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About Chrissy Donovan:

Chrissy Donovan is a guest contributor to the Healthy Travel Blog. She recently graduated from Carleton College in Northfield, Minnesota, where she majored in mathematics. While in school, she spent a semester studying in Budapest. Here, she learned firsthand some of the differences between American and Hungarian health care when she became alarmingly sick one day (but quickly recovered).

What’s Holding Back Happiness In Russia?

Monday, February 8th, 2010 by Chrissy Donovan

If you are a regular reader, you know we’ve been hunting for happiness. But sometimes on our travels, if we look closely, we gain insights into deeply rooted cultural sources of unhappiness.

We recently introduced our Healthy Planet Index, a ranking of 141 countries that is based on a measure called happy life years—a combination of life expectancy and satisfaction with life.   For instance, in Costa Rica, life expectancy in 2005 was 78.5 years and satisfaction with life (on a scale of 0 to 10) was 8.5; we used these figures to create a Happy Life index value of 66.7, which tops the Healthy Planet Index. 

As we reviewed the results, one country that caught our eye is Russia.  With 38.1 happy life years, Russia ranks 91st.  Russia is 75th when our 141 countries are ranked by happiness and 97th when they are ranked by life expectancy.  The question is, what problems are behind these low figures?         

The answers are numerous.  A substandard system of medical care, the prevalence of tuberculosis (a disease of poverty) and overindulgence in alcohol are some of the bigger pieces to the puzzle.  Let’s take a closer look at alcohol.  Everyone knows the stereotype that Russians are heavy drinkers.  We did some research to see how much truth is in this generalization.  First, we’ll give you the numbers.  According to the World Health Organization in 2003, 10.3 liters of pure alcohol were consumed by each Russian person over the age of 15.  10.3 liters of pure alcohol translates into 580 shots (1.5 oz. drinks) of 80 proof vodka (and yes, we chose vodka because we‘re talking about Russia).  That’s an average of 1.6 shots per day.  It should be said that 10.3 liters was not the highest figure for a country in 2003.  In Ireland, which was at the top of the list, the average was 13.6 liters.  Russia is not the only place where lots of alcohol is consumed.  On the other hand, the situation in Russia is said to be even worse than the official numbers portray because of the large black market for alcohol.           

There is more to the story than these raw numbers, and it’s something visitors to Russia should heed:  alcohol in Russia is often consumed more dangerously than in other countries.  History books, newspapers, Russian officials and ordinary Russians all say the same thing:  Russians tend to drink in binges.  And, of course, they tend to drink vodka, a highly distilled alcohol.  This is the Russian way of drinking.  And it is the kind of drinking that can kill in the span of a night.   Bootleg alcohol that has toxic ingredients is not an uncommon thing in Russia.   All of these circumstances add up to a high rate of death due to alcohol poisoning in Russia.        

That’s nothing to take lightly; however, it’s the smaller, more sensational side of the story.  Much of the self-destruction from over-drinking takes more time to show.  We’re talking about heart disease, alcoholism, cancer, violence, weakened immune systems, lost days of work, to name a few.  These ills are the larger villains.

The bottom line? Russia’s problems with alcohol are real, not just stereotypical.   Russia is certainly not the only country that faces a struggle with booze (hint hint Western world). But misery with company is still misery.

Photo info:  http://www.flickr.com/photos/atbaker/ / CC BY 2.0
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Introducing the Healthy Planet Index: Exploring What Produces Long Happy Lives

Friday, December 4th, 2009 by Chrissy Donovan

Here at HTB we’ve taken an interest in what we’re calling comparative healthcare with an eye toward what we can learn from lifestyles and cultures around the globe.  Now that the healthcare reform debate in Congress is reaching a crescendo, we think it’s a good time to ask this: “How do you measure the effectiveness of a healthcare system?”

We think there are two fundamental dimensions that should be considered.  While there is no doubt about the importance of physical health, “well-being” includes happiness too.  To gauge the strength of a healthcare system, we need to somehow measure both.  A population’s health can be gauged by life expectancy, but we have to look harder to find a measure of a population’s happiness.

For this reason, we literally took a page from The Happy Planet Index which respected economists have devised to measure and rank how efficiently (in terms of environmental impact) nations produce “the good life.”  This ranking relies on life expectancy figures and surveys of life satisfaction, as well as a country’s carbon footprint.  We focused on the first two numbers to isolate what they call “Happy Life Years” of the citizens in each country.  The result is a ranking of countries that emphasizes a basic human goal: long, happy years of life. The accompanying chart shows the results for 25 of the 141 countries we evaluated. (Happy life years are determined by multiplying life expectancy and satisfaction with life.)

There are some surprises: Costa Rica heads the list; the U.S. comes in 14th with Mexico not far behind. China and Egypt rank far ahead of Turkey and Russia.  But we were even more surprised when we tried to find variables that correlate with Happy Life Years.

A quick scan of the chart confirms our statistical analysis that there is very little correlation between Happy Life Years and the number of doctors per capita.  This finding calls to mind Voltaire’s maxim that the role of a doctor is “to amuse the patient while nature takes its course.”  Of course, the geographic distribution of doctors and medical technology (i.e., access to care, maybe the sheer size of the country) must play a very large role.

Likewise, government’s share of spending on healthcare exhibits almost no correlation with Happy Life Years.  Even when the dependent variable is reduced to life expectancy, the results still indicate that there is no relationship between how involved the government is and how healthy the people are.  Clearly there are no simple conclusions to be drawn and rationally applied to cool the heated discourse that is unfolding in Congress.

We did find something worth remembering when we looked at total healthcare spending per capita.  Here the relationship between Happy Life Years and how much is spent per person is not what one might expect.  There is a positive correlation with the Happy Life Years; however, the relationship is logarithmic, rather than linear.  This means that there are rapidly diminishing returns on spending.  Our analysis shows that spending $1,000 per person per year rather than $500 can have a huge effect, but spending $3,000 per person rather than $2,500 is not very meaningful.  This finding calls into question the benefits of increased spending — certainly at the levels the U.S. has attained ($6,714 per person).  Are these costs truly necessary?  If not, what are we paying for that is not as essential as we think?  

There is, of course, a moderate correlation with Gross Domestic Product (GDP), but that’s not the end of the story. We’ll continue to wrestle with this topic to gain more insight into how important variables such as environment (air and water quality) and culture (drinking, smoking, obesity, hunger, attitudes toward work, leisure, prison population, size of military force) affect a country’s score.    In the meantime, let’s consider how redistributing some healthcare spending might raise the planet’s health quotient.  As we’ve seen, $500 spent on the have-nots goes a long, long way.  For some, it’s a drop in the bucket, for others, it’s the whole kitchen sink.

HPI

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