t's official. for the first time in a decade, the economy is in recession. The longest period of expansion in U.S. history is over. Between July and September of this year, the economy shrank at an annual rate of 1.1 percent. The Labor Department announced that the unemployment rate rose from 5.4 percent in October to 5.7 percent in November.

Recessions inevitably spell trouble for public health, whether in the form of more Americans losing health insurance or growing queues at community food banks. But while our politicians busy themselves devising an economic stimulus package that will lift us out of the recession, this is a timely moment to reflect on our nation's health achievement during the prolonged boom that just ended. It is a dismal record.

For despite being the richest country in the world, our nation ranks 12th overall on 16 different indicators of health status compiled by the Office for Economic Co-operation and Development (OECD)--behind Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, and Belgium. Among specific indicators, we rank 13th (at the bottom) for percentage of low birthweight babies, 13th for infant mortality, 13th for years of potential life lost due to premature causes of death, and 11th for life expectancy at age one for females (12th for males).

To put it bluntly, our nation's health performance has not matched our economic performance. A major explanation for our lamentable health record lies in the huge racial and socioeconomic disparities that persist in this country. For example, an African-American male born in Washington, D.C., can expect to live on average 57.9 years--which is lower than the average life expectancy of the male citizens of Ghana (58.3 years), Bangladesh (58.1 years), and Bolivia (59.8 years). Disparities in health status are in turn mirrored by disparities in living conditions. Even before the economic downturn, 12 million of our nation's children were going hungry each year, upwards of two million individuals were homeless, and 43 million Americans went without health insurance.

It is no secret that the U.S. pattern of economic growth during the past two decades has been a very uneven one. While the rich got richer and healthier (for example, the average life expectancy of an Asian woman living in Westchester County was 90.3 years), the rising tide of prosperity hasn't done much to narrow our health gaps.

If our abysmal international ranking happened in sports rather than health--let's say at the Winter Olympics--there would be a public outcry, and our politicians would immediately pump hundreds of millions of dollars into athletic programs to correct this source of national shame. Now is the time, more than at any other moment in recent history, to root for a stimulus package for our nation's health. I don't mean just investing in bioterrorism response capability, important as that is. As Congress weighs the merits of alternative economic stimulus packages, consisting of tax cuts and spending increases worth billions of dollars, it is time for public health to lend our support to investments that will lift all boats--not just the luxury yachts--and that will eliminate health disparities, thereby improving the health of all of our citizens.