U.S. Health in International Perspective Shorter Lives, Poorer Health (2013) / Chapter Skim
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health disadvantage exists across the life span, exploring potential explanations, and assessing the larger implications of the findings. THE INFERIOR HEALTH STATUS OF THE UNITED STATES The panel's analysis compared health outcomes in the United States with those of 16 comparable high-income or "peer" countries: Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, 1
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We examined historical trends dating back several decades, with a focus on the more extensive data available from the late 1990s to 2008. Over this time period, we uncovered a strikingly consistent and pervasive pattern of higher mortality and inferior health in the United States, beginning at birth: • For many years, Americans have had a shorter life expectancy than people in almost all of the peer countries.
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health disad antage. The United States has higher survival after age 75 than do v peer countries, and it has higher rates of cancer screening and survival, better control of blood pressure and cholesterol levels, lower stroke mortality, lower rates of current smoking, and higher average household income.
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POSSIBLE EXPLANATIONS FOR THE U.S. HEALTH DISADVANTAGE The panel's search for potential explanations revealed that important antecedents of good health -- such as the quality of health care and the prevalence of health-related behaviors -- are also frequently problematic in the United States.
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Similarly, more Americans may die from violence because firearms, which are highly lethal, are more available in the United States than in peer countries. A stressful environment may promote substance abuse, physical illness, criminal behavior, and family violence.
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In countries with the most favorable health outcomes, resource investments and infrastructure often reflect a strong societal commitment to the health and welfare of the entire population. Because choices about political governance structures, and the social and economic conditions they reflect and shape, matter to overall levels of health, the panel asked whether some of these underlying societal factors could be contributing to greater disease and injury rates and shorter lives in the United States.
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RECOMMENDATION 2 The National Institutes of Health and other research funding agencies should support the development of more refined analytic methods and study designs for cross-national health research. These methods should include innovative study designs, cre ative uses of existing data, and novel analytical approaches to better elucidate the complex causal pathways that might explain cross-national differences in health.
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the extent to which these policy differences may explain cross-national health differences in one or more health domains. This report should be followed by a series of issue-focused investigative studies to explore why the United States experiences poorer outcomes than other countries in the specific areas documented in this report.
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COSTS OF INACTION The consequences of not attending to the growing U.S. health disadvantage and reversing current trends are predictable: the United States will probably continue to fall further behind comparable countries on health outcomes and mortality.
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