring him success" (Ramban at the end of
parshas Bo).
