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  3. The most damning thing that can be said about the world’s best-endowed and richest country is that it is not only not the leader

The most damning thing that can be said about the world’s best-endowed and richest country is that it is not only not the leader

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问题     The most damning thing that can be said about the world’s best-endowed and richest country is that it is not only not the leader in health status, but that it is so low in the ranks of the nations. The United States ranks 18th among nations of the world in male life expectancy at birth, 9th in female life expectancy at birth, and 12th in infant mortality. More importantly, huge variations are evident in health status in the United States from one place to the next and from one group to the next.
    The forces that affect health can be aggregated into four groupings that lend to analysis of all health problems. Clearly the largest aggregate of forces resides in the person’s environment. His own behavior, in part derived for his experiences with his environment, is the next greatest force affecting his health. Medical care services, treated as separating from other environmental factors because of the special interest we have in them, make a modest contribution to health status. Finally the contributions of heredity to health are difficult to judge. We are tempted at conception as to our basic weakness and strengths; but many hereditary attributes never become manifest because of environmental and behavioral forces which act before the genetic forces come to maturity, and other hereditary attributes are increasingly being palliated by medical care.
    No other country spends what we do per capita for medical care. The care available is among the best technically, even if used too lavishly and thus dangerously, but none of the countries which stand above us in health status have such a high proportion of medically disenfranchised persons. Given the evidence that medical care is not that valuable and access to care not that bad, it seems most unlikely that our bad showing is caused by the significant proportion who are poorly served. Other hypotheses have greater explanatory power: excessive poverty, both actual and relative, and excessive affluence.
    Excessive poverty is probably more prevalent in the US than in any of the countries that have a better infant mortality rate and female life expectancy at birth. This is probably true also for all but four or five of the countries with longer mate tire expectancy. In the notably poor countries that exceed us in male survival, difficult living conditions are a more accepted way of life and in several of them, a good basic diet, basic medical care and basic education, and lifelong employment opportunities are an everyday fact of life. In the US a national unemployment level of 10 percent may be 20 percent in the ghetto(黑人居住地)while less than 4 percent elsewhere. The countries that have surpassed us in health do not have such severe or entrenched problems. Nor are such a high proportion of their people involved in them.
    Excessive affluence is not so obvious a cause of ill health, but, at least until recently, few other nations could afford such unhealthful ways of living. Excessive intake of animal protein and fats, dangerous imbibing of alcohol and use of tobacco and drugs(prescribed and proscribed), and dangerous recreational sports and driving habits are all possible only because of affluence. Our heritage, desires, opportunities, and our machismo, combined with the relatively low cost of bad foods and speedy vehicles, make us particularly vulnerable to our affluence. And those who are not affluent try harder. Our unacceptable health status, then, will not be improved appreciably by expanded medical resources nor by their redistribution so much as by a general attempt to improve the quality of life for all.
All of the following are mentioned in the passage as factors affecting the health of the population EXCEPT______.
选项 A、the availability of medical care services
B、the genetic endowment of individuals
C、the nation’s relative position in health status
D、an individual’s own behavior
答案C
解析 本题的四个选项中，只有C项为正确答案。这可从文中第二段的内容推知，即提供健康保健服务、基因对健康的影响和个人行为都是影响美国人健康状况的主要原因。
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