USA - An Unhealthy Nation?

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Back in the 1950s, the USA was a leading country when it came to life expectancy and disease. How things change.  A new study has just been published by a team of experts brought together by the Institute of Medicine and the National Research Council which looked into the health of Americans when compared to 16 other developed nations.  The results were not good if you live in the land of the free. 

Compared to the other nations (including Canada, Japan, Australia, France, Sweden, Germany and Spain) in the report:

“Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States… The findings were stark. Deaths before age 50 accounted for about two-thirds of the difference in life expectancy between males in the United States and their counterparts in 16 other developed countries, and about one-third of the difference for females.”

The panel did not point the finger at any on political party or administration, instead the chairman, Dr Steven Woolf, hinted at something much deeper. He stated:

“Something at the core is causing the US to slip behind these high-income countries. And it’s getting worse.”

The panel noted that the US had a “highly fragmented health care system”, limited primary care resources and a large uninsured population. Tellingly, it had the highest rate of poverty among the countries studied. Less measurable factors were also noted:

“Could cultural factors like individualism and dislike of government interference play a role? Americans are less likely to wear seat belts and more likely to ride motorcycles without helmets.”    

While education played a role (Americans who had not graduated from high school die from diabetes at three times the rate of those with some college education) even the people most likely to be healthy, like college-educated Americans and those with high incomes, fared worse on many health indicators.

“Panelists were surprised at just how consistently Americans ended up at the bottom of the rankings. The United States had the second-highest death rate from the most common form of heart disease, the kind that causes heart attacks, and the second-highest death rate from lung disease, a legacy of high smoking rates in past decades. American adults also have the highest diabetes rates.

Youths fared no better. The United States has the highest infant mortality rate among these countries, and its young people have the highest rates of sexually transmitted diseases, teen pregnancy and deaths from car crashes. Americans lose more years of life before age 50 to alcohol and drug abuse than people in any of the other countries.

Americans also had the lowest probability over all of surviving to the age of 50. The report’s second chapter details health indicators for youths where the United States ranks near or at the bottom. There are so many that the list takes up four pages. Chronic diseases, including heart disease, also played a role for people under 50.”

The news was not uniformly bad – death rates from cancers that can be detected with tests (e.g., breast cancer) were lower in the US.  Adults in the USA had better control over their cholesterol and high blood pressure and those who made it to 75 years old tended to outlive their counterparts in the other countries.

However, the report’s finding overall is pretty depressing. What do you think? I’m particularly interested in hearing from those of you living in the USA. Why does the USA fare so badly? Or are the results not that surprising? Considering that all of the other nations chosen for the report had lower rates of poverty than the USA, is it really a shock that they are more healthy?


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Welcome to Demography Is Destiny. We launched this to counter two media memes: that humans are a cancer which is destroying our planet and that world population is spiralling to unsustainable levels. The real story is that intelligent and inventive humans will rise to the challenge of climate change and that our real problem is the coming demographic winter. The editors of Demography is Destiny are Marcus and Shannon Roberts, who live in Auckland, New Zealand. Send them your comments and suggestions. 

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