US Ranks Last Among Other Industrialized Nations on Preventable Deaths

In a ranking of 19 industrialized countries the United States ranks last when it comes to deaths that could have been prevented by timely access to health care. The Commonwealth Fund, an independent foundation working toward health policy reform, published this finding in their January/February issue of Health Affairs. Many of the other 19 nations drastically improved their death rates, the United States hardly improved. Had the U.S performed as well as France, Japan or Australia, 101,000 fewer Americans would have died due to lack of effective health care.  

Martin McKee and Ellen Nolte, both of the London School of Hygiene and Tropical Medicine compare trends in deaths that access to timely and effective health care could have prevented in “Measuring the Health of Nations: Updating an Earlier Analysis”. McKee and Nolte looked at deaths “amenable to health care before age 75 between 1998-98 and 2002-03.” Their findings were shocking: the U.S. experienced only a 4% decline in these types of deaths while other countries experienced an average of a 16% decline. McKee and Nolte state, “It is difficult to disregard the observation that the slow decline in U.S. amenable mortality has coincided with an increase in the uninsured population, an issue that is now receiving renewed attention in several states and among presidential candidates from both parties.”

In the earlier study, during 1997-98, the United States ranked 15th, however by 2002-03 the U.S. fell to 19th, or last place. The U.S. had 109 deaths amenable to health care for every 100,000 people. In contrast, France, the leading country had 64 deaths per 100,000, just slightly more than half of the U.S. mortality rates.

Because McKee and Nolte focus on deaths amenable to health care, they remove factors such as population and lifestyle differences from their study. Commonwealth Fund Senior Vice President Cathy Schoen refers to this, stating, “The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference.” This is a valuable indicator of health system performance; it considers a range of conditions from which death can be averted after the condition develops, or conditions which can be detected early with screenings.

“Cross-national studies conducted by The Commonwealth Fund indicate that our failure to cover all Americans results in financial barriers that are much more likely to prevent many U.S. adults from getting the care they need, compared with adults in other countries,” said Commonwealth Fund President Karen Davis. “While no one country provides a perfect model of care, there are many lessons to be learned from the strategies at work abroad.”