America, We Have a Death Problem
If someone asked you if you feel lucky to live in the U.S. you’d probably give them a resounding YES, for many reasons related to freedom, affluence, opportunity etc. If the same person asked if you felt part of the advantage of living in our great country is the opportunity to live a longer, healthier life, you’d probably say yes to that too. But did you know you’d be wrong?
I recently attended a briefing in the Capitol on a new report from the National Academies Press called U.S. Health in International Perspective: Shorter Lives, Poorer Health. An expert panel, convened by the National Research Council (NRC) and the Institute of Medicine (IOM), compared the health and longevity of Americans to that of people in our “peer countries:” Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom. In one short hour, their findings blew all of the misconceptions I had about U.S. “superiority” in health and longevity.
Ok, I know about our obesity issue - I see it every day around me. But for the rest of what I learned that day, I had no idea. Most of us are blissfully unaware of where we stand compared to people in peer countries. When Americans and their peers overseas were polled on how Americans fare in health and longevity compared to other developed countries, apparently only the Americans are in the dark – people in peer countries see the stark truth: Americans are less healthy and live shorter lives than almost all other high income countries.
There is far too much information in the report to do it justice in one blog piece, so I plan to submit a series. For now, let me give you the big, alarming picture. Among the 17 peer countries, Americans have the second lowest probability of living to see 50. The reasons can’t be pinpointed to one cause or age group. It would be easier if it were something obvious, like Americans are fatter and therefore are dying from obesity-related diseases in their 40’s. Unfortunately, it isn’t that cut and dried. In fact, all age groups up to 75 are dying from many diseases or injuries related to different risky behaviors (or not). So then you might think, well, it is due to racial or ethnic differences, or poverty, right? Wrong again! Although the problem is more pronounced in these populations, being white and wealthy doesn’t seem to protect you. When compared to white, wealthy people in England and other peer countries, our upper class is much worse off when it comes to health and longevity.
Alright, let’s say you do make it to 50 -- if you live in the U.S., you are at greater risk for developing and dying from heart disease, are more likely to suffer from health issues, and face more chronic disease than your friends overseas. This is where our obesity problem does come into play, as poorer health over 50 tends to be due to risk factors such as smoking, obesity and diabetes.
But that's not all - there are a few other findings that particularly blew my mind.
Number one on my ‘most disturbing’ list: the U.S. has the highest rate of infant mortality! If your head snapped up and your eyebrows are now on the ceiling, you are not alone. Hold on to the rest of your face, because we also rank way down in other measures such as birth weight AND our children are less likely to reach the age of 5.
A more obvious finding is that Americans are more obese and suffer more from diabetes and related complications - after all we’re a nation living on sugar and fat. However, common knowlege or not, this issue is critical as it’s killing not only adults but children – and that is a monumental tragedy.
More surprising findings from the report include: the U.S. has more lung disease and more deaths from lung diseases than our peer countries; Americans lose more years due to alcohol and drug related diseases, even after subtracting out drunk driving-related fatalities (yes, even compared to Germany where the beer is WAY better); American youths have the highest rate of pregnancy and sexually transmitted disease, and the U.S. overall has the second highest rate of HIV infection and the highest incidence of AIDS of the countries compared.
It’s not all bad news though: Americans have a higher survival rate once they pass 75 compared to peer countries. We also have better systems for cancer screening and more cancer survivors, we control our blood pressure and cholesterol better, and we don’t die as frequently following a stroke. We apparently smoke less and commit suicide at a rate similar to other countries as well (Yay Team USA).
However, given the resources available to us as a country, and the amount of money we spend on health care (which far outpaces spending in other countries), I would expect better. The most alarming outcome from this report is that the gender difference in life expectancy is increasing - it has been for the last 30 years, and the axe falls more heavily on women than men! The report didn’t have all the answers as to why, and more research needs to be done to find the answers. However, knowledge is the key to change, and we need to get this information out there.
Listen up, America! We are in trouble, and the first step is to admit we have a problem. Stay tuned for my next installment: America, Why are We So Bad at Birthing Babies?
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