America's health: we're not number one

The United States spends twice as much per person on health care as the rest of the developed world, with little to show for it except shorter and unhealthier lives than citizens of its peer nations enjoy.

That's the depressing conclusion of a study, just released by a panel of experts assembled by the Institute of Medicine, comparing the health of Americans with that of residents of 16 other wealthy nations.

The dire state of health in the U.S. surprised even the scientists who worked on the study. "I expected we would find some problems in certain areas and good news in other areas," said the panel's chairman, Dr. Steven H. Woolf of Virginia Commonwealth University. "I personally was stunned by how pervasive the disadvantage was across so many areas."

Some examples:

• The U.S. has the next-to-lowest life expectancy at birth of all the nations, and we rank at or near the bottom in terms of mortality at every age from birth to 75. Or, to put it another way, the nation ranks dead last, by a significant margin, in the numbers of people who die prematurely before the age of 50.

• We die violently much more often than people in these other countries. Our murder rate is almost seven times higher, and our rate of gun homicides almost 20 times higher. In fact, 80 percent of all firearms deaths in rich countries occur in the United States. We also have the highest death rate from traffic accidents, both absolutely and per vehicle miles traveled.

• We have more STDs and HIV infections, die more often from drug and alcohol abuse, are fatter, and have more diabetes, heart disease and lung disease.

The IOM panel said our abysmal showing likely has multiple causes, including: the roughly 50 million Americans who have no heath insurance, our toleration of much higher rates of poverty and inequality than in other wealthy countries, and our patchy system of public health and primary care.

There's one area where we're number one, however: in the percentage of American adults who believe their health is "good" or "very good."

That may be one reason why the panel recommended a vigorous public education campaign to explain to Americans just how bad things really are.

Source:
U.S. Health in International Perspective: Shorter Lives, Poorer Health [National Academies Press]

—Nancy Metcalf