Column: What Americans’ declining height has to say about the economy

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Uninsured patient Donaji Cruz, 3, has her height measured during a health check-up at Venice Family Clinic in Venice, California, June 25, 2009. Some 47 million Americans are uninsured and have little access to the healthcare system. Insurance costs have doubled in under a decade, prompting businesses that provide much of the coverage to complain it threatens U.S. global competitiveness.  REUTERS/Lucy Nicholson (UNITED STATES POLITICS HEALTH IMAGES OF THE DAY) - RTR251D5

Americans are not standing tall, and our malign neglect of the mixed economy bears a great deal of the blame, write Jacob S. Hacker and Paul Pierson. Photo by Lucy Nicholson/Reuters

Editor’s Note: The following is an excerpt from the new book “American Amnesia: How the War on Government Led Us to Forget What Made America Prosper” by Jacob S. Hacker and Paul Pierson. For more on the topic, tune in to tonight’s Making Sen$e segment, which airs every Thursday on the PBS NewsHour.


Americans pride themselves on standing tall: rising to the challenge, achieving the once unattainable, raising the bar of social success. Yet as we have faltered in harnessing the enormous positive potential of public authority, we have also fallen behind the pace of social improvement in other rich nations as well as the pace we set in our own past. In area after area where we once dominated, we are falling down the rankings of social success. In area after area where new threats loom, we are failing to rise up to the challenge. We are not standing tall — literally, we shall see — and our malign neglect of the mixed economy bears a great deal of the blame.

Losing Ground 


For much of U.S. history, Americans were the tallest people in the world by a large margin. When the 13 colonies that occupied the Atlantic seaboard broke from the British Empire, adult American men were on average 3 inches taller than their counterparts in England, and they were almost that much taller than men in the Netherlands, the great economic power before Britain. Revolutionary soldiers looked up to General George Washington, but not, as often assumed, because he was a giant among Lilliputians. David McCullough, in his popular biography of John Adams, describes Washington as “nearly a head taller than Adams — six feet four in his boots, taller than almost anyone of the day.” Those must have been some boots, for Washington was 6-foot-2. At 5-foot-7, Adams was just an inch below the average for American soldiers and significantly taller than a typical European soldier.



Americans were tall because Americans were healthy.


Americans were tall because Americans were healthy. “Poor as they were,” notes the colonial historian William Polk, “Americans ate and were housed better than Englishmen.” Sickness and premature death were common, of course, especially outside the privileged circle of white men. Still, European visitors like Tocqueville marveled at the fertility of the land and the robustness of its settlers, the relative equality of male citizens and the strong civic bonds among them. J. Hector St. John de Crèvecoeur wrote in 1782 of the American settler in “Letters from an American Farmer,” “Instead of starving he will be fed, instead of being idle he will have employment, and there are riches enough for such men as come over here.”



The cause of the American height advantage could not have been income alone. According to most sources, the average resident of the Netherlands or England was richer than colonial Americans but also substantially shorter. Indeed, as the United States matched and then surpassed Europe economically in the 19th century, the average height of American men actually fell, recovering back to colonial levels only around the dawn of the 20th century. These ebbs and flows, which played out in other industrializing nations as well, are a reminder that economic growth and population health are not one and the same. (We shall unravel the mystery of their interdependence in the next chapter.)

Nonetheless, Americans remained far and away the tallest people in the world throughout the 19th century, and average American heights rose quickly in the early decades of the 20th century. When the United States entered World War II, young American men averaged 5 feet 9 inches — almost 2 inches taller, on average, than the young Germans they were fighting.



While people know that height is a strong predictor of individual achievement (test scores, occupational prestige, pay), it is also a revealing marker of population health. Height has a lot to do with genes, but height differences across nations seem to be caused mostly by social conditions, such as income, nutrition, health coverage and social cohesion. Indeed, one reason for the correlation between height and achievement is that kids whose mothers are healthy during pregnancy and who grow up with sufficient food, medical care and family support tend to be taller adults. An average U.S. white girl born in the early 1910s could expect to reach around 5-foot-3; an average U.S. white girl born in the late 1950s could expect to exceed 5-foot-5. Evolution just doesn’t happen that fast.



So it’s striking that Americans are no longer the tallest people in the world. Not even close: Once 3 inches taller than residents of the Old World, on average, Americans are now about 3 inches shorter. The average Dutch height for men is 6-foot-1 and, for women, 5-foot-8 — versus 5-foot-9 for American men and 5-foot-5 for American women. The gap is not, as might be supposed, a result of immigration: White, native-born Americans who speak English at home are significantly smaller, too, and immigration isn’t substantial enough to explain the discrepancy in any case. Nor can the growing gap be explained by differences in how height is measured. Though some countries rely on self-reported heights for their statistics — and, yes, men tend to “round up” — Americans look shorter even when the only countries in the rankings are those that, like the United States, measure heights directly.

Americans are not shrinking. (Overall, that is — there is some evidence that both white and black women born after 1960 are shorter than their parents.) But the increase in Americans’ average stature has been glacial, even as heights continue to rise steadily abroad. To really see our lost height advantage, you have to break the population into age groups, or what demographers call birth cohorts. People in their 20s, after all, are as tall as they will ever be. Changes in average height come from changes in the height of the young (and deaths among older cohorts). And, indeed, the adult heights of those born during a given period provide a powerful image of the living conditions experienced by infants and adolescents at the time. The fall in average heights among those born in the mid-1800s, for example, signaled the costs as well as benefits of the country’s industrial and urban shift, which brought increased infectious disease as well as higher incomes, harsher lives for the masses as well as better lives for the elite. (The privileged American men who applied for passports in 1890 were, on average, more than an inch and a half taller than army recruits at the time.)



In general, heights are converging among affluent nations, and the biggest gains have occurred in countries admitted most recently to the rich-nation club. Within countries, younger age groups are generally much taller than older age groups — which makes sense: Older people spent their growing years (including their growth within the womb) in poorer societies with more limited health technology and knowledge. But the United States is a conspicuous exception to these patterns: Average heights have barely budged in recent decades, so young Americans — again, even when leaving out recent immigrants — are barely taller than their parents. Older Americans are roughly on par with their counterparts abroad; younger Americans are substantially shorter. The United States is the richest populous nation in the world. Nevertheless, its young are roughly as tall as the young in Portugal, which has a per capita gross domestic product less than half ours.


On Rankings and Ratings


Because height is a powerful indicator of social and individual health, America’s relative decline should ring alarms. Our young are coming up short — relative not just to gains in stature of the past but also to gains in stature in other rich nations.



Still, if shorter kids were the only sign of trouble, we might safely ignore the alarms. For all but aspiring basketball players, tallness is not an end in itself. It can even create problems: The Dutch have had to rewrite their building codes so men don’t routinely smash their heads into door frames. Unfortunately, America’s journey from tallest to smallish has played out in area after area. When it comes to health, education and even income — still our strongest suit, though we’re holding fewer high cards than in the past — we are falling down the rankings of social success.


When it comes to health, education and even income — still our strongest suit, though we’re holding fewer high cards than in the past — we are falling down the rankings of social success.



We often miss this and not just because triumphant cries of American exceptionalism drown out the alarms. Comparing countries on indicators of social health is tricky, and the temptation to stack the deck is strong. Moreover, our standard statistics frequently understate how poorly the United States is doing at harnessing the combined energies of government and the market. To get an accurate picture, we have to spend a little time sifting through the best available data, separating the meaningful from the misleading. We also have to focus on the experiences most relevant for understanding not how we’ve done in the past but how we are doing now — and unless we change course, how we are likely to do in the future.



Put another way, not all performance assessments are equally valid or instructive. Each year brings scores of scores purporting to rank almost every conceivable object of interest — schools, businesses, cities, states, regions, countries — across almost every conceivable category, from college completion, to wine consumption, to online porn viewing. (For the record, Washington, DC, tops U.S. state rankings in all three.) But sensibly comparing states, countries, or anything else requires following a few simple ground rules. The first is to compare apples to apples. Washington, DC, isn’t actually that comparable to the 50 states because it’s essentially a big city (hence the porn-wine-college trifecta). For cross-national analysis, comparing apples to apples means comparing countries at similar levels of economic development. It also means using indicators that are as close to the same as possible across nations. And it requires transparency: Proprietary data and secret formulas are anathema to serious comparison (but endemic to many special-interest rankings).



So we should compare apples to apples. But which apples should we be comparing? A good place to begin is the three core components of the UN’s Human Development Index: health, education and income. The index captures the idea that development is about “advancing the richness of human life” — to quote its intellectual father, the Nobel laureate Amartya Sen — and not just “the richness of the economy in which human beings live.” The index itself isn’t all that useful for ranking rich nations. It often sets the bar low (can people read and write?), and it’s limited to a few basic indicators available for all countries. Nonetheless, the UN’s pioneering investigations provide a solid jumping-off point for asking how well the contemporary United States is doing relative to other rich nations in fostering citizens’ well-being.



When asking that question, the issue isn’t merely how well we are doing today. It’s also whether we are pulling ahead or falling behind. One data point gives us a level; two or more give us a trend. And, in general, it’s trends that reveal the most about our relative performance. To be sure, we should be careful not to read too much into short-term fluctuations. Nor should we forget that on many metrics, there is a natural process of “reversion to the mean”: Relative to other countries, the highest-performing nations are more likely to fall toward other nations’ performances and the lowest performing to rise toward other nations’ performances.



Still, trends matter most. And that means we should be at least as interested in the direction social indicators are heading (and at what pace) as in their level. It also means we should pay special attention to one particular group: the young. Most cross-national analyses look at countries as a whole, comparing several generations of people in one nation with several generations in another. Sometimes that’s appropriate. If we want to know which countries are good at getting all citizens flu shots, we are interested in national averages. Usually, however, the experience of the young is most revealing, and not just because the young are most affected by current conditions. The young tell us about trends. If, for example, we’re falling behind in getting young adults through college (and we are), looking at the average educational level of the entire population will provide false reassurance. Typically, then, the critical comparisons across nations concern the young. Unhappily, these are also the comparisons where the most troubling image of American performance emerges.



A final issue to keep in mind: Investment (or lack of investment) does not bear its (bitter) fruit immediately. Supporting science, technology and education, for example, reaps big returns. But it takes time — sometimes a long time — to see the payoffs. The high-tech expansion of the last few decades rested on scientific and technical advances seeded more than a generation earlier. The opposite problem arises in cases of deferred maintenance: failing to upgrade critical infrastructure, for example, or to seed technological advances that will blossom in the future. The costs, though real, won’t be fully apparent for some time.


Copyright © 2016 by Jacob S. Hacker and Paul Pierson. Reprinted by permission of Simon & Schuster, Inc, NY.

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