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Americans Die Sooner Than Peers in Affluent Countries

Americans’ Health Suffers as Affluent-Nation Peers Live Longer
A patient talks with a nurse before receiving medical attention at a Care Harbor LA free health clinic for the uninsured and underinsured at the Los Angeles Sports Arena. Photographer: Patrick T. Fallon/Bloomberg

People in the U.S. are sicker and more likely to die earlier than peers in high-income countries, a gap that bedevils even the wealthy, the insured and those with healthy behaviors, according to a government-sponsored study.

The U.S., the world’s richest nation by household assets, is close to last in key areas of health that include infant mortality, HIV, drug-related deaths and obesity, according to the study issued today by the National Research Council and the Institute of Medicine. The study compared the U.S. with affluent countries such as Australia, Canada and Japan.

The health gap has worsened for three decades, especially for women, and disproportionately affects children and teens, who die at higher rates from traffic accidents and homicide. For males, almost two-thirds of the life expectancy difference can be attributed to deaths before age 50, and those who reach that age arrive in poorer health than in other wealthy nations.

“The pervasiveness of the problem was really staggering,” Steven Woolf, a family medicine professor at Virginia Commonwealth University in Richmond and chairman of the panel that wrote the report, said in an interview. “I don’t think American parents know their children will live a shorter life with greater disease rates than other countries.”

The gap in health conditions exists from birth -- the U.S. has the highest infant mortality rate of any high-income country -- to age 75. The leading contributors include unintentional injuries such as car wrecks and poisonings, as well as non-communicable ailments such as heart disease and diabetes, according to the study. The report also cited drug abuse and a negative physical environment that centers on automobiles.

Falling Behind

The panel analyzed U.S. health conditions against 16 nations: Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands and the U.K.

The U.S. life expectancy for men is about 76 and ranks last in the 17 countries studied. For women, the life expectancy is about 81 years and ranked 16, followed by Denmark.

“Why are we falling behind leads to broader, complex questions,” Woolf said. “We were not surprised there was a health disadvantage, but by how big and pervasive it was.”

The disadvantage exists even though the U.S. spends more per capita on health care than any other nation, partly because of a large uninsured population and inaccessible or unaffordable medical care, according to the study. Americans also have riskier health behaviors, including being involved in more traffic accidents that involve alcohol and using firearms in acts of violence. Americans who don’t smoke and are not overweight also appear to have higher rates of disease.

The U.S. also has higher levels of poverty than other countries, based on the report.

The nation’s large population of recent immigrants is generally in better health than native-born Americans, according to the report.

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