Your Jan. 27 editorial "Risky Behavior: Americans Hurt Themselves by the Way They Live" on the recent Institute of Medicine/National Research Council report comparing the health status of Americans with other nations missed significant findings of that report, leading you to overemphasize the individual role people have in their health by suggesting that what we need to do to improve our health is to change our habits. Of course this is true to some degree, but the report also notes the following:
"No single factor can fully explain the U.S. health disadvantage. Deficiencies in the health care system may worsen illnesses and increase deaths from certain diseases, but they cannot explain the nation's higher rates of traffic accidents or violence. Similarly, although individual behaviors are clearly important, they do not explain why Americans who do not smoke or are not overweight also appear to have higher rates of disease than similar groups in peer countries.
"More likely, the U.S. health disadvantage has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions."
In Western Pennsylvania, if we want to improve our health, which we clearly need to do, we will need a deeper and more comprehensive approach than exhortations to change our behaviors.
KEN THOMPSON, M.D.