What emerges from such scrutiny is that the United States of America, the richest country in human history, stands behind all other rich countries in what I call the Health Olympics, the ranking of countries by life expectancy. Using the latest available United Nations data, from 1997, we were 25th. Looking at this ranking can tell us a great deal. In 1960, the current gold medallist, Japan, was 23rd. Japan has the highest number of smokers per capita of any country in the world, except China, which has comparable proportions.
Japan places no restrictions on tar or nicotine content, or on tobacco advertising.
While smoking is declining in Japan, as in the US, still three times as many Japanese men smoke as American men, yet their lung cancer death rates are one half to one third of ours. To begin with, Japan spends half of what we do on health care. Japanese doctors see an average of 75 patients a day, more than twice as many as US doctors. The research is pretty conclusive on the medicine needed to make a population healthy. Nothing affects the health of populations as much as the amount of social and economic hierarchy observed in that population.