How about this for a factoid:  roughly one in ten people who die in the U.S.in a given year would survive if they lived in Canada. 

This shouldn’t be too surprising, given the wide and growing health gap between the U.S. and its northern neighbor.  Canadians outlive Americans by about 2 years (a fact I never tire of pointing out).  Two years may seem like a trivial difference, but it’s not.  Canadian’s life expectancy is among the best in the world; but among developed nations, the U.S. is near the bottom of the barrel, trailing Cyprus and Costa Rica—places most Americans would need an atlas to locate—and is now just a little ahead of Cuba. 

The question is:  why?   Why is it that two two neighboring nations with similar ethnic, cultural, and economic traits should have such diverging paths when it comes to health?

Excess U.S. Deaths Relative to Canada by Cause of Death: Both Sexes, Whites, and Nonwhites, 1998

The U.S.-based Population Reference Bureau (see link above) found that nearly 70% of the excess deaths in America could be traced circulatory diseases, such as high blood pressure and heart attacks.  But after that, the story gets complicated.  Differences in tobacco use don’t explain much: historically, Canadians have smoked more than Americans.  High blood pressure is also more prevalent in Canada than the U.S.—and Canadians are less likely than Americans to know they have high blood pressure.  (So much for universal health care…) 

So the leading candidate for the health difference, according to the PRB, is obesity.  In 1998, more than a quarter of American men were obese, as were a third of American women; the corresponding figures in Canada were 13 and 11 percent, respectively.

But there’s been renewed controversy over just how bad obesity is for your health; previous estimates by the U.S. Centers for Disease Control, that obesity and overweight cause 400,000 deaths a year in America are now believed to be too high.

So that leaves the health differences between the two nations a bit of a mystery.  There’s clearly something going on to account for the growing health gap.  But it’s not yet entirely clear what that something is.