January 10, 2013
Americans Are Sicker And Die Younger Than People In Other Developed Countries
Lawrence LeBlond for redOrbit.com - Your Universe Online
A new report shows that Americans live in poorer health and die at younger ages than people in other developed countries–and researchers say the gap is steadily growing. The report also shows that Americans are also dying at far higher rates due to guns, car accidents and drug use than their foreign counterparts.
Although researchers have known for some time that the US fares poorly in comparison to other rich nations, most studies have focused mainly on older ages, when death is more commonly expected anyway.
The researchers were blunt and to the point about their findings.
About two-thirds of deaths seen in ages before 50 were attributable to a difference in life expectancy between males in the US and their counterparts in 16 other developed nations, and about one-third of the difference for females.
The 378-page report is the first to systematically compare death rates and health measures for people of all ages, including American children. It went further than in previous studies by documenting deaths from more than just health-related causes. The report was based on a broad review of mortality and health studies and statistics.
The panel said the pattern of higher disease rates and shorter lifespans in the US is responsible for dragging the country down the tubes when it comes to life expectancy rates over the past 30 years. American men ranked dead last in life expectancy among 17 countries in the report, and American women were second to last.
"The tragedy is not that the United States is losing a contest with other countries," the report says, "but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary."
Steven Woolf, a family physician and professor at Virginia Commonwealth University, who chaired the panel of experts, said he and his colleagues were “stunned by the findings.”
The most important purpose for the report, according to Woolf, is to alert Americans of the problems. “Our sense is that Americans don't really know about this... I don't think people realize that their children are likely to live shorter lives than children in other countries.”
Not only are American men and women at the bottom of the totem pole when it comes to life expectancy, but infant mortality in the US is also the highest of any developed country, and has been for several decades, due in part to a high rate of premature birth. The US also has the highest child poverty rate among 17 countries, with more than 20 percent of children living impoverished.
Poor outcomes are especially depressing because the USA spends twice as much on healthcare–an estimated $9,000 per person–as other developed countries, Gerard Anderson of Johns Hopkins School of Public Health, who was not involved in the study, told Liz Szabo of USA Today.
Authors of the report examined health by income and race to ascertain whether Americans´ overall low health scores were mostly due to the poor health among minorities and low-income Americans, according to Woolf. Studies often note the stark disparities in health between whites and blacks, he noted.
Yet even wealthy, white Americans fare worse than equally wealthy people in other countries, Woolf remarked. Well-educated Americans–those with medical insurance and healthy living-habits–have been shown to still be sicklier than their peers abroad.
It´s not all bad news, however. Woolf did say that the USA fares better in a few areas, such as cancer death rates and greater control of cholesterol and blood pressure. But for the most part, the US sits at, or close to, the bottom in all other areas.
The report found that the USA ranks at or near the bottom in nine key areas of health: low birth weight; injuries and homicides; teenage pregnancy and sexually transmitted infections; HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; respiratory illness; and general disability.
The authors said a number of factors likely contribute to Americans' poor health.
Although Americans are smoking and drinking less, they have many other bad habits that contribute to poorer lifespans, the report said. Americans consume more calories per person and are more likely to abuse drugs; less likely to wear their seatbelt when driving or riding in a vehicle; and are more likely to use a firearm for acts of violence.
These trends could be reversed if more people invest in early childhood education, David Howard, and associate professor at the Emory University School of Public Health in Atlanta, said in an interview with USA Today. He added that better-educated people have an easier time navigating the medical system and applying health information to their lives.
This report is an important reminder that Americans “need to do a better job of prevention,” intervening early in life to make sure our kids are, and stay, healthy, said Thomas McInerny, president of the American Academy of Pediatrics (AAP).
McInerny said he was most concerned about new research on chronic, “toxic stress” that is caused by poverty, violence, neglect and other traumas. Unlike temporary obstacles, which help build character, long-term “toxic stress” can damage children for a lifetime.
“It's becoming increasingly clear that the first 1,000 days of life are critically important for children's development, and can determine the course of their life span from then on," McInerny said. "Investing in children in the first three years of life provides higher returns, for improving their productivity as adults, compared to intervening later."
Woolf said that experts already know what they have to do. "It's more a matter of having the resolve and resources to actually do it," he remarked.
One of the most shocking findings in the report revolved around homicides.
The rate of firearm homicides in the US was 20 times higher than in other countries included in the report. That finding drew from a 2011 study of 23 countries. The report also found that while overall suicide rates were lower in the US, suicide by firearms was six times higher.
Samuel Preston, a demographer and sociologist at the University of Pennsylvania, who was on the panel of experts, said one study they looked at showed 69 percent of all American homicides in 2007 involved firearms.
“The bottom line is that we are not preventing damaging health behaviors,” he said. “You can blame that on public health officials, or on the health care system. No one understands where responsibility lies.”
Something else strange appeared in the report findings, admitted Woolf.
While children born in the US are less likely to reach their fifth birthday than kids from other developed countries, and while teenagers have higher rates of death from car accidents, murders, teenage pregnancy and STDs, for those who are lucky enough to make it to their 75th birthday, the playing field changes. Woolf said if Americans make it to 75, then they actually have a higher life expectancy than people in other well-developed nations.
But why are we faring so poorly up until 75? There are a number of reasons why many of us do not see the golden age.
Diet, exercise, traffic safety, firearm safety, etc. are all factors that play a role in how far we make it through life. And we cannot just do one or two things right and expect to live a full, happy life. We need to conform to all standards, and if we do, and do make it to 75, then we can enjoy life at the top of the heap.
It´s not hopeless, Woolf said. “There is action that can be taken at the individual, family, community, and national levels that can address the various conditions.” For example, there are recommendations about the importance of healthy food choices and weight management that can help prevent obesity and diabetes. And this is just one step in a room full of stairs.
One of the biggest problems in the US is that expert solutions more often than not tend to look at how we can treat problems once they occur, when they should be looking at how they can prevent the problem from occurring in the first place. The country needs to shift emphasis from treatment to prevention.
“This report shows where the differences and disparities exist and who bears the greatest burden, but they don´t tell us why these differences exist,” said Allison Norris, MD, PhD, assistant professor in epidemiology at Ohio State University´s College of Public Health, who reviewed the report for WebMD.