What’s Ailing America? New Report Finds U.S. Falls Behind International Peers in Health and Life Expectancy

A new study by the National Research Council and the Institute of Medicine compares the health of Americans to their international counterparts, and the results are bleak.

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Mark Makela / Reuters

A patient has her blood pressure taken before receiving treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia July 20, 2012.

A new study by the National Research Council and the Institute of Medicine compares the health of Americans to their international counterparts, and the results are bleak.  Americans, regardless of their status or background, live shorter lives and experience more injuries and illnesses than their peers in almost any other high-income country.

“It’s a tragedy,” says Steven H. Woolf, the professor of family medicine at Virginia Commonwealth University, in Richmond, Va., and chair of the panel that wrote the report. “We expected to see some bad news and some good news,” Woolf told the New York Times. “But the U.S. ranked near and at the bottom in almost every heath indicator. That stunned us.”  The report also showed that America’s “health disadvantage” still exists when correcting for wealth and access to health care, showing that America’s high level of income inequality and lack of universal health coverage aren’t the only contributing factors.

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The 378-page report goes further than previous studies in comparing death rates and health policies for Americans across all age groups; previous studies have tended to focus on older ages.

Entitled “U.S. Health in International Perspective: Shorter Lives, Poorer Health”, the study compared the existing data from the 1990s to 2008 on life expectancy and health in the U.S., alongside data from 16 “peer countries” including Canada, Japan, Australia and much of Western Europe. It builds on findings from a similar 2011 report, which found that despite improvements in Americans’ life expectancy and health over the past century, both metrics were still lagging those of other high-income democracies.  Among the 17 countries ranked, American men came last in life expectancy, American women second to last.

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So why exactly is that the case? The report examines “the role of underlying social values and public policies” in America’s lagging health statistics, identifying a range of factors including individual behaviour, social and economic status, education and income, environment and public health policies. What its authors sought to emphasize was that it was not the work of any one of these single issues in isolation, but the combined effect of these factors that have resulted in this great disadvantage.

Americans were more likely to “engage in certain unhealthy behaviors…that increase the risk of fatal injuries,” according to the report — including those caused by car accidents, gun violence and drug overdoses. The authors, citing a 2011 study,  found that the rate of firearm related deaths was higher in the U.S. than in 23 other countries. The authors also cited research showing that Americans were less likely to wear seat belts in cars and more likely to be in a car accident than residents of other countries, and also more susceptible to taking drugs and to overdoses. These risks, coupled with other well-known factors such as higher caloric intake and the highest diabetes rate of any country on the list, all combined to make Americans lead shorter and more unhealthy lives.

Those under 50 are particularly disadvantaged, the data indicates. “I don’t think most parents know that, on average, infants, children, and adolescents in the U.S. die younger and have greater rates of illness and injury than youth in other countries,” says Woolf. The U.S. has had the highest rate of infant mortality rate among developed countries for many decades now, in part due to low birth weights and premature births.

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Americans over 75 do tend to live longer than their peers in other countries, but that only seems to beg the question of what has caused younger generations of Americans to be less healthy than their elders.

For the authors of the report, the most distressing aspects of the findings were not that “the United States is losing a contest with other countries, but that Americans are dying and suffering from illnesses and injury at rates that are demonstrably unnecessary.”

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