Although I usually post in the RSD forum, I thought this one should be seen over here as well:

Please open this link from the Minneapolis StarTribune, dated 02.28.10: http://tinyurl.com/yfyrdyj as a new tab on the page.

It's two things. The top half is a world-wide map indicating incidence diabetes, and says a lot about diet.

But the bottom half is (at least at first) more interesting. While laid out as a series of lines, charting national per capita health spending and life expectance at birth, among the 30 countries of the Organization for Economic Cooperation and Development (OECD). And which country has the highest life expectancy of the bunch, at 82.6 years, with only an average per capita cost? Japan. Health at a Glance 2009 - OECD Indicators, released December 8, 2009, a PowerPoint presentation, upon which the StarTribune graph is explicitly based. See, http://www.oecd.org/health/healthataglance or if you have PowerPoint loaded on your system, check this out, http://www.oecd.org/dataoecd/24/8/44231736.ppt (Open them as new tabs as well, if you please.)

Now, it might be more accurate, from a statistical point of view, to just have each country as a single point on a two dimensional plane. See, OECD Slide 45. But when laying each country out as a line connecting its per capita spending on the vertical axis, with life expectancy on the horizontal, what becomes salient are the slopes of the respective lines. The average number of doctor visits per year is also represented in the color of the line.

If spending per capita directly translates into whole life expectancy, then you get lines that are flat, which is to say that they have a zero slope, as in the case of the U.K and France. France spends more, it gets better results.

Where the line has a downward (negative) slope, you see less "bang for the buck," as in the case of the U.S. And then there are those many countries represented with an upwards (positive) slope, suggesting better returns than what would be expected from mere spending levels per capita alone.

But where it gets really interesting, is when you take into account that of the 30 countries included, all but three have universal or near-universal health care coverage — Mexico, Turkey and the United States. That's when the comparisons become fun. Why should the U.S. have a steeply negative slope while Mexico's is positive? Perhaps it reflects nothing more than the effect of subsidized access to childhood vaccinations in Mexico? Not clear.

And of the other countries with universal or near-universal health care coverage, why the disparities among four relatively advanced countries that spend about the same amount per capita with equivalent levels of doctor visits? Say, South Korea, the Czech Republic, Slovakia and Hungary. Diet?

And of course, the whole exercise may be subject to the effects of currency exchange rates. But still, it's interesting to see the divergence among countries from which you would expect equivalent results.

And just what is it that Japan is getting so right? Well if you go through the OECD PowerPoint presentation, you will see at Slide 27 that it has, by far and away, the highest average length of stay for acute care among all OECD countries, along with by far and away the highest number of MRI and CT scanners per capita. Slide 23. And how do they do that while keeping their costs no more than average? Well, in addition to not paying its nurses all that well (Slide 21) Japan clearly has the lowest level of obesity in the bunch: for 2006, Japan's rate was 3% opposed to 34% for the United States! Slide 13.*

Thank you, Food, Inc. ! ! !

Mike

* In fact, in comparing South Korea, the Czech Republic, Slovakia and Hungary, on Slide 13 it quickly becomes apparent the South Korea's 2005 obesity rate was second only to Japan's at 4% while the Czech Republic’s 2002 rate was almost 4 times as high - at 15% - although comparable figures were not available for either Slovakia or Hungary.