A Gloomy Portrait of Americans’ Health and Longevity

We like to promote our standard of living, but a recent analysis of health and longevity shows that compared with other developed nations, America’s collective health is decidedly suspect, especially for the young among us.

As widely reported last week, including in the New York Times, younger Americans die earlier and have a poorer quality of health than their peers elsewhere.

The U.S. hasn’t fared well for several decades in such comparative studies, but those generally focused on older people. The new one looks at a younger demographic and, as The Times says, “The findings were stark. Deaths before age 50 accounted for about two-thirds of the difference in life expectancy between males in the United States and their counterparts in 16 other developed countries, and about one-third of the difference for females. The countries in the analysis included Canada, Japan, Australia, France, Germany and Spain.”

The study was sponsored by the Institute of Medicine–the independent, nonprofit health arm of the National Academy of Sciences that provides unbiased, authoritative advice to decision makers and the public-and the National Research Council-the academy’s body for promoting the acquisition and dissemination of knowledge in matters involving science, engineering, technology, and health. This study went further than others in documenting all causes of death-disease, accidents and violence-and was based on a broad review of mortality and health studies and statistics.

The panel of experts called our higher rates of disease and shorter lives “the U.S. health disadvantage” that over the last 30 years has ranked the country at the bottom of life expectancy. American men ranked last in life expectancy among the 17 countries in the study, and American women ranked second to last.

In the land of Newtown, Aurora, Tucson and many other scenes of violence, it will surprise no one that among developed countries, the U.S. has far higher rates of death from guns for people younger than 50. Also notable were the mortality numbers for car accidents and drug addiction.

Gun homicide was 20 times higher here than in the other countries; nearly 7 in 10 American homicides in 2007 involved firearms, compared with about 1 in 4 in other countries. The Times quoted one demographer and panel member as saying, “You can blame that on public health officials, or on the health-care system. No one understands where responsibility lies.”

In summarizing the study’s finding, the panel’s leader, Dr. Steven Woolf of the Department of Family Medicine at Virginia Commonwealth University, told The Times, “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it’s getting worse.”

On the disease front, the U.S. had the second-highest death rate from the most common form of heart disease, and the second-highest death rate from lung disease. U.S. adults have the highest rates of diabetes.

We also have the highest infant mortality rate among countries compared. Our youth have the highest rates of sexually transmitted diseases and teen pregnancy. Younger people here die earlier from alcohol and drug abuse than elsewhere.

Possibly most shocking of all is that Americans have the lowest overall probability of surviving to the age of 50. As The Times notes, the report’s second chapter takes four pages to enumerate all the health indicators for youths in which we rank near or at the bottom, including chronic disorders commonly associated with the elderly, such as heart disease.

But even a black cloud allows a little sun to shine through. Death rates from cancers detectable through diagnostic testing, such as breast cancer, were lower in the U.S. Adults were better at controlling their cholesterol and high blood pressure than those in other countries. And Americans older than 75 tend to outlive their counterparts.

What’s to blame for the poor performance? The panel noted that a highly fragmented health-care system, with a large uninsured population and limited resources for primary care were contributors. Not to mention America’s poverty rate, which is the highest among the countries studied.

Education was a factor, but a surprising one. Although Americans who didn’t graduate from high school die from diabetes at three times the rate of those with some college, even the college-educated and high-income earners scored poorly on many health indicators. In the other countries, the study noted, the more widespread availability of health-care programs that hedge against the consequences of poverty.

Then there’s the character issue, which wasn’t really studied scientifically, but which might be a factor in our lagging numbers. Americans are individualistic, and decry government interference (two words here: gun control). We’re also less likely to wear seat belts and motorcycle helmets, which obviously contribute to our higher rates of vehicle accident deaths.

We’re a bigger, more culturally diverse society than most countries, with greater economic inequality. Still, as the researchers note, we spend more, far more, on health care than any other country in the survey.

Clearly, we are not getting value for our money. Is anyone surprised?

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