Modern Medicine (01.11.13)
Aids Weekly Plus
According to a report by the National Research Council and Institute of Medicine, the United States spends more per capita on healthcare than any other nation, but its people—including those with health insurance, college educations, high income or healthful habits—contract diseases, are injured, or die earlier than the inhabitants of other high-income countries. The report notes that the health disadvantage exists at all ages from birth to age 75, and even advantaged Americans appear to be less healthy then their peers in other rich nations.
The report compared the United States with 16 peer nations, including Australia, Canada, Japan, and many western European countries. The United States was at or near the bottom in nine key areas of health: infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability. Many of the health conditions disproportionately affect children and adolescents. The United States has had the highest infant mortality rate of any high-income country for decades, and it ranks low on premature birth and the proportion of children who live to age 5. Also, US adolescents have higher death rates from traffic accidents and homicide, the highest rates of teenage pregnancy, and higher likelihood of contracting STDs. Approximately two-thirds of the difference in life expectancy between males in the United States and the other countries are because of deaths before age 50.
The United States ranked higher than the other countries in some areas: Americans older than 75 years live longer; and Americans have lower death rates from stroke and cancer, better control of blood pressure and cholesterol levels, and lower rates of smoking.
The report examines the role of social values and public policy in determining why the United States is outdone by its peers on both health outcomes and conditions that affect health, but the results suggest that the health disadvantage is more than a reflection of the serious health disadvantages among poor or uninsured people or ethnic and racial minorities. When the analysis was limited to non-Hispanic whites and people with high incomes and health insurance, nonsmokers or people who are not obese, Americans still rated lower.
The report provides recommendations. It suggests an intensified effort to pursue established national health objectives, a comprehensive outreach campaign to share the findings with the public and stimulate national discussion about its implications, and data collection and research to better understand the factors responsible for the US disadvantage and potential solutions, including lessons learned from other countries.
The study was sponsored by the National Institutes of Health and the US Department of Health and Human Services.
The full report, “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” was published by the National Academies press and is available at http://www.nap.edu/catalog.php?record_id=13497.