U.S. ranks dead last in preventable deaths
The United States ranks dead last in a new study of preventable death in 19 industrialized nations. The study "Measuring the Health of Nations: Updating an Earlier Analysis" was done by researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine (Citation: E. Nolte and C. M. McKee, Health Affairs, January/February 2008, 27(1):58–71).
France, Japan and Australia had the lowest rates of preventable death, and the United States had the highest. If the US health care system performed as well as the top three countries, there would be 101,000 fewer deaths in the United States per year.
This puts another nail in the coffin for the idea that the United States has the best health care system in the world. According to the authors of the study, "[T]he findings presented here are consistent with other cross-national analyses, demonstrating the relative underperformance of the U.S. health care system in several key indicators compared with other industrialized countries." No one disagrees that the United States can provide outstanding care for some people. That "top tier" medical service is often touted to justify the belief that the United States has the "best system in the world." But access to that premium care is severely limited based on ability to pay. As Nolte said in an interview, "I wouldn't say it (the last-place ranking) is a condemnation, because I think health care in the U.S. is pretty good if you have access. But if you don't, I think that's the main problem, isn't it?" About 16% of the US population has no health insurance - about 47 million people.
Researcher Nolte said that statistic probably was a key factor in the poor showing of the United States compared to other industrialized nations. The research was backed by the Commonwealth Fund (commonwealthfund.org), a private New York-based health policy foundation. Commonwealth Fund Senior Vice President Cathy Schoen said in a statement that "It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance. The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals and efforts to improve health systems make a difference."
For details see: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=640980
For a Reuters piece on this study (January 8, 2008) see: http://www.reuters.com/article/topNews/idUSN0765165020080108?feedType=RSS&feedName=topNews&pageNumber=2&virtualBrandChannel=0
The Details
In addition to the U.S., the study included 14 Western European countries, Canada, Australia, New Zealand, and Japan. The concept of "amenable mortality" was developed in the 1970s to assess health systems. This study used data from the World Health Organization on conditions considered amenable to health care in people under age 75. Causes of death that may be prevented by timely and effective health care include cardiovascular disease, some cancers, diabetes, some infections, and surgical complications.
Rates of mortality amenable to health care in the period 2002-2003 ranged from a low of 65 deaths per 100,000 population in France, to a high of 110 in the United States. Japan and Australia were almost tied for second place in the rankings, each with about 71 deaths per 100,000 population.
The United States also fell behind when you consider rates of improvement since the 1997-1998 period. Between 1997–98 and 2002–03, amenable mortality fell by an average of 16 percent in all countries except the U.S., where the decline was only 4 percent. In 1997–98, the U.S. ranked 15th out of the 19 countries on this measure, ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people. By 2002–03, the U.S. fell to last place.
