Paul Krugman: America Comes Up Short

Paul Krugman wonders why Americans are losing stature:

America Comes Up Short, by Paul Krugman, Commentary, NY Times: Traveling through Europe recently, I’ve been able to confirm through personal experience what statistical surveys tell us: the perceived stature of Americans is not what it was. Europeans used to look up to us; now, many of them look down on us instead.

No, I’m not talking metaphorically about our loss of moral authority in the wake of Guantánamo and Abu Ghraib. I’m literally talking about feet and inches. ...

Americans, who in the words of a recent paper by the economic historian John Komlos and Benjamin Lauderdale ..., were “tallest in the world between colonial times and the middle of the 20th century,” have now “become shorter (and fatter) than Western and Northern Europeans...”

This is not a trivial matter. As the paper says, “height is indicative of how well the human organism thrives in its socioeconomic environment.” There’s a whole discipline of “anthropometric history” that uses evidence on heights to assess changes in social conditions.

For example, nothing demonstrates the harsh class distinctions of Britain in the age of Dickens better than the 9-inch height gap between 15-year-old students at Sandhurst, the elite military academy, and their counterparts at the working-class Marine School. The dismal ... conditions of urban Americans during the Gilded Age were reflected in a 1- 1/2 inch decline in the average height of men born in 1890, compared with those born in 1830. Americans born after 1920 were the first industrial generation to regain preindustrial stature. ...

There is normally a strong association between per capita income and ... average height. By that standard, Americans should be taller than Europeans:... But ... something has caused Americans to grow richer without growing significantly taller.

It’s not the population’s changing ethnic mix...: the stagnation ... is clear even ...[for] native-born whites.

And although ... growing income and social inequality in America might be one culprit, the remarkable thing is that ... even high-status Americans are falling short...

We seem to be left with two main possible explanations... One is that America really has turned into “Fast Food Nation.”

“U.S. children,” write Mr. Komlos and Mr. Lauderdale, “consume more meals prepared outside the home, more fast food rich in fat, high in energy density and low in essential micronutrients, than do European children.” Our reliance on fast food, in turn, may reflect lack of family time because we work too much: U.S. G.D.P. per capita is high partly because employed Americans work many more hours than their European counterparts.

A broader explanation would be that contemporary America ... doesn’t take very good care of its children. Recently, Unicef issued a report comparing a number of measures of child well-being in 21 rich countries... The report put the Netherlands at the top; sure enough, the Dutch are now the world’s tallest people, almost 3 inches taller ... than non-Hispanic American whites. The U.S. ended up in 20th place, below Poland, Portugal and Hungary, but ahead of Britain.

Whatever the full explanation for America’s stature deficit, our relative shortness, like our low life expectancy, suggests that something is amiss with our way of life. A critical European might say that America is a land of harried parents and neglected children, of expensive health care that misses those who need it most, a society that for all its wealth somehow manages to be nasty, brutish — and short.

_________________________
Previous (6/11) column: Paul Krugman: Authentic? Never Mind
Next (6/29) column: Paul Krugman: The Murdoch Factor

Comments

[tom s.]

I wonder whether the influx to the US of mainly shorter people from the south has an effect on this?

[James Killus]

So Krugman says:

It’s not the population’s changing ethnic mix...: the stagnation ... is clear even ...[for] native-born whites.

And although ... growing income and social inequality in America might be one culprit, the remarkable thing is that ... even high-status Americans are falling short...

And Tom S. says:

I wonder whether the influx to the US of mainly shorter people from the south has an effect on this?

I can think of three possible explanations for this situation, all of them too unflattering to state.

[RP]

If you track where the major wars were, and who participated, the
answer might actually turn out to be that taller people were easier
targets. But add Fast Food Nation, Tang, Powdered Milk,
and various other cultural binge-and-purge all carb, all protein,
all dairy manias to a decline in manual (non-power
tool) labor, and the answer is as obvious as your toes....you just
have to be sitting down to see them.

[calmo]

I just dunno...iz PK like a basketball height guy (duck here comes another door way) or like on the short side and tons of fun?
Can we hear from the basketball players on this score?
Ok, do we need to go over the height difference between w and Kerry and concede that the media is going to trump any real difference in height with the perception of level, fair and balanced?
Ok, the Dutch who would win this height contest (it B the dikes, man, which select for length of limb) but the brains and mental stature goes to those peewee Japanese? (Ok, put the Sumo wrestlers out of mind.)

Last shortassed thing: Would you say that PK was deliberately distracting us from the real shortness which has nothing to do with physical height?...and not much to do with fast food (or lack of dikes) really.

[CDN]

This editorial draws some flimsy conclusions from data that satisfies curiosity at best. The Dutch being first and tallest might reflect a subconscious preferene for height by the evaluators. Or more like - it's a coincidence! I'd love to see the rest of the list ranked by height and compare.

It sounds incredibly far fetched to assume we do not take care of our children because we're no longer the tallest in the world. Doesn't that strike anyone as a little flimsy? And all the references to past height discrepencies refer to times when people lacked nutrition on a massive scale. That will certainly stunt growth, but the 'micronutrients' probably accout for less than a centimeter of height growing up if the child has absorable vitamans and enough calories (I'm not a nutritionist, maybe there are a couple more important ingredients.)

And another problem with this is that Krugman's piece again emphasizes the superiority of tall people. Genetic traits that are worthless for valuing a person's productivity and usefulness should stop being used to evaluate a culture. (Useless aside from subjective physical attraction and negligable conveniences of height).

The stagnation of height makes perfect sense to me. It'd be much more interesting to see why northern and western europeans' still have increasing heights generation after generation.

The US has much larger concerns than crossing into Europe and worrying why we don't literally look down on the Europeans 'as we used to'. Forsooth, this is a trivial matter.

[reason]

I'm curious about this, because I read exactly the same from PK over a year ago. Is it republished or just rediscoved?

CDN...
you don't know what you are talking about. Average height (rather than individual) has proven historically to be a very good measure of health in childhood. As PK says ín the article (perhaps more so in places not shown) it is used for historical comparisons of health. (Read 1491 for instance). It is well known to depend however on the health not just of the child but also the mother (so it will continue to grow over generations) even if nutrition and freedom from disease has not made progress. The US experience is rather exceptional, which is why it is a bit of a puzzle.

And I say this as someone who for mainly genetic reasons is well below average height (at least I was well below average for an Australian when I was a young adult, maybe I should move to the US).

[anne]

http://www.nytimes.com/2007/04/22/health/22infant.html?ex=1334894400&en=5d5d40b319346648&ei=5090&partner=rssuserland&emc=rss

April 22, 2007

In Turnabout, Infant Deaths Climb in South
By ERIK ECKHOLM

HOLLANDALE, Miss. — For decades, Mississippi and neighboring states with large black populations and expanses of enduring poverty made steady progress in reducing infant death. But, in what health experts call an ominous portent, progress has stalled and in recent years the death rate has risen in Mississippi and several other states.

The setbacks have raised questions about the impact of cuts in welfare and Medicaid and of poor access to doctors, and, many doctors say, the growing epidemics of obesity, diabetes and hypertension among potential mothers....

"I don't think the rise is a fluke, and it's a disturbing trend, not only in Mississippi but throughout the Southeast," said Dr. Christina Glick, a neonatologist in Jackson, Miss., and past president of the National Perinatal Association.

To the shock of Mississippi officials, who in 2004 had seen the infant mortality rate — defined as deaths by the age of 1 year per thousand live births — fall to 9.7, the rate jumped sharply in 2005, to 11.4. The national average in 2003, the last year for which data have been compiled, was 6.9. Smaller rises also occurred in 2005 in Alabama, North Carolina and Tennessee. Louisiana and South Carolina saw rises in 2004 and have not yet reported on 2005.

Whether the rises continue or not, federal officials say, rates have stagnated in the Deep South at levels well above the national average.

Most striking, here and throughout the country, is the large racial disparity. In Mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1. (The national average in 2003 was 5.7 for whites and 14.0 for blacks.) ...

[anne]

http://www.nytimes.com/2007/04/26/opinion/l26south.html

Infant Deaths: Shame of a Nation

To the Editor:

"In Turnabout, Infant Deaths Climb in South":

When my colleagues and I started a community health center in the Mississippi Delta in the 1960s, we estimated the actual black infant mortality rate in our area at nearly 60 per thousand live births.

The causes were abysmal poverty, wide unemployment, crumbling shacks, outright malnutrition, contaminated water and lack of transportation.

We addressed those problems, in addition to providing desperately needed medical care. The infant mortality rate dropped sharply.

Those causes persist, now worsened by deep cuts in Medicaid and welfare.

The consequence of shredding the social safety net is more dead black (and white) babies. No health service can overcome the effects of social policies that devastate the lives of the poor.

This is not just a health problem; it is a measure of our moral commitment to a fair chance for survival. We should be enraged, and ashamed, that these preventable excess deaths continue, and increase, among us.

H. Jack Geiger, M.D.
Brooklyn, April 25, 2007
The writer was a founding member and national coordinator of the Medical Committee for Human Rights.

[anne]

Just so we understand:

"It’s not the population’s changing ethnic mix due to immigration: the stagnation of American heights is clear even if you restrict the comparison to non-Hispanic, native-born whites."

[JRossi]

Are Americans actually getting shorter? If so, Krugman's explanations might have merit. If not, it could easily be that the Dutch and Germans, for example, are genetically taller than Americans on average, and now better nutrition has allowed them to more fully realize their potential.Certainly more than one process could be at work.

[JRossi]

I assume Krugman got his data from the authors' 2007 paper. This paper states the US heights have stagnated, not decreased. Their findings, which they state they do not have the explanation for, are consistent with genetic differences, environmental differences, or a combination of the two. Krugman has taken an unexplained phenomenon and used it to support his political and economic positions (which I happen to agree with). This was not a good column.

[evagrius]

"Objective: We use the complete set of NHES and NHANES data collected between 1959 and 2004 in order to construct trends for the physical stature of the non-Hispanic white and black US adult population and compare them to those of Western- and Northern-Europeans. Method: Regression analysis is used to estimate the trend in US heights stratified by gender and ethnicity holding income and educational attainment constant. Results: US heights have stabilized at mid-century and a perio0d of stagnation set in with the birth cohorts 1955-74, concurrent with continual rapid increases in heights in Western and Northern Europe. The American population had been the tallest in the world for two centuries until World War II, but by the end of the 20th century fell behind many of their European counterparts. Only since the most recent birth cohorts 1975-83 is some gain apparent among whites but not among blacks. The relationship between height and income and between height and educational attainment has not changed appreciably over time for either men or women. Conclusion: We conjecture that the American health-care system, as well as the relatively weak welfare safety net might be the reason why human growth in the United States has not performed as well in relative terms as one would expect on the basis of income. The comparative pattern bears some similarly to that of life expectancy insofar as the US is also lagging behind in that respect.

From the abstract to this report;

Underperformance in affluence: the remarkable relative decline in American heights in the second half of the 20th-century

This conclusion states the argument quite clearly;

We conjecture that the American health-care system, as well as the relatively weak welfare safety net might be the reason why human growth in the United States has not performed as well in relative terms as one would expect on the basis of income. The comparative pattern bears some similarly to that of life expectancy insofar as the US is also lagging behind in that respect.

Komlos has studied this field for quite a number of years. He is the leadsing expert in anthropomorphics. The New Yorker had an article about him a few years ago on this subject.http://www.newyorker.com/archive/2004/04/05/040405fa_fact

In that article, Komlos gave an interesting example. Immigrants from the Mayan areas of Mexico are quite short. However, their children born in the U.S., having better early childhood nutrition, are at least a head taller than their parents. One can see this patter in Japanese and Chinese as well.

As Komlos states, it all has to do with pre-natal and post natal health care and nutrition. It has to do with excellent nutrition in childhood.

It's not a very complex idea to grasp; Feed your children well and they will be healthy and tall.

[spencer]

I'm 6'2" and it is like riding the subway in Tokyo.
You stand and see a sea of heads at about shoulder level,
except down at the other end of the car are a couple of Japanese teenagers sticking up above the crowd.

Look a the data on the children of Japanese immigrants--
they are massively taller then their parents.

Height is an unquestioned measure of the populations health, especially in childhood.

What we are seeing is the rest of the advance world catching up with the US -- a highly desirable outcome.

If the US is stagnating it could be for several reasons.
One, maybe we have reached the genetic-biological upper limit on average hight.
Two, maybe diets and health have quit improving.
This is what he is emphasizing and there are very good reasons to agree.

It is just another bit of the mounting evidence that the economic well being of the entire US population has not experienced significant growth over the past quarter century.

Convincing evidence in and of itself, of course not.
But in combination with a wealth of other evidence
the story becomes very, very convincing.

[anne]

Thanks to Evagrius:

http://www.newyorker.com/archive/2004/04/05/040405fa_fact

April 5, 2004

The Height Gap: Why Europeans are getting taller and taller-and Americans aren’t.
By Burkhard Bilger

When Vincent van Gogh was thirty-one years old, in the fall of 1883, he travelled to the bleak moors of northern Holland and stayed at a tavern in the village of Stuifzand. The local countryside was hardly inhabited then—“Locus Deserta Atque ob Multos Paludes Invia,” an old map called it: “A deserted and impenetrable place of many swamps”—but a few farmers and former convicts had managed to carve a living from it. They dug peat, brewed illegal gin, and placed poles across the marshes to navigate by. Any squatter who could keep his chimney smoking for a full year earned title to the land he cleared.

There is little record of what happened to van Gogh in Stuifzand—whether he got lost in the marshes or traded sketches for shots at the bar. When I visited the village, the locals mentioned him merely to illustrate an even greater national obsession: height. At the old tavern, which is now a private home, I was shown the tiny alcove where the painter probably slept. “It looks like it would fit only a child,” J. W. Drukker, the current owner, told me. Then he and his wife, Joke (a common Dutch name, they explained, pronounced “Yoh-keh”), led me down the hall, to a sequence of pencil marks on a doorjamb. “My son, he is two metres,” Joke told me, pointing to the topmost mark, six and a half feet from the floor. “His feet”—she held her hands about eighteen inches apart—“for waterskiing.” Joke herself is six feet one, with blond tresses and shoulders like a Valkyrie. Drukker is six feet two.

The Netherlands, as any European can tell you, has become a land of giants. In a century’s time, the Dutch have gone from being among the smallest people in Europe to the largest in the world....

[anne]

Mark Thoma - Notice the fine articles on Orgeon by Brad DeLong's friend...

http://www.nytimes.com/2007/06/15/business/15subsidy.html?ex=1339560000&en=8339d6fd7efcb5fd&ei=5090&partner=rssuserland&emc=rss

June 15, 2007

Assisting the Good Life
By DAVID CAY JOHNSTON

BANDON, Ore. — Mike Keiser, who made a fortune selling greeting cards on recycled paper, turned this remote spot on the southern Oregon coast into a golfing mecca that attracts wealthy people in private jets from around the world.

To many in this hard-luck town of 3,000, Mr. Keiser is an economic hero. Work became scarce after the timber and fishing industries collapsed a quarter-century ago, and his Bandon Dunes Golf Resort, a few miles north of town, has created 325 full-time jobs, plus hundreds more part-time jobs. Mr. Keiser earns millions of dollars in profits each year....

http://www.nytimes.com/2007/06/15/business/15land.html?ex=1339560000&en=9e22570b77f34cff&ei=5090&partner=rssuserland&emc=rss

June 15, 2007

A Man Would Lose His Land While Another Would Benefit
By DAVID CAY JOHNSTON

BANDON, Ore. — Many here praise Mike Keiser because his Bandon Dunes Golf Resort created 325 full-time jobs in an area where work has been scarce since 1980. But Scott Cook says Mr. Keiser is going too far.

Mr. Keiser bought land south of town for a second resort. Because the site lacks water, he signed up for an adequate supply to water the course from a proposed municipal reservoir.

Mr. Cook's family owns more than 300 acres of timberland, a renewable resource that would provide income indefinitely. The reservoir would make logging impossible, however....

[reason]

I'm sure now that I think about that Krugman wrote a previous article based on figures from Army recruitment showing that the average size of US army volunteers had DECREASED in recent decades.

[JRossi]

Spencer, You contadict yourself in your comments. You say that the US might be close to its biological upper limit of height, and then you write that the height findings are another bit of evidence that the US has not experienced an increase in economic well -being over the last 25 years. So first you state that the cause of the phenomenon is unknown(which is true), and then you make the assumption that you know the causes. True, true, and unknown connection. It is true that heights have stagnated. It is true that we have social pathologies in the US like obesity and a crappy health care system. It is possible that these phenomena are only slightly related, if at all.It is possible that these phenomena are strongly related. Krugman should know this. Maybe he just wanted to throw some red meat to his supporters. His credibility has taken a hit to my mind.

[JRossi]

Reason, Now that would be more convincing evidence of environmental influences, assuming of course the groups were comparable. I'd be interested in the reference for that.

[anne]

Reason:

"I'm sure now that I think about that Krugman wrote a previous article based on figures from Army recruitment showing that the average size of US army volunteers had DECREASED in recent decades."

Please do post a reference if found, for I have found no reference.

[evagrius]

JRossi- Komlos has studied the heights of specific groups in the U.S. over time. As stated above, the height of the average U.S. colonial, ( of either English or German descent), was higher during the Revolutionary period, lower during the industrial phase and did not rise until WWII or so. The same population is now shorter than the WWII generation.

Komlos does recognize genetics, in fact, he states in the New Yorker article that he, ( being of a somewhat short stature), might have been taller had he grown up in the U.S. but he still wouldn't be a basketball player). The genetic component is a height limit. control.

Face it, the "secret" is very simple and obvious. Lousy, lousy, pre-natal care and nutrition,and lousy early childhood nutrition.

What's so hard to understand?

Medicine in the U.S. is crisis driven. Heroic measures, ( such as found in E.R.'s), is considered to be true medical care. The boring, tedious, everyday medical care of pregnant women and little children just isn't sexy, ( nor profitable).

[reason]

Anne,
my guess is http://select.nytimes.com/gst/tsc.html?URI=http://select.nytimes.com/2006/05/05/opinion/05krugman.html&OQ=_rQ3D1&OP=3631e74dQ2F-p,4-GqxFFG-X33y-3L-3L-F05Q3B5FQ3B-3LSxe_dQ51Q3BtQ7EGd@

But I don't get to read Times Select.

[jamzo]

there is an article on the columbia school of journalism blog by dean starkman that is relevant to the subject matter of paul krugman's column

dean strarkan is a free lance journalist who has created a project he calls the insurance transparency project

the article link is http://www.cjr.org/the_audit/the_great_risk_shift.php?page=2

i cut and pasted some of his thoughts below

What's missing from coverage of the insurance "industry

What “the system shifts the risk from” is not coastal dwellers to inlanders, but from insurers to everybody else. And when it comes to paying for things the insurance industry doesn't want to pay for, there are only two other candidates: taxpayers and policyholders.
There is no third choice

This insurance “system” defeats the point of insurance, which is to spread risk as widely and efficiently as possibly. Not for nothing is insurance known to operate by the "the law of large numbers.” The more premiums you collect from the more people, the cheaper the whole system becomes. The more you chop up risk—separating sick people from healthy ones, for instance, or Louisiana homeowners from Mississippi homeowners from New York homeowners in a utterly stupid state-based system—the more expensive it becomes to cover the risky, the more lucrative to cover the unrisky and the more costly it becomes to administer all the separating that’s required. Saying “No” costs money.

But insurers hold $4.3 trillion in assets, stocks, bonds, real estate, etc. That ridiculous. The Gross Domestic Product—the market value of the nation's output of goods and services—is $13 trillion, in case you were wondering.

Insurance isn’t supposed to be an "industry" at all; but something that spreads risk so people can do something productive, like buy a house, provide medical care or make things.

And yet, it’s every household’s third or fourth largest expense. We’ve got 47 million people without health insurance. The Gulf Coast recovery is a disgrace. Thousands still live in FEMA trailers; many are fighting insurance claims. And FAIR plans are being swamped with new risks they can't handle.

Point is: Insurance is a great business story

[jean]

I would like to add to the discussion about our national health with a comment about agri-business farming practices. They treat the soils with herbicides and pesticides, which are detrimental to the health and life of soil organisms. They mono-crop, which singularly uses the same micronutrients, year after year. They tend to use synthetic fertilizers, which are usually just nitrogen, phosphorus and potassium. Synthetic fertilizers leave salts in the soils which affect soil fertility. Plants need a wide range of micronutrients (of which there are about 11: secondary nutrients and micronutrients), that are not being replenished. The farming practices may decrease the multitude of other organisms needed for soil health: fungi, bacteria and worms, and things we are just discovering. I believe that soil health impacts on the nutrient status of our food sources. Depleted soils will eventually deplete the nutrients in our produce. And I wonder if even eating a so-called healthful diet, leaves one with less than enough nutrition.

Not to mention the meat raising practices.

European farming practices? I don't know.

I believe that unless a person makes an effort to eat organic foods, they are being short changed.
This is obviously just a part of the food picture and 'short/tall' debate. Fast food is a huge part of it, but even fast food was grown somewhere.

The following link is just one of several I found.
“Concentrations of Anthocyanins in Common Foods in the United States and Estimation of Normal Consumption" (pdf).

J. Agric. Food Chem.; 2006; 54(11) pp 4069 - 4075
This came from The Society for Food Science and Technology website.

[cm]

JRossi: But are "white" "Americans" not largely from the same genetic stock as Europeans?

[cm]

evagrius: "The boring, tedious, everyday medical care [...] just isn't sexy, (nor profitable)."

Point well made, but perhaps it could be presented more clearly as "not as profitable, hence not sexy". Which also holds for many other businesses besides healthcare. The fame (sexiness) is largely where the money is.

[evagrius]

"But are "white" "Americans" not largely from the same genetic stock as Europeans?"

In the early 20th century, immigrants from such diverse places as Ireland, Italy and Greece were not considered "white", nor were people from central, east Europe nor the French.

This changed over time but it's still an opinion held by many.

[James Killus]

There have been several popular articles on anthropometrics in the past several years, including one in The New Yorker in 2004. Of course the popular articles barely scratch the surface of the scholarly literature.

I'm trying to decide if I'm more saddened or amused by the thrashing around here of those who are pretending to be all rigorous and logical about a subject that has been studied greatly, has a large amount of empirical backing, yet reaches conclusions that they'd rather not accept. There have, in the past, been multiple examples of generation-to-generation height changes over a wide range of ethnic groups and circumstances and I doubt that one can find a single one of them that was anything but environmental (usually dietary) in origin. Yet here we have yet more attempts to ascribe the matter to "genetics," (by those who probably have even less real knowledge of genetics and population statistics than they have of anthropometrics i.e. they are merely ignorant about the latter, while filled with misinformation about the two former subjects).

The short version (so to speak) is that when someone ascribes a particular phenomenon to an environmental cause, they may be wrong, in that they often choose the wrong environmental variable. When someone attempts to ascribe a phenomenon to "genetics," the likelihood that they are wrong is close to 1. They simply have no idea what they are talking about.

[anne]

Related but not the same....

http://select.nytimes.com/2006/05/05/opinion/05krugman.html

May 5, 2006

Our Sick Society
By PAUL KRUGMAN

Is being an American bad for your health? That's the apparent implication of a study just published in The Journal of the American Medical Association.

It's not news that something is very wrong with the state of America's health. International comparisons show that the United States has achieved a sort of inverse miracle: we spend much more per person on health care than any other nation, yet we have lower life expectancy and higher infant mortality than Canada, Japan and most of Europe.

But it isn't clear exactly what causes this stunningly poor performance. How much of America's poor health is the result of our failure, unique among wealthy nations, to guarantee health insurance to all? How much is the result of racial and class divisions? How much is the result of other aspects of the American way of life?

The new study, "Disease and Disadvantage in the United States and in England," doesn't resolve all of these questions. Yet it offers strong evidence that there's something about American society that makes us sicker than we should be.

The authors of the study compared the prevalence of such diseases as diabetes and hypertension in Americans 55 to 64 years old with the prevalence of the same diseases in a comparable group in England. Comparing us with the English isn't a choice designed to highlight American problems: Britain spends only about 40 percent as much per person on health care as the United States, and its health care system is generally considered inferior to those of neighboring countries, especially France. Moreover, England isn't noted either for healthy eating or for a healthy lifestyle.

Nonetheless, the study concludes that "Americans are much sicker than the English." For example, middle-age Americans are twice as likely to suffer from diabetes as their English counterparts. That's a striking finding in itself.

What's even more striking is that being American seems to damage your health regardless of your race and social class.

That's not to say that class is irrelevant. (The researchers excluded racial effects by restricting the study to non-Hispanic whites.) In fact, there's a strong correlation within each country between wealth and health. But Americans are so much sicker that the richest third of Americans is in worse health than the poorest third of the English.

So what's going on? ...

[anne]

In the above article, Paul Krugman speculates about the lack of correlation between cost of medical care and effectiveness....

http://www.nytimes.com/2007/06/14/health/14insure.html?ex=1339473600&en=3b83aad4ce8bdb79&ei=5090&partner=rssuserland&emc=rss

June 14, 2007

In Health Care, Cost Isn't Proof of High Quality
By REED ABELSON

Stark evidence that high medical payments do not necessarily buy high-quality patient care is presented in a hospital study set for release today.

In a Pennsylvania government survey of the state's 60 hospitals that perform heart bypass surgery, the best-paid hospital received nearly $100,000, on average, for the operation while the least-paid got less than $20,000. At both, patients had comparable lengths of stay and death rates.

And among the 20 hospitals serving metropolitan Philadelphia, two of the highest paid actually had higher-than-expected death rates, the survey found.

Hospitals say there are numerous reasons for some of the high payments, including the fact that a single very expensive case can push up the averages.

Still, the Pennsylvania findings support a growing national consensus that as consumers, insurers and employers pay more for care, they are not necessarily getting better care. Expensive medicine may, in fact, be poor medicine....

[anne]

Also, I was startled when several years ago I looked carefully at the organic store-brand breads at Whole Foods and realized that even an organic white wheat bread was higher in nutrients than any whole or multi-grain processed bread in the store, and no comparison at all to the ordinary grocery breads I later looked at. What we eat really must make a difference.

While at a really-formal dress dinner a few days ago, the food was absurdly rich even to excessively salty with no regard to the eaters. Oh well, I can eat formally on my own.

[Detlef]

JRossi says:

If not, it could easily be that the Dutch and Germans, for example, are genetically taller than Americans on average, and now better nutrition has allowed them to more fully realize their potential.

Ancestry Reporting 2000:
http://www.census.gov/prod/2004pubs/c2kbr-35.pdf
"In 2000, 42.8 million people (15 percent of the population) considered themselves to be of German (or part-German) ancestry, the most frequent response to the census question."
("The estimates in Figure 2 and Table 2 in some cases differ slightly from the estimates in other data products due to the collapsing schemes used. For example, here German does not include Bavarian.")

If you just add Dutch, Swedish and Norwegian ancestry you already reach 20% of the American population. That´s a pretty large percentage. And it´s an even larger percentage in some American states.

"At the state level, 8 different ancestries were each the largest reported in 1 or more states. German led in 23 states, including every state in the Midwest, the majority of states in the West, and 1 state in the South (Figure 3). In 3 of those states, German was reported by more than 40 percent of the population: North Dakota (44 percent), Wisconsin (43 percent), and South Dakota (41 percent)."

Unless somehow the "height" genes are "switched off", one would suspect at least some growth in "native-born whites".

[evagrius]

James Killus- I'm not knowledgeable about anthropometrics and genetics yet I can figure out what the source of the anomaly is. It doesn't take rocket science- just a clear seeing of what's going on.

The denial of the state of U.S. health is in the same sphere as denial about global climate change or the war in Iraq.

[realpc]

The decreasing height of Americans was a hot topic at ZMag, a far-left website. The whole point was to prove that capitalism sucks and it's about time America finally realizes the superiority of socialism.

Krugman is probably hanging out with far leftists who read ZMag.

[KThomas]

Americans eat too much junk food and have crappy health-care for it's children. Millions of our children go without proper nutrtion, dental care, and basic health-care. That we are shrinking is just hillarious, if not sad.

As for leadership on this issue, don't look to the White House. There's hasn't been a President since Eisenhower that actually cared for his people.

[anne]

"The whole point was to prove that capitalism sucks and it's about time America finally realizes the superiority of socialism."

Always idiocy and always meanness, all the time, the whole point being the point as a whole.

[KThomas]

anne, noboby likes bad news.

realpc was a bit over-board, but killing the messanger is so easy.

[anne]

"Probably hanging out with far leftists...."

http://select.nytimes.com/2007/05/19/opinion/19herbert.html

May 19, 2007

Young, Ill and Uninsured
By BOB HERBERT

Fourteen-year-old Devante Johnson deserved better. He was a sweet kid, an honor student and athlete who should be enjoying music and sports and skylarking with his friends at school. Instead he's buried in Houston's Paradise North Cemetery.

Devante died of kidney cancer in March. His mother, Tamika Scott, believes he would still be alive if bureaucrats in Texas hadn't fouled up so badly that his health coverage was allowed to lapse and his cancer treatment had to be interrupted.

Ms. Scott, who has multiple sclerosis, understood the grave danger her son would be in if he were somehow to be left without the Medicaid coverage that paid for his chemotherapy, radiation and other treatment. She submitted the required paperwork to renew the coverage two months before the deadline.

"I was so anxious to get it processed," she said, "so we wouldn't have a lapse of coverage."

In Texas, as in many other states, there is a concerted effort to undermine programs that bring government-sponsored health care to poor and working-class children. It is not an environment in which bureaucrats are encouraged to be helpful, not even when lives are at stake.

"They kept losing the paperwork," Ms. Scott told me, her voice quivering with grief. She submitted new applications, made dozens of phone calls and sent off a blizzard of faxes. Despite her frantic efforts, the coverage was dropped.

When the coverage lapsed, the treatment Devante had been receiving ceased. "They put us on clinical trials," Ms. Scott said. "They changed his medicine, and he started getting sicker and sicker. After awhile it was like his body was so frail and he was so weak he could barely walk on his own."

Four months after the Medicaid coverage lapsed, the mistakes were finally corrected and the coverage was reinstated. By then, there was no chance to save Devante....

[evagrius]

Realpc- Uh, uh.

I suppose that Europe is far left, ( the Durch are rabid socialists- that's why they're so tall).

[anne]

Probably hanging out with whom?

http://select.nytimes.com/2007/05/15/opinion/15herbert.html

May 15, 2007

The Right to Paid Sick Days
By BOB HERBERT

It sounds reasonable: seven paid sick days a year. Why should you have to lose a couple of days pay, or maybe even your job, because you had the misfortune to catch the flu?

And it certainly seems unreasonable to penalize an employee in good standing who misses a day or two of work to care for a child who is ill or has met with a serious accident.

After all, this is the 21st century.

The reality, for a surprising percentage of the U.S. population, is more like the 19th century. Nearly half of all full-time private sector workers in the U.S. get no paid sick days. None. If one of those workers woke up with excruciating pains in his or her chest and had to be rushed to a hospital — well, no pay for that day. For many of these workers, the cost of an illness could be the loss of their job.

The situation is ridiculous for those in the lowest quarter of U.S. wage earners. Nearly 80 percent of those workers — the very ones who can least afford to lose a day's pay — get no paid sick days at all....

[evagrius]

Anne- Regarding Devante Johnson- Texas was, and still is to my current knowledge, changing its Medicare eligibility system to a computerized system called TIERS.
Harris County went on line around June 2006.

The computer system is similar to the Colorado and California computer systems.

In all caes, there have been boondoggles, FUBARs, and other unmentionables, that are too many to mention.

Each system has cost the respective states hundreds of millions of dollars and there has been no improvement in services nor any cost savings.

This is an area begging for a good economic study but so far there has been total silence.

The young man need not have died. The Human Services Department could have easily issued temporary coverage and, if my memory serves me right, were obligated to do so.

All three systems "suck" and all three are the subject of lawsuits brought on behalf of people like the late Devance Johnson.

[donna]

55-74 is about the range of time when breastfeeding was unpopular and most U.S. babies were bottle fed. In 74 there was a turnaround to natural breastfeeding.

My kids were breastfed and one is 6 feet and the other is about 5' 11". I suspect breastfeeding alone would explain this phenomena.

[anne]

[Notice that Mark Thoma suggested under "Things You Might Want to Read,"

Common bird species in dramatic decline - csmonitor.com,

I would also suggest,

http://www.nytimes.com/2007/06/15/us/15birds.html?ex=1339560000&en=7b0714da3b0b33a6&ei=5090&partner=rssuserland&emc=rss

June 15, 2007

Meadow Birds in Precipitous Decline, Audubon Says
By FELICITY BARRINGER

Spreading suburbs and large-scale farming are contributing to a precipitous decline in once common meadow birds like the Northern bobwhite, the Eastern meadowlark, the loggerhead shrike and the field sparrow, a report released yesterday by the Audubon Society said.

Twenty common birds have lost more than half their populations in 40 years. The population of the bobwhite, a rotund robin-size bird that lives in meadows from the mid-Atlantic to the Plains, has dropped more than 80 percent, to 5.5 million from more than 31 million....]

[anne]

Thank you, Evagrius. What Donna points out about the possible effects of breast-feeding is interesting, but we would need to know much more about comparative feeding in other countries. I remember reading about a move to try to limit the amount of advertising that formula companies could do in hospitals here and abroad, but when I read of this a while ago I was thinking of the problem of formula feeding in Africa.

[James Killus]

Exactly so, evagrius. The basic problem is not very difficult to grasp and the obvious solutions (eat better and get more exercise) are almost certainly correct.

Your message makes an interesting contrast to realpc's message that immediately follows it, don't you think?

I will note that getting the precise causal relationships in this matter may well be a matter equivalent to rocket science (though it should always be noted that most of rocket science isn't all that difficult). How much of it all is due to sedentary children, which micronutrients are lacking, are there specific amino acid imbalances in the typical American diet, has early consumption of stimulants increased, etc? There could even be problems with environmental exposure to various hormone analogs, though that one seems less likely, given the American/European gap and the broad range of such exposures in the U.S.

But if I wanted to check a slightly "zebra-ish" conjecture ("when you hear hoofbeats in the night, think horses and not zebras") I'd wonder if too many women are eating badly when pregnant, not just the junk food thing, but simply too little in the cases of affluent American women who fear the weight gain from pregnancy.

But in truth, my own prejudice is that children currently get too little exercise and that the general reduction of overall health that goes with sedentary behavior is more important than most people appreciate.

[donna]

Interesting history of U.S. breastfeeding here:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1448139

From 1930 to the early 1970s, now with the collusion of physicians, not only did mothers continue to supplement their breast milk with cows’ milk and wean infants in the first few weeks and months of life, but more and more mothers did not breastfeed at all. By 1971, breastfeeding had reached an all-time low in the United States. Only 24% of mothers initiated breastfeeding—that is, only 24% breastfed at least once before hospital discharge.39 Not until later in the 1970s did the feminist-inspired women’s health reform movement rekindle interest in breastfeeding. One young mother, caught up in the social activism of the 1970s, recalled how the politics and communalism of the time heralded new infant care practices. Her daughter “never drank out of a bottle. . . . When we needed a baby sitter, there were always other nursing moms in the neighborhood willing to take her. We all nursed each other’s babies. In fact, it seemed that every woman I knew was nursing.”40

Yet the breastfeeding initiation rate has not seen the steady increase that this woman and her cohorts might have predicted in the 1970s. Rather, the rate has inexplicably receded and surged. Between 1984 and 1989, initiation rates declined 13%, from almost 60% to 52%. Not until 1995 did these rates return to their high of 60%.41 And in December 2002, the Ross Products Division of Abbott Laboratories reported the highest rates since the company began collecting data in 1955. In 2001, 69.5% of US mothers initiated breastfeeding.42

[donna]

Haven't found any comapirson of European - American breastfeeding yet, but here's a correlation of height and breastfeeding from a British study:

http://fn.bmj.com/cgi/content/abstract/87/3/F193

Results: Breast feeding was associated with the survey district, greater household income, and food expenditure, but not with number of children in the household, birth order, or social class. In childhood, breast fed subjects were significantly taller than bottle fed subjects after controlling for socioeconomic variables. The mean height difference among boys was 0.20 standard deviation (SD) (95% confidence interval (CI) 0.07 to 0.32), and among girls it was 0.14 SD (95% CI 0.02 to 0.27). Leg length, but not trunk length, was the component of height associated with breast feeding. In males, breast feeding was associated with greater adult height (difference: 0.34 SD, 95% CI 0.13 to 0.55); of the two components of height, leg length (0.26 SD, 95% CI 0.02 to 0.50) was more strongly related to breast feeding than trunk length (0.16 SD, 95% CI -0.04 to 0.35). Height and leg length differences were in the same direction but smaller among adult females. There was no association between breast feeding and body mass index in childhood or adulthood.

Conclusions: Compared with bottle fed infants, infants breast fed in the 1920s and 1930s were taller in childhood and adulthood. As stature is associated with health and life expectancy, the possible long term impact of infant feeding on adult mortality patterns merits further investigation.

[evagrius]

Breastfeeding- Hmmm. Something about breasts, something...well nasty. A bottle is so much more wholesome.

There's an icon somewhere of the Theotokos, ( Virgin Mary), breastfeeding Jesus, in full view. Interesting that it was considered a holy activity.

says...

Is Krugman looking at average per capita income? I thought he was a better economist than that.

However, his point is well taken, that America's health care and nutrition has gone down as it's income has risen.

If you want to see this in action, walk around the Amsterdam airport. Everyone looks so humongous and healthy looking.

[Suvi]

"Why should you have to lose a couple of days pay, or maybe even your job, because you had the misfortune to catch the flu?"

...or anything else, such as migraine, monthly pains or whatever.

[Peteb]

Part of the reason the Dutch are taller is genetic- there are a lot of tall, skinny, platinum-blond Dutch people. I used to have a friend who was one of them, and he claimed that one part of Holland was just "like that"- everybody is really tall and really white-haired there.

[anne]

"There is normally a strong association between per capita income and a country's average height. By that standard, Americans should be taller than Europeans: U.S. per capita G.D.P. is higher than that of any other major economy. But since the middle of the 20th century, something has caused Americans to grow richer without growing significantly taller."

I find no problem with the passage.

[evagrius]

Regarding art and breastfeeding;

http://www.darkfiber.com/pz/toc.html

http://www.crisismagazine.com/december2001/feature1.htm

http://www.usq.edu.au/resources/bartlettpaper.pdf

Amazing, isn't it?

[im1dc]

Great comments. I found them interesting, stimulating, fun and far ranging (fads in breast feeding?).

PK's editorial actually discusses a 'correlation' found among demographic matrices and must not be considered or confused with 'cause and effect'.

Though admittedly I'm sorely tempted as he is to blame our cultural nutritional fetishes and the tilting to the Far Right begun in the 1970's for the observed stagnant height stature , i.e., Corporate America rules, not the wishes of the Electorate, as is witnessed too clearly inside D.C. today from the failure to limit our exposure to IRAQ and the Immigration bill.

Are we truly just Lab Rats or Lemmings seen in another context? Maybe so.

[anne]

As far as I can tell, this is the first time Paul Krugman has discussed this issue though writing often on health care. However, when Mark Thoma posted the column I excerpted above a reader mentioned the New Yorker article I also excerpted. Krugman did also use height in a recent article to discuss a point about theoretical economics. Mark Thoma also posted that Rolling Stone article.

[Suvi]

Didn't PK mention in one of his books that the "tallness gene" was also linked to the "intelligence gene" ??

I hope I don't have this wrong, but I think he did.

[kharris]

Here's a thing to do. Go strolling down a street in The Hague or Amsterdam. You will immediately notice that there are far more tall people than just about anywhere else. If you are a good people watcher, you'll then notice that the Dutch don't notice. That's how you know that you have not run into a statistically abnormal tall spot. Dutch people (other than Dutch teenage boys) don't blink when a pack of 6-foot tall teenage girls wander past, blond as sunlight. You'll notice, but they don't think a thing about it. If you ask somebody old enough, they'll tell you they Dutch started getting tall after the War. That may not be strictly true, but that's what you'll hear.

realpc,

Krugman worked for Reagan as an economist. In the recent hetero vs orthodox economic debate, Krugman is more orthodox than not. Each of these argues that he is not, as you say, hanging out with far lefties. The logic represented in your surmise - that a guy who believes the same thing as a group must be hanging out with the group - ain't really logic at all. It's guilt by association.

It also ignores the possibility that Zmag or Krugman, or both, are just accurately observing things that you have failed to observe.

[kharris]

Peteb,

Blond giantism is native to Kroningen, Freisland, Drenthe and thereabouts. It slops over into neighboring parts of Germany, too, but don't tell a Dutch person I said that.

[evagrius]

Height variations within a population are largely genetic, but height variations between populations are mostly environmental, anthropometric history suggests. "If Joe is taller than Jack, it’s probably because his parents are taller. But if the average Norwegian is taller than the average Nigerian it’s because Norwegians live healthier lives. That’s why the United Nations now uses height to monitor nutrition in developing countries. In our height lies the tale of our birth and upbringing, of our social class, daily diet, and health-care coverage. In our height lies our history."

From the New Yorker article.

I really wish people would read this article before making comments such as, " the Durch are genetically taller".

[anne]

'Didn't PK mention in one of his books that the "tallness gene" was also linked to the "intelligence gene" ??'

Please....

[Suvi]

"Go strolling down a street in The Hague or Amsterdam. You will immediately notice that there are far more tall people than just about anywhere else"

kharris, I like your posts, but you've got this wrong. There are tall people everywhere in northern Europe.

Need one mention the Finnish PM, who (somewhat embarrassingly) towers over all heads of state at 2,03 metres (six feet eight, I think)

[Suvi]

"Please...."

I wasn't joking, Anne.

[anne]

I know, I know.

[evagrius]

'Didn't PK mention in one of his books that the "tallness gene" was also linked to the "intelligence gene" ??'

If this is true, then both Kerry and Gore were manifestly more intelligent than Bush.

But considering that both are is taller than the general population of voters one must conclude....

[anne]

What I am interested in, Suvi, is how the Finns have come to take over much of the classical music world.

[Isabel]

Oh, lots, Evagrius. For example:

http://www.museuregionaldebeja.net/web/47.htm

http://www.geocities.com/Heartland/Bluffs/6737/Leite/Leite.htm

http://www.aleitamento.com/a_artigos.asp?id=10&id_artigo=1020&id_subcategoria=22

[realpc]

Yes our health system is messed up, but lack of medical care is not the reason Americans are shorter than northern Europeans. Health care doesn't make you healthier, a sensible lifestyle makes you healthier.

America has great life-saving medical technology, but the average person never needs it. Our health and our height are not related to surgical and diagnostic technology.

There can be many reasons for height differences, some of them mentioned in these comments. The Marxist assumption is that America is sinking into poverty and malnutrition, oppressed by a parasitic wealthy class.

The Marxists at ZMag insisted that poor Americans are undernourished because all they can afford is junk food. If that's true, why are poor people more likely to smoke? If they can't afford natural food, how can they afford cigarettes?

Americans are unhealthy, and if they're getting shorter it's because there are so many channels on TV no one wants to get off their couch. They eat junk food because it's addictive, not because it's cheaper.

But Marxists will twist anything to fit their ideology.

No, I don't think Krugman is a Marxist, but he's leaning towards some kind of anti-capitalism. All because he hates Bush. Why can't people hate Bush without turning into anti-capitalists?

[realpc]

And furthermore, tallness does NOT correlate simply with better health. Shortness CAN be caused by disease and malnutrition during childhood, but it also can be genetic.

Americans include more diverse ethnic groups than northern Europeans.

[realpc]

This article http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1071721 claims that short people are healthier. So there.

[Mark Thoma]

Here's the introduction to a pre-publication version of the article:

Introduction

Prior to reaching adulthood, the physical stature of children and youth is determined by the balance between the intake of nutrients and expenditure of energy, called net nutritional status. Final adult height is reached by the early 20s and after about age 50 people begin to shrink. Hence, height provides a historical record of nutritional status until early adulthood. It is influenced by nutritional intake which, in turn, is determined by such economic variables as real family income and food prices. However, nutritional status is also affected by the claims on nutrient intake such as work during adolescence, frequency, length and severity of endemic or epidemic diseases. Hence, growth is basically affected by food intake and by the availability, effectiveness and accessibility of medical care. The cost of medical services are therefore important as well as how the medical sector is organized, because that affects transaction costs, entitlements to health services as well as externalities, thereby determining quality and quantity of care. The distribution of income within a society also matters to height insofar as that has an impact both on the ability to acquire nutrients and to obtain medical care and medicine. Thus, the political economy of the health care system, education, transfers to the poor, and government policy toward equality (hence taxation policy) all matter. Genetics have a large effect at the individual level, but tend to be unimportant in the aggregate as long as the ethnic composition of the population examined is held constant (Fogel 1994, Tanner 1978, 1986; WHO, 1995). Hence, height is a measure of the biological well being of children and youth, whereby conditions in utero, in infancy, and during adolescence are particularly salient.

We estimate for the first time the long-term trends in the height of the US population stratified by gender and ethnicity using the National Health Examination Surveys (NHES, 1959-62) and the National Health and Nutrition Examination Surveys (NHANES, 1970-74, 1976-80, 1988-94, 1999-2004). Heights in the survey are actual measurements, not self-reported values. Insofar as people reach final height generally in their early 20s and begin shrinking at the end of their 40s, the analysis of adult cohort trends using cross-sectional data is limited to this roughly 25-year window during which individual adult heights are stable. Longitudinal samples would be better to estimate long-term trends of the height of a population but are unfortunately rarely available. Because one of the most important contributions that trends in height can add to our understanding of biological welfare historically is its ability to allow cross-temporal comparisons, it is imperative to combine the results of cross-sectional surveys to evaluate long-term trends.

Two previous studies based on limited evidence suggested that US heights essentially remained stable after World War II (Komlos and Baur 2004, Komlos and Lauderdale 2006). After being the tallest population in the world for at least two centuries, Americans have lagged behind their European counterparts. The current study has the advantage of being based on a much larger number of observations and covers almost the whole 20th century (the birth cohorts of 1910-1983).While the trend in the weight of the US population has been extensively reported that of height has been almost neglected (Ogden et al. 2004), even though it is a useful overall measure of the biological well being of a population and correlates negatively with all-cause mortality risk until about 185 cm among men and 170 cm among women (Waaler; 1984).

That income and education are correlated with height has consistently been observed, in all samples studied, but references to the extent to which such relationships have changed over time have been few. Such effects might well vary over time: as there is more information about proper childhood nutrition, and as income increases allow food consumption to reach levels of satiation, education might become more important than income in determining long-term nutritional status, i.e., adult height.[1] Additionally, we ought to see such variation if social mobility changes in a society, greater social mobility leading to adult height being less strongly correlated with adult income or education as the latter two variables become more weakly correlated across generations.

We have evidence on the income and education of the adults in the sample, but we do not have information on the socio-economic characteristics of their parents which affected their wellbeing during childhood. While it is true that the social status of persons in the sample is by no means a perfect proxy for that of their parents, or the resources available during childhood, we note that the results obtained do not depend crucially on controlling for income and education. We do the analysis in two ways. After stratifying by race and gender we calculate the trends in height with and without controlling for education and income. Ideally we would want to have education and income of the subject’s parents, because those are salient during the time the child is growing. Not having information on the subject’s socio-economic characteristics during childhood we use his/her income and education in adulthood as a proxy variable. In any event, there is a high correlation between father’s and son’s socio-economic status. Only 9% of sons whose fathers were in the lowest quartile of the income distribution ended up in the top quartile during the second half of the 20th century (Blanden, 2005; Perruci and Wysong, 2003; Wysong and Perrucci, 2006) and intergenerational social mobility has diminished over time (Schmitt, 2005). Hence, it is not so farfetched to include the subject’s own income in the regression as a proxy variable for parental socio-economic status.

[mrrunangun]

I doubt the premise. I suspect politically tainted research. I was in high school in the mid sixties and there were several 5'9" 165# all conference linebackers and 6'3" basketball centers. 8 years later anybody 5'9' 165# would have been crushed by the huge O linemen of the day, more so today. Basketball guards were 6'3" and the 6'5'centers were small centers by the mid seventies. Today the Illinois class 3 state football champions fielded an O line AVERAGING 268#. Any one of them would have been the biggest man on the field in 1966. As for women, in my class of 300 the tallest girls were 5'9". My 5'10" niece is too small for the front ranks of high school volleyball now. The young women of today tower over their mothers. My daughter played highschool sports during the nineties against Morgan Park Academy, a school populated and supported largely by the south suburban Dutch population near Chicago. None of their girls was less than 5"9" in basketball or softball.
Apart from giving him growth hormone, I doubt there is much a pediatrician can do to make your kid taller. Good nutrition, good sleep habits, and proper exercise may do it. If American kids are shorter, it may be because the increasingly fragmented families that raise them put too much stress on them and interfere with sleep and so their naturally occurring growth. In our town's hospital's adolescent psychiatry unit, we rarely see a kid from a non-divorce background.

[evagrius]

mrrunangun ;

Which premise from who?

Komlos has done numerous studies of a large variety of populations. His studies are the standard in the field.

Your anecdotal evidence needs more grounding. You mention people of Duch heritage. Perhaps your niece would have been 6 feet tall instead of 5'10' had she grown up in Holland. You may also note that perhaps the colleges are now more selective than in past as regards athletes and they have a larger population. You also don't mention race which certainly has a bearing.

As for realpc- again and again, it must be stressed that Komlos studied a particular population, not looking at Asian or Hispanics, but focusing on people of Durch/ German descent.

There's nothing Marxist about this. It's facts, basic facts.

Causality can be debated. Correlations can be debated. But not the facts.

[anne]

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1540-6237.2007.00458.x

June, 2007

Underperformance in Affluence: The Remarkable Relative Decline in U.S. Heights in the Second Half of the 20th Century
By John Komlos, University of Munich and Benjamin E. Lauderdale, Princeton University

Abstract

Objective. We use the complete set of NHES and NHANES data collected between 1959 and 2004 in order to construct trends for the physical stature of the non-Hispanic white and black U.S. adult population and compare them to those of western and northern Europeans.

Method. Regression analysis is used to estimate the trend in U.S. heights stratified by gender and ethnicity, holding income and educational attainment constant.

Results. U.S. heights stabilized at mid-century and a two-decade period of stagnation set in with the birth cohorts 1955–1974, concurrent with continual rapid increases in heights in western and northern Europe. Americans had been the tallest in the world for (more than) two centuries until World War II, but by the end of the 20th century fell behind many European populations. Only since the most recent birth cohorts 1975–1983 is some gain apparent among whites but not among blacks. The relationship between height and income and between height and educational attainment has not changed appreciably over time for either men or women.

Conclusion. We conjecture that the U.S. health-care system, as well as the relatively weak welfare safety net, might be why human growth in the United States has not performed as well in relative terms as one would expect on the basis of income alone. The comparative pattern bears some similarly to that of life expectancy insofar as the United States is also lagging behind in that respect.

[anne]

"I suspect politically tainted research." I suspect politically tainted growling.

[anne]

http://select.nytimes.com/2007/06/12/opinion/12herbert.html

June 12, 2007

The Divide in Caring for Our Kids
By BOB HERBERT

A few weeks ago, Teri Hatcher, one of the stars of the television series "Desperate Housewives," was on David Letterman's show, talking very animatedly about a time when her daughter needed emergency dental care.

"It was causing her some pain," Ms. Hatcher said. "And then, of course, it was a Friday night. Overnight the whole thing blew up and it turned out to be an abscess."

Where to get a dentist on a Saturday?

Luckily, Ms. Hatcher's best friend is married to a dentist who was more than happy to open up his office that Saturday. But he needed an assistant. Ms. Hatcher volunteered.

She digressed: "I hate the dentist... . Just my whole life, you know. It's the worst. I would do anything to get out of going to the dentist. Really. Anything."

But Ms. Hatcher stood there like a trouper as the dentist examined her daughter's tooth. "He sees it is an abscess, and he has to do surgery," she said. "So you, I'm trying to — I hate it. I'm squeamish. I'm going to throw up, and then I'm trying to pull it together...

"So he does the Novocaine and gives her a little of the gas. She is perfectly fine, because she's going, 'I love the dentist. I want to come here every day.' And then, of course, I'm thinking, 'Can I take a tank of that home? Because that is really what I need.' "

And so on. The story, of course, had a happy ending. Ms. Hatcher's daughter was fine. Mr. Letterman got to tell a raunchy dentist joke. The audience was amused, and Ms. Hatcher eventually exited to a robust round of applause.

I was particularly interested in the segment because just a few hours earlier I had filed a column for the next day's paper about health care for children. The column included the story of Deamonte Driver, a homeless 12-year-old from Prince George's County, Md., who also had an abscessed tooth.

Now, if I had been in Ms. Hatcher's position, I would have done exactly as she did. I would have knocked down doors if necessary to get help for a child in distress. So this is no criticism of her. It's an illustration of the kind of stunning differences in fortune that can face youngsters living at opposite ends of America's vast economic divide.

Deamonte needed his tooth pulled, a procedure that was estimated to cost $80. But his mother, Alyce Driver, had no health insurance for her children. She believes their Medicaid coverage lapsed early this year because of a bureaucratic foul-up, perhaps because paperwork was mailed to a homeless shelter after they had left. In any event, it would have been difficult for Ms. Driver to find an oral surgeon willing to treat a Medicaid patient.

Untreated, the pain in Deamonte's tooth grew worse. He was taken to a hospital emergency room, where he was given medication for pain and sinusitis and sent home.

What started as a toothache now became a nightmare. Bacteria from the abscess had spread to Deamonte's brain. The child was in agony, and on Feb. 25 he died....

[realpc]

Yes Anne, we know that people can die from infections if they can't afford medical treatment. Antibiotics and surgery are what modern medicine is good at. It sucks at almost everything else.

"nutritional status is also affected by the claims on nutrient intake such as work during adolescence, frequency, length and severity of endemic or epidemic diseases. Hence, growth is basically affected by food intake and by the availability, effectiveness and accessibility of medical care."

Yes, the article is making the point that Americans are shrinking, relative to northern Europeans, because we can't afford health care.

The logic is weak and biased. Americans are not shrinking because of too much physical work and not enough food. And we are not shrinking because we don't have universal health coverage. Most Americans are covered -- yes it's terrible that some are not -- and most of us who are covered are relatively healthy. And we are healthy in spite of, not because of, modern medicine.

Unless you need emergency surgery or antibiotics, stay away from MDs. They will not make you taller, or healthier, or make you live longer.

And if you read the article I linked to, you will see that the health-height association isn't true.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=10717

The healthiest people live in traditional societies where no one has medical coverage. And they aren't tall.

Besides, how did these researchers factor out genetics? Americans have been inter-marrying much more than northern Europeans.

[realpc]

"The logic represented in your surmise - that a guy who believes the same thing as a group must be hanging out with the group - ain't really logic at all. It's guilt by association."

kharris,

Yes, I know. But this is a traditional Marxist theme. I realize there is an infinite grey area between libertarian and socialist. I'm in the middle of that grey area myself. But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Chomsky. Just a feeling. But I'm starting to hear Chomskian terminology like "chilling" and "stunning" in mainstream news, not just from Krugman. Not sure what's going on. I was reading Chomsky when no one had heard of him, but now his ideas are seeping into the general consciousness. Mostly indirectly, I guess.

It's a good idea to read ZMag.

[anne]

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Chomsky."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Kurt Vonnegut."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Tennessee Williams."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Elizabeth Moore."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Philip Roth."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Edna O'Brien."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Joseph Heller."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Arthur Miller."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Margaret Atwood."

"But I have a suspicion Krugman's deep hatred for the current administration is inspiring him to read leftists, like Toni Morrison."

[reason]

Hey everybody, just a small point, but averages don't tell you much about individuals. If a significant proportion of one population (but not the other) is being held back by malnutrition and illness then that will affect the average, even if everybody else remains comparable.

As for genetics, I believe the evidence is that all human populations (apart from some pygmy populations) given the same health and nutrition environment over several generations has a similar average height. After all, human populations spread very quickly and many migrations were in biological time very recent.

[real person from the real world]

Again at the end here, so probably no one will read, except perhaps the kind host of the blog. My take: Look at all the diet products, or ads to buy things to make you look young? Frankly, while I think fast food is a temptation for overly buy people, I think that the obsession with keeping weight down to look young, is part of the problem. We have fewer kids, and we rant at them from an early age, about weight. We may eat less, but instead of eating properly, we cut back because of weight, on the right foods, and eat the easy greasy fast foods that you can buy at whim. Those that become overweight, are trapped. If you cannot lose, some don't care and will eat anything, at that point.

[evagrius]

realpc;

The article you referred to is concerned with the mistaken notion that height, in and of itself, is an indicator of health and that one should use genetic manipulation in order to insure taller, therefore healthier, children.

This is not the point of Komlos' study.

Again, you forget that Komlos studied a specific population in the U.S., those of Northern European descent, ( who did not intermarry with other groups etc;). He did not, did not, compare the general populations.

Given that, why, especially since that particular population happens to be quite affluent, is there such a height difference? It's not genetic since they have essentially the same genes, ( in fact, the New Yorker article states that American relatives of Dutch residents were compared).

Can you please understand the basic facts and quit interjecting nonsensical piffle about Marxism?

And by the way, are you short? Is this why you're so sensitive?

( I'm 6'4" because I have Norwegian and Dutch ancestry from both my mother, ( half French), and my biological father, ( Dutch).)

[Chris]

I wonder what the geographical distribution of height is in the US. Moving to California from the Midwest a few years ago, I'm struck at how short everybody is out here. We do know that the Midwest is where all of those Scandinavians and Germans and Dutch went....

[jean]

Health is only linked to height changes because the quality of food and the relative intake affects health.
It's the food. Medicine is only good for infections (when you can get their attention) and surgery. They don't CURE. They only palliate. They (doctors and medical researchers, both) barely understand nutrition. Consider the weekly or monthly 'bulletins': 'Eating fat causes cancer', 'Eating fat doesn't have anything to do with cancer' etc, etc, etc. Not only that, but the nutritional levels of foods were established in the 30's and 40's, before the advent of major chemical enhancement of our food supply. We don't really know todays' levels.
Add to that poverty, fad diets, anorexia, obesity, poor digestion and just plain ignorance.

[realpc]

"Given that, why, especially since that particular population happens to be quite affluent, is there such a height difference?"

Well then don't draw the conclusion that the American economic system is inferior. Affluent Americans have good health coverage. Good health coverage does not generally make you healthier -- unless you have some catastrophic accident and need to be put back together.

If Americans are getting shorter, it is not because the health system sucks (although it does, in many ways), or because of lack of money to buy food.

Yes I'm short, by the way, and an ethnic minority, but that is not why I'm sensitive about this. Well, not the only reason. This is yet another example of Krugman's America-bashing. Not that I think America is perfect. But I do get tired of leftists mooning over northern Europe and what a paradise it is. Yeah, it's wonderful until the eononomy becomes stagnant and they swing back to capitalism. Yes, I'm sure Krugman understands the need for balance. But ever since Bush was elected you would never know it.

And that reminds me of Sicko, the new Moore movie. He shows that Cuba is better than the US because it can spend a fortune in Venezuelan oil money on free health care and free medical education. I do not think I'm exaggerating if I say the average American leftist admires Cuba, as well as the social democracies of Europe, and wants to follow their examples.

[anne]

Viva Zapata!

[evagrius]

You still haven't gotten the point, have you?

Why not read the New Yorker article, PLEASE?

Then come back and write something sensible.

anne says...

http://www.newyorker.com/archive/2004/04/05/040405fa_fact

April 5, 2004

The Height Gap: Why Europeans are getting taller and taller-and Americans aren't.
By Burkhard Bilger

When Vincent van Gogh was thirty-one years old, in the fall of 1883, he travelled to the bleak moors of northern Holland and stayed at a tavern in