Our neighbors to the north live significantly longer than us, despite the fact that they are not a tiny enclave halfway around the world, but rather a geographically proximate, and culturally similar population at reasonable economic parity with our own. There is no life-extending technology that citizens of Vancouver, BC should (theoretically) have access to that could not also be available to citizens of Vancouver, WA.

But, of course, that isn’t the full story. Obviously Canada has universal healthcare, and the extent of this for calming the daily health anxieties of Canadians (I estimate) must be significant, because in trips to Canada to explore these concepts we have repeatedly heard Canadians cite fears of being sick or injured during visits to the US (much in the same way a US resident might express fears over being gravely injured while visiting Mexico and having to seek treatment there). While medical care is important for those who are sick, lack of medical care (when not yet sick) is not necessarily the root cause of sickness. Just as we take aspirin for a fever, the cause of a fever is not necessarily a deficit of aspirin.

One must consider the effect of stress and uncertainty on health.  Canadians enjoy a year of paid parental leave, weeks of guaranteed paid vacation, access to universal medical care if they do get sick, free or affordable university education, and a host of other social goods. Americans get little of this, experience more stress for it, and then are less able to seek care to deal with their health deficits once they are sick.

According to the Institute of Medicine, Americans “consume the most calories per person, have higher rates of drug abuse, are less likely to use seat belts, are involved in more traffic accidents that involve alcohol, and are more likely to use firearms in acts of violence. Although the income of Americans is higher on average than in other countries, the United States also has higher levels of poverty (especially child poverty) and income inequality and lower rates of social mobility. Other countries are outpacing the United States in the education of young people, which also affects health. And Americans benefit less from safety net programs that can buffer the negative health effects of poverty and other social disadvantages.”