America may be one of the richest countries in the world, but its people are less healthy and more likely to die early from disease or accidents than those in any other affluent country, a damning official US report has found.
Even the best-off Americans – those who have health insurance, a college education, a high income and healthy behaviour – are sicker than their peers in comparable countries, says the report by the US National Research Council and the Institute of Medicine.
“We were struck by the gravity of these findings,” said Steven H Woolf, professor of family medicine at Virginia Commonwealth University in Richmond and chair of the panel that wrote the report. “Americans are dying and suffering at rates that we know are unnecessary because people in other high-income countries are living longer lives and enjoying better health. What really concerns our panel is why, for decades, we have been slipping behind.” The report, US Health in International Perspective: Shorter Lives, Poorer Health, was commissioned by the National Institutes of Health. It compares the US with 16 affluent democracies, including Australia, Canada and Japan and many in Europe including Britain. There have been similar findings from the Commonwealth Fund over some years, but they have compared the US with only a handful of nations.
The new report looked in detail at data from the late 1990s to 2008. “Over this time period, we uncovered a strikingly consistent and pervasive pattern of higher mortality and inferior health in the United States, beginning at birth,” it said.
For many years, Americans have had a shorter life expectancy than people in almost all the comparator countries and for the past three decades the gap has been widening, particularly for women.
The US does badly in nine specific areas. It has the highest infant mortality rate of any wealthy country and also does poorly on other birth outcomes, such as low weight babies.
Deaths from injuries and homicides are far higher than elsewhere and a leading cause of death in children, adolescents and young adults. US adolescents have had the highest rate of pregnancies of affluent countries since the 1990s and are more likely to acquire sexually transmitted infections. The US has the second highest HIV rate and the highest incidence of Aids among the 17 countries.
Even taking out drunk driving, Americans lose more years of life to alcohol and other drugs than people in other affluent countries. The US has the highest obesity rate and, from age 20, one of the highest levels of type 2 diabetes. The death rate from heart disease is the second highest in the 17 countries. There is more lung disease and more deaths from it than in Europe and older people report more arthritis and other limitations on their activity than in Europe or Japan.