Perhaps it's not the best time and place to contemplate mortality, but as you wait to board a flight at the airport in Sacramento you are likely to see an advertisement on the wall that will make you stop to think about exactly that.

The wall poster makes the statement that how long a person lives shouldn't depend on where he or she lives, but it does. And it cites this striking example: The life expectancy for someone who lives in Stockton (95202) is 73 years. The life expectancy for a person in Irvine (92606) is 88 years.

Think about what you were doing 15 years ago and all that has happened since.

Now, wipe it from your memory. That's the difference between dying at 73 and living to 88.

The ad, placed there by the nonprofit health advocacy group the California Endowment, illustrates how it can be simultaneously true that America has the most advanced medical facilities on Earth and also one of the lowest life expectancies in the industrialized world.

Great medicine, lousy health care system.

The focus of the endowment's awareness campaign is to promote its "Health Happens Here" initiative, designed to improve environmental conditions in unhealthful neighborhoods by doing such things as creating safe parks so that children can run and exercise, improving access to fresh produce and healthy foods, providing clean drinking water and unpolluted air.


Advertisement

"Most of what determines our health is not medical intervention," the endowment's senior vice president, Daniel Zingale, told me this week. "Added years of life are mostly attributable to the environment."

It should not be surprising that the top-two items on the organization's list of factors that contribute to a healthy community environment are these: "Secure health coverage" and "Family-centered schools and doctors and nurses who promote preventive health."

And that is why Zingale was leading the cheers in California over the U.S. Supreme Court's decision to uphold the Affordable Care Act, which analysts say will ultimately result in about 92 percent of Californians having insurance that will provide them with ongoing access to health care.

He called it "the greatest legal victory for America's health in our nation's history."

Those whose professional lives are focused on health do not view the Affordable Care Act through a political prism. Peel away the politics, and what they see is a road map to a healthier country.

"There is a tremendous amount of confusion over all the partisan bickering," Zingale said. "Health should rise above that."

The California Endowment last week -- implementing what Zingale called "Scenario A" among three plans of action that depended on the outcome of the Supreme Court decision -- began publishing more than $100,000 in print advertisements promoting the benefits of the Affordable Care Act and ramped up a multimillion-dollar television advertising campaign.

"The more people know about the ACA, the more they like it," Zingale said, noting that the decision creates an opportunity for those who value its health benefits to do a better job of explaining what they are.

"An aspect we really treasure is it begins to focus on preventive care," he said, noting the act's provision that requires health plans to cover such things as annual checkups, vaccinations and mammograms with no deductibles or copays.

"More than 6 million Californians have already taken advantage of preventive provisions," he said. "The more people who do that, the more money we save."

C. Duane Dauner, president and CEO of the California Hospital Association, last week told reporters what it would mean if most of the estimated 7 million Californians without health insurance obtained it. "They don't get health care on an ongoing basis," he said. "We need to get them into a system of care. We want people to be healthy and to manage chronic conditions."

Providing preventive care. Managing chronic conditions.

How many lives can be extended by detecting and managing hypertension or elevated cholesterol? By screening for and discovering early breast, prostate and colon cancers? By controlling diabetes? By counseling people about the health dangers of obesity? By treating kidney disease before dialysis is required?

Zingale acknowledges that the most important message in promoting the health benefits of the federal law is to appeal to people's self-interest, but says there is more to it than that.

"The first thing you have to do is let people know what's in it for them and their families," he said. "At the same time, it is important for people to know that when it comes to health, we have a shared interest. We're all in the pool together."

Timm Herdt is a columnist for the Ventura Star.