Study reveals Americans have lowest life expectancy among rich nations

First Posted: Jan 12, 2013 04:49 PM EST

An extensive report by a panel of experts from the National Research Council and the Institute of Medicine in the US found that Americans die younger and have higher rates of many types of diseases and injuries than people in other high-income countries.

The 378-page report, "U.S. Health in International Perspective: Shorter Lives, Poorer Health," compares life expectancy and health in the United States with that in 16 major rich nations including Japan, Australia and the Western European countries, examining data beginning in the 1970s, but relying mainly on statistics from the late 1990s through 2008.

One of the new findings that wasn't scientifically confirmed yet is that the health disadvantage exists at all ages from birth to age 75 and in all socioeconomic groups. "Even those who are insured and college educated and have high incomes seem to be in worse health than people in other nations," says Dr. Steven Woolf, chairman of the Department of Family Medicine at Virginia Commonwealth University, who led the panel, during a news conference.

"This goes all the way back to the beginning of life," he says. "We found that American babies are less likely to survive to their first birthday than babies born in other high-income countries. Young children are less likely to survive till age five. American adolescents are in worse health than their counterparts in other countries. American adults have higher rates of obesity, diabetes and chronic diseases."

Among the 17 countries examined, in 2007 the US ranked last in life expectancy for males (75.64 years) and second to last for females (80.78 years). The disparity was the greatest for females, with a woman born in the US in 2007 expected to live more than five years less than a woman in Japan, where the highest life expectancy was 85.98 years. Male life expectancy in Switzerland, 79.33, was 3.69 years higher than that for US males.

And these are the results of the most expensive health care system in the world, as spending per capita in the US far exceeds that in any of the other countries studied - yet the health of the US population continues to deteriorate.

"The health of Americans is far worse than the health of people in other countries despite the fact that we spend more money on health care," Dr. Woolf said. "This has been going on since 1980 and getting progressively worse. I am struck by the gravity of our findings."

The experts list nine key health areas where the U.S. is at or near the bottom of the 17 advanced nations:

    Infant death and low birth weight
    Injuries and murders
    Obesity and diabetes
    Heart disease; chronic lung disease; and disability
    Teenage pregnancies and sexually transmitted infections
    Prevalence of HIV and AIDS
    Drug-related deaths

The panel identified the inaccessibility of health care, high levels of poverty and income inequality, as well as the prevalence of gun violence as major contributing factors to the poor life expectancy rate in the US.

The study notes that social inequality is one of the key underlying causes of what they term the "U.S. health disadvantage." While the average income of Americans is higher than in the other countries studied, the authors write, the US has higher levels of poverty, particularly among children. This, combined with "income inequality and lower rates of social mobility," is one of the greatest contributing factors to both lower life expectancy and poor health overall. On top of this, Americans are not shielded by a social safety net, like those in most of the other advanced nations, to buffer these effects.

"Unlike its peer countries," they write, "the United States has a relatively large uninsured population and more limited access to primary care. Americans are more likely to find their health care inaccessible or unaffordable and to report lapses in the quality and safety of care outside of hospitals."

Among the factors contributing to the lowest odds of living to age 50 in the US, the study found that the leading causes include car accidents, gun violence and drug overdoses. Citing a 2011 study of 23 countries, the panel found the rate of firearm homicides to be 20 times higher in the US.

"One behavior that probably explains the excess lethality of violence and unintentional injuries in the United States is the widespread possession of firearms and the common practice of storing them (often unlocked) at home," the authors write. "The statistics are dramatic."

SOURCE: National Research Council and Institute of Medicine report: "U.S. Health in International Perspective: Shorter Lives, Poorer Health."

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