IN THE BUBBLE JOHN THACKARA - witz cultural

systems in 191 member states, it found that France provides the best overall health
care, followed among major countries by Italy, Spain, Oman, Austria, and Japan.
The U.S. health system spends a higher portion of its GDP than any other country,
but ranks 37th out of 191 countries according to its performance, the report found.
‘‘World Health Organization Assesses the World’s Health Systems’’ (press release
WHO/44, June 21, 2000, available at http://www.photius.com/rankings/who_world
_health_ranks.html).
4. About one in five Americans has some form of CVD; more than twenty-six
hundred Americans die of the condition each day. Apart from the human suffering
involved, the costs are enormous. One estimate in 2002 put the direct and indirect
costs of CVD at $253 billion a year. This number includes direct costs, such as hospital
and nursing home care, physicians and other professional services, drugs and
other medical durables, and home health care; it also factors in indirect costs such
as lost productivity because of morbidity and mortality.
5. One major study of patients with advanced coronary heart disease found that
82 percent of those with extensive support networks survived at least five years, as
opposed to only 50 percent of those who were socially isolated. S. E. Taylor, Health
Psychology, 2nd ed. (New York: McGraw-Hill, 1991); R. Williams, ‘‘Prognostic Importance
of Social and Economic Resources among Medically Treated Patients with
Angiographically Documented Coronary Heart Disease,’’ Journal of the American Medical
Association 2676 (1992), 520–524. Other studies have confirmed that social
ties predict survival after acute myocardial infarction: In these studies, patients who
lacked social support, lived alone, or had not been married had an increased mortality
risk following myocardial infarction.
6. Board on Neuroscience and Behavioral Health, ed., Health and Behavior: The Interplay
of Biological, Behavioral, and Societal Influences (Washington, D.C.: Institute of
Medicine, 2001), available at http://www.nap.edu/books/0309070309/html/. Health
and disease are determined by dynamic interactions among biological, psychological,
behavioral, and social factors. These interactions occur over time and throughout
development. Cooperation and interaction of multiple disciplines are necessary for
understanding and influencing health and behavior.
7. Durkheim’s work is discussed in Healy and Cote, The Well-Being of Nations, 52.
8. Taylor, Health Psychology, 17.
Notes to Pages 114–115 253
9. TedMed (http://www.tedmed.com/) is a conference, sponsored by the Wall Street
Journal, that focuses on the business and communication of medical technology research
and health care in the twenty-first century.
10. For an overview of the quantity of currently available prosthetic devices, see the
website of AbleData (http://www.abledata.com/), which provides access to a database
that contains over twenty thousand items.