According to the latest report by the U.S. Census Bureau, an American baby born in 2004 can expect to live 77.9 years. That's over 4 years less than a Japanese baby, who can expect to live a full 82 years."

"Something's wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries," said Dr. Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington, in an article reported by the Associated Press. Americans rank behind countries like France (80.4), Sweden (80.3) and Canada (80.0). In fact we rank behind most of Europe, and even one Middle Eastern country (Jordan).

What's going on? Some of the difference ? a tiny bit ?is attributable to racial disparities in life spans. White Americans actually live about 78.3 years according to the CDC---still about 4 years shorter than the Japanese or six years shorter than some Europeans---while African Americans can expect to live 73.3 years. Researchers explain the alarming gap in life spans to a combination of inadequate health insurance, obesity and lifestyle factors such as stress. Countries such as England, Canada and France have national health coverage which may explain some of the gap.People with health coverage are more likely to seek medical attention immediately when they need it, rather than wait until the problem gets worse and their health deteriorates.

This problem of non-existent health coverage plagues about 47 million of us. And the remaining 253 million of us with health insurance often encounter a health care system that seems more intent on denying us coverage than ensuring our access to health care. In fact, many life-or-death health decisions are no longer made solely by you and your doctor. Instead, these decisions are ultimately made by HMOs. If you are denied coverage by some person ? who may no even be a medical doctor ? in some cubicle at an HMO, you do have a right to appeal. If you survive long enough to win the appeal, then you may be able to finally get the coverage you have paid premiums to get. Of course, if you win your appeal, you better not get sick again.

Most HMOs have many loopholes which give them the right to not renew your insurance contract in the next renewal period. That's not right or fair ?but then again it was probably not fair to deny you coverage in the first place. Of course, you can appeal the non-renewal to some court and spend the remainder of your shortened lives fighting HMOs, right? A lot of Americans caught up in this crazy maze have started heading for the EXIT sign.

You may have heard about the new growing trend of ?medical vacations?. BBC News (owned by The British Broadcasting Company) ran a report on September 14, 2007, about India's attempts to become a medical tourism destination. In the report, a woman from Oregon explained that she had traveled from Oregon to Mumbai, India for a hip replacement. The woman explained that her health insurance would have required her to pay 20% of the cost. Apparently, even after factoring in the cost of a plane ticket for a 5000 mile trip and the costs for a hotel and food, it was still cheaper to have the operation in Mumbai than in Oregon.

Which leaves lifestyle factors ---- stress, obesity? We Americans are, to put it impolitely, fat. The latest research reports put the number of overweight or obese Americans at 67%. That's two out of three of us. Americans under 30 may be the first generation which will die at an earlier age than their parents. As for stress, that factor is hard to pin down. We Americans work longer hours for many more years than any other people in the industrialized world. We take an average of less than a week of vacation per year. Europeans average total vacation time of 6 to 8 weeks. A recent survey by KFC reported that 62% of us believe that the one hour lunch is ?the biggest myth of working life?. MSNBC reported that many of us take only a half hour for lunch and plenty of us eat at our desks. Job security has all but vanished for the current generation of us working. And because older Americans ? our parents ? are on average sicker than, say, Europeans and Japanese and Canadians for longer periods of their mature years, working Americans often find ourselves sandwiched between the need to care for aging parents and kids.

So, while it's hard to pin down exactly what kind of stress may be killing us off sooner than the rest of the industrialized world, we have plenty of candidate stressors which may be to blame.How do we close the gap? Much of it is beyond our fixing immediately. But surely, we can work on the problem of obesity. Doctors say losing even a few pounds, especially around the middle, can add years of healthy living.