Analysis: Life in U.S. can be hazardous to your health
The panel of experts called the pattern of higher rates of disease and shorter lives among Americans younger than 50 "the U.S. health disadvantage."
The New York Times
Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.
Researchers have known for some time that the U.S. fares poorly in comparison with other rich countries, a trend established in the 1980s. But most studies have focused on older ages, when most people die.
The findings were stark. Deaths that occur before age 50 accounted for about two-thirds of the difference in life expectancy between males in the U.S. 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, Germany and Portugal.
The 378-page study by a panel of experts convened by the Institute of Medicine and the National Research Council is the first to systematically compare death rates and health measures for people of all ages, including U.S. youngsters.
It went further than other studies in documenting the full range of causes of death, from diseases to accidents to violence. It was based on a broad review of mortality and health studies.
The panel called the pattern of higher rates of disease and shorter lives "the U.S. health disadvantage," and said it was responsible for dragging this country to the bottom in terms of life expectancy over the past 30 years. U.S. men ranked last in life expectancy among the 17 countries in the study, and U.S. women ranked second-to-last.
"Something fundamental is going wrong," said Dr. Steven Woolf, chair of the Department of Family Medicine at Virginia Commonwealth University, who headed the panel.
"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."
Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50.
Gun violence is just one of many factors contributing to lower U.S. life expectancy, but the finding took on urgency because the report comes less than a month after the shooting deaths of 26 people at an elementary school in Newtown, Conn.
The United States has about six violent deaths per 100,000 residents. None of the 16 other countries included in the review came anywhere close to that ratio. Finland was closest to the U.S. ranking, with slightly more than two violent deaths per 100,000 residents.
The rate of firearm homicides was 20 times higher in the U.S. than in the other countries, according to the report, which cited a 2011 study of 23 countries. And though suicide rates were lower in the U.S., firearm suicide rates were six times higher.
Sixty-nine percent of all U.S. homicide deaths in 2007 involved firearms, compared with an average of 26 percent in other countries, the study said.
"The bottom line is that we are not preventing damaging health behaviors," said Samuel Preston, a demographer and sociologist at the University of Pennsylvania who was on the panel. "You can blame that on public-health officials, or on the health-care system. No one understands where responsibility lies. But put it all together and it is creating a very negative portrait."
The U.S. has long lagged in life expectancy compared with other economically developed nations.
In this analysis, researchers culled existing studies to examine why. Most statistics in the report are from the late 1990s through 2008. The report found that U.S. health disadvantages aren't limited to the poor and uninsured. Even white, college-educated and wealthier Americans tend to be in worse health than their peers in other developed countries.
The nation's health disadvantages have economic consequences. They lead to higher costs for consumers and taxpayers as well as a workforce that remains less healthy than that of other high-income countries.
"With lives and dollars at stake, the United States cannot afford to ignore this problem," said the report.
In attempting to explain why Americans are so unhealthy, researchers looked at three categories: the nation's health-care system, harmful behaviors and social and economic conditions.
Researchers noted that the U.S. has a large uninsured population compared to other countries with comparable economies, and more limited access to primary care.
And although the income of Americans is higher on average than that of other wealthy countries, the United States also has a higher level of poverty, especially among children.
Researchers said American culture probably plays an important role in the life-expectancy rates falling short of other wealthy countries.
"We have a culture in our country that, among many Americans, cherishes personal autonomy and wants to limit intrusion of government and other entities on our personal lives and also wants to encourage free enterprise and the success of business and industry. Some of those forces may act against the ability to achieve optimal health outcomes," said Woolf, the study-panel chairman.
Includes material from The Associated Press