I recently ran across an article about the changes that farmers in China have experienced over the past sixty years. Prior to 1949 most farmers worked as tenants and paid high rents to the landholders. In 1950 the government adopted the Land Reform Law, which gave tenant farmers full private ownership of their land. As a result agricultural production soared.

In 1954, however, private ownership of farmland was rescinded. All farmland came under government ownership and large collective farms, in which the farmers shared equally in the farm income, were set up. Productivity plummeted, food shortages became widespread, and it is estimated that 15 – 30 million people died from famine between 1959 and 1961.

In 1978 a dramatic change took place in China. Most collective farms were replaced by the “household responsibility system” under which individual farmers were assigned a plot of land for which they assumed personal responsibility for the profit or loss resulting from use of the land. Farm productivity jumped 50 % in just four years.

Farmers were not granted long-term leases on the land, however. Fearing that their allotment would be reassigned, farmers did not invest in improving the land and agricultural growth slowed. In 2002 the Rural Land Contracting Law strengthened farmers’ land rights with 30 year leases and provision for land transfers between individuals. As a result, agricultural production in China is again on the rise.

So how does Chinese agriculture relate to achieving optimum health in the United States? A great deal. I am old enough to remember a time when the average American took responsibility for his or her own health. Stated another way, the average person claimed ownership of his or her own health.

Wives and mothers took great pride in preparing a balanced meal for their families. Physical activity was a part of life. Men were engaged in yard work, women in household chores and gardening, and children routinely engaged in activities such as jumping rope, playing, and riding bicycles.

Steps were routinely taken to minimize the likelihood that an illness requiring a trip to the doctor would occur. My mother’s favorite strategy was to top off our breakfast with a tablespoon of cod liver oil on the way out the door. I hated the taste, but knowing what I now know about the role of vitamin A in decreasing the frequency and severity of viral illnesses I have to admit that the tactic was sensible and reasonable. My father followed the advice of Ted Mack and took a dose of Geritol each day.

Just as Chinese agricultural productivity soared in the early 1950s due to the farmer’s ownership of the land, Americans’ personal ownership of health care resulted in one of the highest levels of wellness ever achieved by a society. The community of my childhood was populated by people who were active and productive, regardless of their age. Nursing homes existed, but I did not know anyone who was living in one. In 1954 there were only 260,000 nursing home beds in the United States. Only 2.1 % of individuals over the age of 65 were nursing home residents.

In the closing decades of the twentieth century, however, Americans saw the ownership of their health transferred to impersonal corporations. The leading question in the minds of most changed from “What can I do to stay healthy and avoid a visit to the doctor?” to “Is this covered by my insurance?” Ownership of the diet passed from mothers to manufacturers of packaged foods and owners of fast food franchises. More and more homeowners hired yard service companies to maintain their property and children’s games changed from hopscotch and baseball to Barbie and Nintendo.

The effect of the corporate take over of health care in the United States was as devastating as the effect of collective farming on the Chinese economy. According to the 2000 census report, the percentage of people over the age of 65 living in nursing homes was 4.5 % - more than double the percentage of individuals in 1954. Today there are over 1.8 million nursing home beds in the United States.

This year over 1.5 million people in the United States will have a heart attack, something that can be prevented by almost everyone who assumes ownership of his or her own health. Over half of all Americans over the age of 65 spend every day in pain, much of which could have been prevented had they simply retained ownership of their health care.

I know this to be true because I see two distinct populations of people in my office. One group consists of individuals who have applied for disability through the Social Security system. Almost to a person, they have given up ownership of their health. They view their condition as inevitable and irreversible and they see them selves at the mercy of the medical profession, the government, and the insurance industry.

While some individuals applying for medical disability have suffered irreversible structural damage to their bodies in accidents, the vast majority have conditions that developed as a direct result of their failure to take personal responsibility for the maintenance of their health. Many could still be helped if they were to reclaim ownership of their health care and seek ways to improve their health status.

The other group of people I see consists of individuals who have made a decision to take ownership of their health. They are determined to do whatever it takes to restore and maintain their health without regard to whether their doctor approves of their actions or whether their insurer is willing to pay. They are anxious to explore their options and they refuse to blindly accept the opinions of physicians on the subject of their health. They are determined to get well and they almost always achieve their goal.

My observation that people who take ownership of their health care fare far better than those who turn health care decisions over to others is supported by several recent studies on what is being termed “health literacy.” Health literacy refers to an individual’s ability to obtain, process, and understand basic health information.

Individuals who are classified as being health literate are 50 % less likely to die at any given age than their peers who are health illiterate. Those who are health illiterate are over twice as likely to be hospitalized as persons who are health literate. Research is showing that health literacy is a stronger predictor of a person's health than age, income, employment status, education level or race.

Becoming health literate is the first step toward taking ownership of one’s health. As important as it is to be able to read and understand basic health instructions it is even more valuable to question the validity of those instructions. When you begin to regularly ask the question, “Is the course that has been recommended the one that is most likely to restore and maintain my health?” you are on the way to achieving an ever higher level of personal wellness, just as the farmer who has taken ownership of his land is on the way to improving its productivity. You are about to leave the years of declining health behind and enjoy increasing vitality with each passing year.