A Mystifying American Metamorphosis

At the restaurant he never gets a price. Only an estimate. Whatever happened to the all-American Rock Hudson-ish tall, crew-cut, lean look? Once the world's tallest, Americans have by now morphed into the world's fattest. And become shorter to boot. But how can this be, if physical stature ranks as a good indicator of biological well-being and Americans have been experiencing a long economic boom that has placed them more firmly than ever in the top-income club? Besides, don't they spend oodles in health care, more than just about everyone else?

It's a bit of a mystery, but apparently not unsolvable: John Komlos, a professor of economics at the University of Munich, and his colleague Marieluise Baur perused hard data on this new, King-of-Queens-sized phenomenon and published their findings in a CESifo Working Paper.

Physical height is affected by many socio-economic variables and tends to be positively correlated with most health outcomes throughout life: it generally increases in good times and contracts during adversity. That makes it a good supplement to, or proxy for, conventional standard-of-living indicators.

What underpins the relationship between degree of economic development and physical stature? For one thing, such factors as medical technology, access to medical services, quality and availability of perinatal care, virulence of the disease environment and pollution levels all bear upon your height —once genetic factors have done their part, of course.

For another, social status is a major determinant of height: better educated parents are better informed about habits conducive to good health and are usually able to take better care of their offspring. The consumption of proteins, vitamins and minerals is also greater in this case.

Americans do sport a high level of economic development, and up until the Second World War they were indeed the world's tallest. Even in colonial times American men —173 cm tall on average— towered well above the bulk of their European counterparts, and would continue to do so for a long time to come, with the exception of a tiny segment of Europe's upper aristocracy. As regards weight, they were, by today's standards, a bit underweight.

Thereafter Americans increased in height by only a few centimetres, in contrast with Europeans, who added 1 cm per decade. Worse, American height may have actually started to decline. By now, Americans are considerably shorter, up to 6 cm, than Western and Northern Europeans. The Dutch, Swedes and Norwegians are the tallest, but even Danes, Brits and Germans are taller. The gap is probably slightly greater among females.

With respect to body mass, American girths have ballooned since about 1980, with around 20% of the population now considered obese, practically topping the OECD ranking in that area. The American idea of a balanced diet seems to be "one cake on each hand".

What could account for this development? Americans spend a much larger fraction of their GDP on health-related services: at 13.7%, nearly twice as much as Japan. And still, their life expectancy lies well below that of Japan or, for that matter, that of 27 other developed nations. Their infant mortality rate is the highest among the OECD countries as well.

In short, Americans are far from achieving the highest biological standard of living in the world today, despite their high average per capita income.

Among the probable factors leading to this, the authors point to the fast-food culture that has developed since the middle of the 20th century in response to the restructuring of work and family. Inequality also plays a role. It has been increasing over the past several decades and is a far cry from Western European's welfare state. Insofar as the lower classes have a higher propensity to obesity, the US social structure might be conducive to horizontal but not vertical bodily development.

Health care systems in Europe provide a more comprehensive coverage than those of the US, with almost universal coverage. In the US, close to 15% of the population has no coverage at all. On top of that, health delivery is complicated there.

The West-European welfare states provide also a more comprehensive social safety net. Although unemployment levels in the US are much lower than in Western Europe, only about half of the unemployed receive benefits. Spells of unemployment with a parent lacking proper unemployment or health insurance may affect adversely the nutritional status of their children.

A further element is the notorious dichotomy between inner city and suburbs in the US, a phenomenon practically unheard of in Europe. Among other things, sanitary conditions and health care are generally less adequate in disadvantaged neighbourhoods.

So, it appears as if the West-European welfare states do have some advantages in providing a higher biological standard of living to their populations than the American more market-oriented one.

As the authors conclude, "the wealthiest are by no means the tallest or the healthiest, or live longer. They do appear, however, to be among the heaviest."


John Komlos, Marieluise Baur: From the Tallest to (One of) the Fattest: The Enigmatic Fate of the American Population in the 20th Century, CESifo Working Paper No.1028

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