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Report: Americans Live Sicker, Die Younger

Health disadvantage is pervasive across age and socio-economic groups (Jan. 9)

On average, Americans die sooner and experience higher rates of disease and injury than do people in other high-income countries, according to a new report from the National Research Council and the Institute of Medicine. The report finds that this health disadvantage exists at all ages from birth to age 75 and that even advantaged Americans &mdas; those who have health insurance, college educations, higher incomes, and healthy behaviors &mdas; appear to be sicker than their peers in other major nations.

The report is the first comprehensive look at multiple diseases, injuries, and behaviors across the entire life span, comparing the U.S. with 16 peer nations &mdas; affluent democracies that include Australia, Canada, Japan, and many western European countries. Among these countries, the U.S. is at or near the bottom in nine key areas of health: infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability.

Many of these health conditions disproportionately affect children and adolescents, the report says. For decades, the U.S. has had the highest infant mortality rate of any high-income country, and it also ranks poorly for premature births and for the proportion of children who live to age 5. U.S. adolescents have higher rates of death from traffic accidents and homicide, the highest rates of teenage pregnancy, and are more likely to acquire sexually transmitted infections. Nearly two-thirds of the difference in life expectancy between men in the U.S. and those in other countries can be attributed to deaths before age 50.

This health disadvantage exists even though the U.S. spends more per capita on health care than any other nation. Although documented flaws in the healthcare system may contribute to poorer health, the panel concluded that many factors are responsible for the nation's health disadvantage.

The panel did find that the U.S. outperforms its peers in some areas of health and health-related behavior. People in the U.S. over age 75 live longer, and Americans have lower death rates from stroke and cancer, better control of blood pressure and cholesterol levels, and lower rates of smoking.

The report examines the role of underlying social values and public policies in understanding why the U.S. is outranked by other nations on both health outcomes and the conditions that affect health. For example, Americans are more likely to engage in certain unhealthy behaviors, from heavy caloric intake to activities that increase the risk of fatal injuries, the report says.

The document’s authors call for a comprehensive outreach campaign to alert the American public about the U.S. health disadvantage and to stimulate a national discussion about its implications. In parallel, the authors recommend data collection and research to better understand the factors responsible for the U.S. disadvantage and to formulate potential solutions, including lessons that can be learned from other countries.

Source: National Research Council; January 9, 2013.

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