This report does not deserve the consideration it is obviously demanding. To compare the American population to developed nations dismisses the immigration effects. The U.S. population is not homogeneous. The immigrants would have health characteristics more akin to the country of origin than to the U.S. The study of this health effect is perhaps one of the few times when separating the population by ethnic and cultural characteristics might be justified. More so if the immigrant arrived in the U.S. as an adult.