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

admin2008-10-11  34
问题    The most damning thing that can be said about the world’s hest-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 lends to analysis of all health problems. Clearly the largest aggregate of forces resides in the person’s environment. His own behavior, in part derived from his experiences with his environment, is the next greatest force affecting his health. Medical care services, treated as separate 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 templated at conception as to our basic weaknesses 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 U.S. 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 a longer male life 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 U. S. a national unemployment level of 10 percent may be 40 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.
The author is primarily concerned with ______.
选项 A、condemning the U.S. for its failure to provide better medical care to the poor
B、evaluating the relative significance of factors contributing to the poor health status in the U. S.
C、providing information which the reader can use to improve his or her personal health
D、comparing the health status of the U.S. population with that of the world averages
答案B
解析 作者在二、三、四、五段主要关注的是导致健康状况不佳的原因。D不对，因为文中将美国的总体健康水平同那些超出美国的国家的健康水平进行比较，并未比较美国的总体健康水平与世界的平均健康水平。
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