Why are Americans getting shorter?

Americans are getting shorter. Average height has been in decline since about 1980. What’s causing that and why does it matter?

In the 1800s, Americans were the tallest people in the world.

But in the 1980s, average American height began shrinking.

Today, American men stand at 47th in national height rankings. American women rank 58th. So what?

"Height is an overlooked indicator. It has effects that are important from the point of view of human welfare," Professor John Komlos says.

Komlos says changes in average height reveal a lot about how well a society cares for its children. For example, look to the tallest people on earth — in the Netherlands.

Today, On Point: Why are Americans getting shorter?

John Komlos, professor emeritus in economics and economic history at the University of Munich in Germany.

Majid Ezzati, professor at the School of Public Health at Imperial College London.

Jörg Baten, professor of economic history at the University of Tuebingen.

Gert Stulp, sociologist at the University of Groningen.

Carolina de Weerth, professor at Radboud University Medical Center.

Part I

MEGHNA CHAKRABARTI: This is On Point. I'm Meghna Chakrabarti. Back in the 1800s, Americans were the tallest people in the world. On average, at least. And unfortunately, that form of American exceptionalism is long gone. Nowadays, the average height for American women ranks 58th in the world. Men, 47th. And in fact, the decline in average height for Americans has been going on for quite some time.

So what exactly is going on? What is manifesting itself in American bodies? That's what we're going to talk about today. And joining us now is John Komlos. He's one of the pioneers of the study of population height and what it reveals about society. And he's a professor emeritus in economics and economic history at the University of Munich in Germany.

Professor Komlos, welcome to On Point.

JOHN KOMLOS:  Thank you very much. It's a pleasure to be here.

CHAKRABARTI: First of all, tell us, you've been, you're the leader, if not one of the leaders of the study of height and populations. What actually attracted you to this field, first of all?

KOMLOS: Height is a very important indicator of how well the human organism thrives in its socioeconomic environment.

And it is particularly important because it pertains to children and youth on whom we do not have many economic indicators. As economists, we use indicators like money, income, GDP per capita and so forth, but these indicators do not pertain to children and youth. And therefore, I thought that we needed an additional indicator for this group in the population, and it's very important.

What happens to the human organism during the first 20 years of life, and it's important to know that it's the first 20 years. And what happens after that is a different story.

CHAKRABARTI: Yeah. Okay. So before we get into what's been happening here in the United States, I'd love to know about how far back does your data go in terms of average population for various countries?

There's archaeological evidence, and that is something that I have not dwelled into. I use written evidence, archival evidence, and that goes back to the early 18th century when the French military began to measure the height of soldiers. And that, of course, means that it pertains to the birth cohort of the late 17th century. From then on, we have all sorts of different data available to us. Military records, West Point cadets, civil war soldiers, runaway slaves, runaway indentured servants, on which there were advertisement in newspapers that could be collected and schools that recorded the height of students. So there are the whole passport applicants, a whole bunch of different records.

CHAKRABARTI: Can you tell me more about those early military records?

How did, it sounds like there's a somewhat of a detective story here too. How did you find them?

KOMLOS: Many of these records are in archives and they're not easy to find. And even when you do find them, they're not easy to work with because they haven't been looked at for sometimes, 200 or 300 years.

And it takes a little bit of, it's very dusty and the writing is not always easy to decipher. So it was a bit of a detective work, and it took some while to collect hundreds of thousands of data.

CHAKRABARTI: Okay. I'm sticking with history here for a moment because I want to understand if there's a pattern that we've been seeing for several hundred years in terms of what has an impact on adult average height.

Were there differences amongst groups that were evident, let's say, in the 18th and 19th centuries?

KOMLOS: Oh, definitely. Definitely. One important pattern is that social status is always and everywhere an important indicator. Because people who are better off are taller. So the aristocracy, for example, is taller than the average height.

Students are taller, usually than the average height. Passport applicants in the 19th century U.S. are much taller than the average. Because they were from the better off segment of the population. Yes, that is one important aspect. The other one is that economic transformation always leaves an imprint on the human body.

So the advent of agriculture, for example, during the agricultural revolution, meant that for a while people became shorter. Because their protein supply declined, population density was greater. And that left an imprint on the human body. The same thing with the industrial revolution, the same thing with the onset of modern economic growth.

And it appears that within the last few decades, the advent of the knowledge economy also meant, also has the same pattern that the American population's height either stagnated or declined for similar reasons.

CHAKRABARTI: This is remarkable, professor.

KOMLOS: Yes.

CHAKRABARTI: So you're saying that economic transition leaves a mark on the human body.

All the transitions that you described, though, the idea, at least, in capitalism is that they lead to efficient, more productive economies. But I didn't hear you describe a positive impact or a positive mark on the human body.

KOMLOS: It's a more productive economy, let's say, with the industrial revolution, definitely.

But the people who are working in cities are not making sufficient amounts of money to be able to afford food, nutrition at the same rate as they did when they were living near to the food supply. And closer to the animal products that were being produced. So population density has a very important role to play.

Urbanization has a very important role to play, because food is more expensive in an urban environment. So that is why it is so important to consider diet, because it pertains again to children and youth who are not earning an income, and yet the parents very often have to pay a higher price for the nutrition.

Even though the economy may be more productive.

CHAKRABARTI: Yeah. But of course, to state the obvious, the lower incomes earned by industrial era, Industrial Revolution era workers or let's say the larger fraction of their income that they had to spend on food, that didn't just happen by accident, right?

Someone was setting their wages.

KOMLOS: Yeah, exactly.

CHAKRABARTI: No, go ahead, if you wanted to respond to that.

KOMLOS: No the same thing happens in America. American population in the 1840s, birth cohort, let's say, has an incredible amount of food supply available to it relative to Europe. And Americans are taller than Europeans by a couple of inch.

But at the same time, urbanization in the 1840s is proceeding at such a rate that food prices increase, and as a consequence, the population's height declines. It's an incredible story.

CHAKRABARTI: So you're seeing that strong correlation regardless of what essentially historical era you're looking at.

There's one more thing, though, about the 18th and 19th centuries, particularly in the United States, that I wanted to ask you about, in terms of where you got records from and what it shows. Because, of course, the slave trade was quite active at that time. And if I understand correctly, it involved, if not some, then quite a bit of detailed record keeping. Because, of course, those enslaved people were considered property and commodity to be traded, and those things are very carefully tracked.

Did you find data from that section of American history?

KOMLOS: Yes, actually, somebody else studied that data set, it pertains to the cost wise manifests, because slaves that were traded, their height were recorded on account of the fact that they had to be documented that they were actually American slaves and not imported slaves, because imports were no longer allowed.

The height of slaves was measured, and it's extremely important to know that they were, of course, shorter than American ones. Because obviously their nutrition was not as good, but they were taller than those who they left behind in Africa, which means that the American nutritional environment was much better than what was available in Africa.

So that's an interesting realization.

CHAKRABARTI: Okay. We're headed towards the break here. We have about 30 seconds left Professor Komlos. Do you mind if I quickly ask you, you're free not to answer this question, but I'm just curious.

KOMLOS: Okay.

CHAKRABARTI: How tall are you?

KOMLOS: I'm 5'7.

CHAKRABARTI: You're 5'7. We're the same height.

KOMLOS: Okay. 5'7. But you have to take into consideration that I was born during the Holocaust in Hungary in 1944. So my nutrition in the womb was not particularly good. I'm two inches shorter than my father.

CHAKRABARTI: I see. So that gets us again to this truth that your receipt research has revealed. That circumstances, environment policies do imprint themselves literally on our bodies.

Part II

CHAKRABARTI: Before we get back to our examination of what's going on in the United States, I want to look to another period of time in another country for an example about how we have seen rapid changes in average national height before, but in the other direction. Because today, Dutch men and women are the tallest in the world on average. They've held that position as number one in height for a couple of decades now, but it wasn't always. Dutch men born in 1930 were about 5 foot, 9 inches tall on average.

Women, 5-foot-5. But just third, excuse me, but just 50 years later, men born in 1980, in the Netherlands, grew to a remarkable six feet tall on average. Women, 5 foot 7. Now that quick rise came after 1945, because prior to that, during World War II, the Netherlands suffered severely under Nazi occupation.

Very little food, and the winters were long, and all children started to suffer from malnutrition. God knows I know the value of food, and I was suffering from rather high degree of malnutrition when the war ended.

But as a child and considering that you had very little food and you say you were malnourished, what sort of dreams of food did you have or little fantasies?

Oh, we, that was a great topic of conversation of what we were going to eat when the war ended. And it usually had lots to do with bread, butter and lots of jam or something. Very sweet things or whole boxes of chocolate. And in fact, I think, one of the first things I did was eat a whole can of condensed milk and then was terribly ill afterwards.

Sweet things is what I longed for.

CHAKRABARTI: Now that happens to be legendary actress Audrey Hepburn. In a 1988 interview with the British talk show Sunday, Hepburn spent much of her childhood and all of her teen years growing up in the Netherlands, which means she and her family lived through the Dutch famine brought on by the war.

Food was so scarce, Hepburn's family, like many others in the Netherlands, resorted to making baking flour out of tulip bulbs. So of course, that scarcity took its toll. The average height of Dutch children fell temporarily as a result of the war. But after Allied forces defeated the Nazis, independent Netherlands achieved a meteoric rise in average height.

Economic historian Jörg Baten says that's thanks to two related factors. One, the Dutch had, in fact, been getting taller before World War II.

JÖRG BATEN: There was a revolution taking place in the late 19th century in the Netherlands, as well as similar countries, but most extreme in the Netherlands, that we see a strong increase in agricultural productivity.

So basically, it was the new fertilizers.

CHAKRABARTI: So those new cheap fertilizers allowed the densely populated Netherlands to produce more food from its limited agricultural land, particularly certain forms of protein.

GERT STULP: So we basically love milk and cheese.

CHAKRABARTI: That's Gert Stulp, a sociologist at the University of Groningen.

He says the Netherlands has one of the highest rates of dairy consumption. And of course, that was severely interrupted in World War II, which I want to just emphasize again. But that high rate of dairy consumption appears to be good for children's growth.

STULP: And these effects can be massive. We know, particularly from milk, there have been many studies that if you consistently drink milk across your entire childhood that this can add up to so much as two or three inches later on.

CHAKRABARTI: So the Netherlands produced and consumed a lot of milk. But other countries also increased protein consumption during the 20th century, thanks to more efficient agriculture. So the Dutch aren't alone there.

What's special about the Netherlands is the social safety net that post war Netherlands created, which according to Jörg Baten, helped make the Netherlands one of the most egalitarian countries in the region.

BATEN: They invested very much in, for example, into school milk programs, which helped to make the Netherlands the tallest nation in the world after the 1950s.

The situation became very different, even for low-income groups. Because they received this nutrition for free in school and then the whole population increased to these abnormally high height levels.

CHAKRABARTI: He calls it abnormally high, but it's the norm in the Netherlands. Now, it's not just school nutrition programs.

It's also, you guessed it, health care. The Netherlands has had a national health insurance program since the Second World War, says Gert Stulp.

STULP: And in the Netherlands, everyone gets the same. It's free. It's always free. You can walk to a doctor at any time and to a hospital. So in that sense, the barriers there are definitely less than in other countries.

CHAKRABARTI: And one part of the Netherlands health care system that may be particularly important when thinking about average adult height is the support that families get around the time of childbirth. That's according to Professor Carolina de Weerth at Radboud University Medical Center.

CAROLINA DE WEERTH: The perinatal care in the Netherlands is quite special.

You see the midwife around 13 times during pregnancy. You get two echoes and around three times postnatally, post-delivery.

CHAKRABARTI: Also postpartum, a service that seems like a total godsend for new parents.

DE WEERTH: Another thing that's also covered by your health care is having what we call a  kraamverzorgende and this is a very important professional.

It's like a maternity care and she comes to your house for 10 days after the delivery and she takes care of the mother, checks on her that she's healing well, controls the baby. To see that he's healthy and also helps the mother, learn to breastfeed, to bathe the baby, to change the baby, so all kinds of practical issues.

CHAKRABARTI: The maternity caregiver comes to the home of new parents for 10 days, up to 8 hours each of those 10 days. To help the family get off on the right track with feeding, hygiene, and health, even cook a meal, do dishes, or babysit older siblings. Overall, de Weerth says perinatal care in the Netherlands creates a sense of calm in what might otherwise be amongst the most stressful times in someone's life.

DE WEERTH: And we know that stress during pregnancy, the same as unemployment, or financial struggles in general, they all lead to smaller babies. If we're talking again about height and growth, I think that having a baby with less stress, anxiety, depression contributes to taller children later on.

CHAKRABARTI: Now, the study, or one of the major studies for heights for people in the Netherlands is conducted by the Netherlands Central Bureau for Statistics.

And recently that Central Bureau for statistics found that after a period of stagnation, there's now been a clear contraction in the height of Dutch men and women. Dutch men born in 2001 are now on average, one centimeter shorter than the generation born in the Netherlands in the 1980s, and Dutch women are 1.4 centimeters smaller, so some reduction in stature there as well. But that brings us back to the United States and the change that we've seen here, also since the 1980s. Professor Komlos, stand by for just a moment because I want to bring Majid Ezzati into the conversation. He's professor at the School of Public Health at Imperial College London and he's with us from London.

Professor Ezzati, welcome to On Point.

MAJID EZZATI: Thank you. Good to be on NPR always.

CHAKRABARTI: Okay, so obviously with the example of the Netherlands, there's several public health issues that we should talk about here. You've done some global studies on height. Do you see similar either increases or reductions in average stature depending on let's say policy changes in various countries?

EZZATI: We do see, we certainly see remarkable increases. Netherlands was mentioned in the 20th century. Since then, this has been happening in some countries in central Europe, places like Montenegro are by any standard now, indistinguishable from the Dutch. And then on the other side of the world, South Korea, more recently, China they have had remarkable increases.

So the increases we see. On the decreased side, they tend to be more rare, fortunately. The United States actually hasn't really decreased in height. It has dropped in rankings, but it has been stagnating for a few decades. So in some ways you can say that things have stagnated there. Other countries have done much better and the U.S. is falling farther behind because things are, things have stopped getting better. We have seen decreases elsewhere, in some countries in Africa, unfortunately, during the '80s and '90s. Perhaps because of certain economic policies around structural adjustment and the fact that actually the people who most needed the food weren't getting the food, we have seen declines, but fewer of them than we have seen increases, fortunately.

CHAKRABARTI: Okay, so we should just get some numbers out specifically about the United States. We're not talking about people being half a foot shorter, right? We're talking about people on average having shrunk, what, four tenths of an inch off the highest average height we had. Is that correct?

EZZATI: It depends on the exact sources that you look at. And we should remember that all of these sources have a level of uncertainty on them. John Komlos mentioned some of these, some of these uncertainties. Who is being measured, who is not and who takes part in a particular study.

So when we take all of these, I think for all practical reasons, we would say that actually the U.S. is indistinguishable from a stagnation. Whether it's 0.3 centimeters, so that's maybe a tenth of an inch taller or two tenths of an inch shorter. It's hard to say, because there is always a bit of noise in the signal that we are looking at.

So we call it a stagnation as others are improving, in everything we have been doing since around 1985.

CHAKRABARTI: I see. Okay. Professor Komlos, let me go back to you on that. And first of all, I'm just referencing sort of one of the most recent compilations of some of the data coming from the Washington Post. And they got interested in this because they were actually looking at if there's a pattern that they could detect regarding average height in various professions as because they quoted you actually in their article. But one of their analyses shows that for people, let's say for women, American women born in 1950. When they reached adulthood, average height for American women was 5 foot 4.

5'4 or 5'4, 6 I should say. Then, for people, for women born around 19, between 1970 and 1975, average adult height peaked to just under 5 foot 5, or 5 foot 5 inches. And now the thing is that for people born in the '80s and '90s, for women, average adult height is now back to 5 and 5 foot, 4.6 inches.

So back to, you know, what it was for folks born in the 1950s, and I'm just trying to describe this so that people know exactly what we're talking about. When we look at men. Men born in the 1950s in the United States, average height was look like 5 foot 10, I think 4 inches, according to the Washington Post.

These are white Americans. Let me, I forgot to mention that. That's very important. These are white Americans. And then but now for folks who were born in the '80s or '90s, that's dropped again now to less than 5 foot 10. 6 inches. I think overall average American men are 5 foot 9 when you count for all races.

Okay. Professor Komlos. What's going on in the United States? In the 80s, that we can attribute to this, both of the curves curve downward.

KOMLOS: It's very interesting that 1980 is exactly the moment when American life expectancy begins to fall behind its European counterparts. It's still increasing, but it is increasing at a slower rate. So it's very important in order to underline the fact that the human organism is not doing as well in its economic environment as it did previously.

And that is also the beginning of Reaganomics. It's the beginning of an incredible rise in inequality, a new ideology in the administration that puts more emphasis on individual agency and less on public service. And as a consequence, the American health care system becomes the most inefficient in the world.

Okay. That's a very strong statement, but you have to take into consideration that Americans spend twice as much as Europeans do on health care and get two years less life for it. And that's the classic definition of inefficiency. So you have an incredibly inefficient health care system.

And then you have the problem of the kinds of food that people, and unfortunately to a considerable degree, it has become a habit to have prepared food, which is less healthy than homemade fresh food. And as a consequence, there is a beginning of the obesity epidemic.

That's another thing to consider. So all these put together indicates that children and youth are not getting good nutrition.

CHAKRABARTI: Yeah. And by the way, we've done several shows on childhood obesity in particular and policy plays a role there too. Because in one of the shows we featured how some aspects of the Farm Bill, the major farm bill from the 1970s basically pumped more high fructose corn syrup into the American food system.

That was a policy choice made in Washington, which then contributed to what would soon become the obesity epidemic. But Professor Ezzati, on that, is there a relationship between greater rates of obesity and overall height?

EZZATI: There absolutely is, and there are two reasons for this. One is the food issue. That again, John Komlos alluded to. It's easier to eat things that are not healthy.

And it's much harder to eat things that are healthy these days. And the U.S. is to some extent in the industrialized world an extreme of it, but it's happening elsewhere, everywhere. Some of that are things that were bad policies. Some of it is just general direction of economics and technology that weren't managed.

They weren't prevented. So as Professor David Cutler from actually Boston has stated, it's just really easy to get chocolate chip cookies. Whereas in the past it was very difficult to do that. And whereas it's much harder to get to get lean meat. It's harder and more expensive more expensive to get a low-fat dairy and all of the things that are good for us.

Part III

CHAKRABARTI: Professor Ezzati, I just want to have you describe briefly what actually is the physiological connection between increased obesity, and particularly childhood obesity, and how that may, how that physiologically determines, contributes to the final determination of height.

EZZATI: Sure, so there is the food aspect, and then there is the biology, the physiology, and the physiology goes both ways. So being shorter, any amount of weight that's gained actually leads to more obesity. Obesity is a measure of how much a person weighs for their height, and there is actually increasing evidence that when growth in the first few years, is stunted.

Not only there is more obesity, but it's actually more detrimental obesity because of where fat accumulates. But on the other side of this, there is also work that shows that as obesity increases when children get to the adolescence and to the growth spurt that they have that, it affects either the rate at which they are growing taller or the final height.

And so you can imagine this as a as a circle that can be either a virtual circle, growing tall early gaining less weight and less unhealthy weight, and then growing tall after that, or going the other way. And both the nutrition and biology go hand in hand together.

CHAKRABARTI: We've been seeing that perhaps more evident in young girls, that there's been a growth in early onset puberty, for example. Is that what you were talking about in terms of height determination?

EZZATI: It is. So studies actually coming from Boston started to look at initially people who, girls initially who, who gain either too little weight potentially, these were ballet dancers, or perhaps too much weight for their height and for their age. And it seems to affect the age of puberty and again, both the onset of puberty and the growth spurt that comes after it and how much that growth is goes hand in hand with the height, weight, obesity relationship.

So yes, the onset of puberty and the amount of growth spurt.

CHAKRABARTI: Okay. So Professor Komlos, I think in order to do an appropriate analysis here, we have to talk about potential contraindicators, if I can put it that way. And, the data is being collected about as many people as possible.

And of course, in America, we have a multiethnic diversity here. So what does immigration or immigration have anything to do with the slight reduction or stagnation of average American adult height?

KOMLOS: No, because immigrants are not included in the sample. So these results pertain only to people who were born in America.

CHAKRABARTI: Okay. But could, but I'm wondering if they could be, have, does it matter that they, many of them were born to parents who are immigrants? T

KOMLOS: hat was also true in prior decades, that we had a lot of immigrants in the 19th century, early 20th century, and the second generation was able to do quite well.

So I don't suspect this to be a big problem. I did one study on second generation Americans, and they did not show a significant difference from the rest of the population.

CHAKRABARTI: I see. So what really matters is that they were born, people who were born here and grew up here. Spent their childhood here.

KOMLOS: Exactly. Exactly.

CHAKRABARTI: Okay. Is there any evidence Professor Ezzati, that let's see, these early impacts, obesity, stress, other privations of different kinds. Can they be overcome let's say in, during the teen years if they are overcome? Can people get back on track to the height they might have been?

EZZATI: We hope so. And the evidence seems to indicate it. In fact, it would be a rather depressing world to say that, "Look things happen during the fetal period or in the first few years of life, and then there is nothing we can do about it." And the other side of it would be that if that really didn't matter, we would say it's free for all after five years of age.

And we don't say any of those, and we don't say any of those for good reason. So things both can go backwards in older childhood and adolescence. There are places in the world that things do just fine for the first three, four years of life. And then they start falling behind because the school meal programs are not good, because adolescent care isn't as good, and there are occasionally places that they do catch up and countries that their ranking becomes good.

The first, what is called the first thousand days, so the fetal period and the first couple of years really matter. But so does the next 17 years or 18 years after that. And there is a chance to recorrect and readjust whether it's all of the things that have been missed or some of it we don't know, but there is a chance in those later years.

CHAKRABARTI: Okay. So bottom line, what is emerging here, and Professor Komlos, he pretty much said it as clearly as possible, is that our bodies are, they demonstrate the impact of the policies and the decisions made about how to run a nation, right? They show the effectiveness or lack thereof of those policies.

KOMLOS: It's a record. It's a record.

CHAKRABARTI: Yeah, and so here we have in the United States, especially since that 1980s inflection point is so important to understand, we have an era in which Reaganomics came in. There was a tight embrace of free markets for many working class Americans. Their wages subsequently stagnated for a long period of time.

KOMLOS: A profit oriented medical system.

CHAKRABARTI: Yep. Changes in the food supply, reduced access to health care for many Americans because of those increased costs and lack of even local hospitals. Much higher stress in younger ages of life, family stress. And then you said that's the same time life expectancy didn't keep up with peer nations.

We have the rise in the obesity epidemic and now a reduction or stagnation in height. You're describing a completely sick people, but made sick by politics, by the policies enacted supposedly on their behalf, Professor Komlos.

KOMLOS: Exactly. History is not going to judge us very kindly.

CHAKRABARTI: Can it be undone?

KOMLOS: Of course, it could be undone, but I do not see a lot of political will to do.

CHAKRABARTI: What would you, your note about the challenges of getting things done in the United States is appreciated, but where?

KOMLOS: We can't pass a budget. We're not going to change the medical system, right?

CHAKRABARTI: Except under duress, because there were major pieces of legislation passed during the pandemic, right? We had a year where people had --

KOMLOS: Yeah.

CHAKRABARTI: Yes. So maybe kids born --

KOMLOS: That would have been, and that would have been an opportunity, a missed opportunity.

CHAKRABARTI: Tell me more. Go ahead.

KOMLOS: I guess to make these kinds of big changes, you would need to have a crisis situation, right? Like we did during the financial crisis, then the financial crisis, we could put the economy on a different track. The same thing under COVID, but there was not the ideological willpower to do so, to copy. All you have to do is copy what the Scandinavians or Netherland or Western European welfare states did for the medical system and for the food chain.

These are two very important issues. And we haven't mentioned inequality yet, inequality in the United States is the highest among, also among the peer nations. So the development of height also reflects the development and inequality. Because nobody's going to become taller because Jeff Bezos was able to buy a $400 million yacht for himself, that's not going to translate into less expensive drug prices.

CHAKRABARTI: Well, Professor Ezzati. I'm hearing very carefully what Professor Komlos is saying and it is a little disheartening to hear that it will, the policies were put into place, but the undoing of those policies is what may change the trajectory here. But it's not just in the United States.

I'm understanding that this issue about lower stature has also become a political issue in the UK.

EZZATI: It has in the past two or three weeks, the issue of the UK falling behind its peers, lagging the United States by a couple of decades, but mirroring that is very much in the news here also. I must say just, so I tend to agree with John Komlos, that there is massive political forces.

We should also remember that nations and including the U.S. and the UK have room for innovation, it still takes a political will, but when we look at incredible improvements in the past few decades in places like Japan, Korea, and China that it really was through innovations in delivering good nutrition and good services to people, while there is still a whole set of other social problems happening. So I hope we deal with the fundamental issues. But at the same time, as we do that, things like a school meal programs, things that are on good antenatal care.

These are things that I hope are easier as nations to agree with. That look, how could we leave alone young children and let them just be on their own. At least we should be doing that as we deal with, again, with much broader social and policy debates around economics of a country.

CHAKRABARTI: Yeah. Okay. Speaking of examples and innovation, you mentioned Korea. I'm seeing that a century ago, the average South Korean woman. This is, again, a century ago, was about 4 foot 7. A hundred years later, they're on average 8 inches taller. So 5 foot 3, a huge eight-inch growth on average.

South Korean men now are on average, six inches taller than they were a hundred years ago. So do you have more information, Professor Ezzati, about what kind of innovative things the Koreans have done? Because especially, I'm imagining that most of this increase in growth. What, did it take place after the Korean War?

Because the nation went through so much pain and violence and disruption prior to that.

EZZATI: That's correct. So post Second World War in Japan and then post Korean War in Korea. Korea is actually really interesting because they have also had some of the largest increases in life expectancy. So just about many, everything has gone well for health.

And we should remember, it is a country that actually has moderate to large economic inequalities. There are the large industrialists and then there are the people who work in it. Nothing in the same level as the United States or the UK. But it has large inequalities. What Korea has been remarkable and our colleagues in Korea who have been working on this global work with us say that what they have been remarkable has been actually what we call absorbing new knowledge and using it to put in place programs.

So Korea has been very good in early childhood nutrition, while there are social inequalities, trying to get good nutrition to schools. Korea has been really good in actually keeping the healthy aspects of traditional diet. Diets that are high in vegetables. And then add to it, providing proteins without doing all the things that include obesity.

So there are institutions in place that absorb science and turn that into action. And that action happens against the backdrop of economic and political debate that's still happening in the country and in some ways that kind of a policy innovation and intervention innovation is the other thing that the United States used to be at the forefront of, and as we saw during the pandemic, increasingly has actually been lost.

CHAKRABARTI: Professor Komlos, we only have a minute or two left here in the conversation. And earlier in the show, when I asked you how tall you are, you very graciously told us. But also, you mentioned that your childhood was spent in wartime Hungary, correct?

KOMLOS: Yes, that's correct.

CHAKRABARTI: I wonder what it makes you think that many American children today are living lives that have shades of similarity to the kinds of stresses that you experienced during the Second World War, even though the United States is not in wartime and is ostensibly the richest country in the world.

KOMLOS: Yes, that is the immense contradiction. That you have an incredibly rich country in which a considerable segment of the population is not thriving and all kinds of indicators. It's not only high. That's not only life expectancy. It's also school performance, suicides, mass murders, all sorts of things are going on here that should not be going on in a very rich country.

And that just indicates to me that the policies, the institutions that are in place are not adequate for a humanistic perspective.

CHAKRABARTI: I think if, given the fact that we as Americans are not standing so tall physically anymore, even though we like to say as a country that we're always standing tall, that contradiction in and of itself means that we deserve to closely examine why that is.

And I hope this hour helped us do a little bit of that.