U.S. Health in International Perspective Shorter Lives, Poorer Health (2013) / Chapter Skim
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2 Poorer Health Throughout Life
2 Poorer Health Throughout Life
Pages 57-90
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From page 57... ...
This chapter looks at cross-national comparisons of physical and psy hological illnesses, injuries, and biological risk factors across the life c course, from infancy to old age, with a special focus on childhood and adolescence. The panel chose to focus on youth for four reasons: 1.
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From page 58... ...
The chapter focuses on illnesses and injuries, not unhealthy behaviors or other modifiable risk factors (health behaviors such as smoking and unhealthy diets are examined in Chapter 5)
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From page 59... ...
, examined mortality rates by cause in the United States and 26 other high-income countries2 for five age groups -- 1-4, 5-9, 10-14, 15-19, and 20-24 -- and then reanalyzed the data for the 17 peer countries of interest to the panel. These data were drawn from the WHO World Mortality Database.
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From page 60... ...
youth relative to their peers in other countries has followed a U-shaped pattern: the United States has exhibited higher infant mortality rates than the OECD average, comparable mortality rates at ages 1-9, and higher mortality rates at older ages, especially after age 15 (Viner, 2012)
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From page 61... ...
4.4 17 Infant mortalityf 2.5-6.7 (3.9) 6.7 17 Days of life lost,g 0.05-0.12 (0.07)
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From page 62... ...
29.5 17 aged 45-54 Diabetes,o females aged 1.7-4.7 (3.1) 4.5 16 35-44 Diabetes,o males aged 3.2-7.1 (5.1)
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From page 63... ...
cLow birth weight is the number of live births weighing less than 2,500 grams as a percent age of the total number of live births. Values (if present)
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From page 64... ...
Data from Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group at http://www1.imperial.ac.uk/publichealth/departments/ebs/ projects/eresh/majidezzati/healthmetrics/metabolicriskfactors/. pAverage FPG is average fasting plasma glucose (mmol/L)
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From page 65... ...
. Cross-national variation in infant mortality rates is partly affected by differences in how countries register preterm births.
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From page 66... ...
children often enter life under unfavorable health conditions. The high rate of adverse birth outcomes in the United States does not appear to be a statistical artifact, such as a difference in coding practices for very small infants who die soon after birth (MacDorman and Mathews, Sweden 4.2 Finland 4.2 Norway 5.0 Canada 6.0 Denmark 6.2 Australia 6.3 Switzerland 6.4 Netherlands 6.5 France 6.7 Italy 6.8 Germany 6.8 Austria 7.1 United Kingdom 7.3 Spain 7.5 Portugal 7.8 United States 8.2 Japan 9.6 0 2 4 6 8 10 Percentage of Live Newborns Weighing Less Than 2,500 g FIGURE 2-2 Low birth weight in 17 peer countries, 2005-2009.
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From page 67... ...
For example, the United States fares poorly with respect to adolescent pregnancy and child poverty (see Chapter 6) , which are, respectively, proximate and distal determinants of low birth weight and infant mortality.
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From page 68... ...
. mortality declined by 20 percent between 1990 and 2010, other high income countries experienced much steeper declines and halved their infant mortality rates over those two decades (Palloni and Yonker, 2012)
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From page 69... ...
The U.S. infant mortality rate among mothers with 16 or more years of education is still higher than the infant mortality rate in most high-income countries (Mathews and MacDorman, 2007)
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From page 70... ...
. Although the United States and OECD countries have equivalent child mortality rates after infancy, the United States develops a clear mortality disadvantage in the adolescent and young adult years (Viner, 2012)
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From page 71... ...
A U.S. health disadvantage at this age has been documented in particular for obesity, chronic illness, adolescent pregnancy, sexually transmitted infections, mental illness, and injuries.
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From page 72... ...
Among the 17 peer countries in 2010, the United States had the fifth highest prevalence of diabetes among children ages 0-14, led only by Finland, Norway, Sweden, and the United Kingdom (OECD, 2011b)
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Surveys 11 Early-age childbirth is a leading risk factor for low birth weight and infant mortality.
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However, we note it here because many mental illnesses first appear in late adolescence and young adulthood (Merikangas et al., 2010)
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From page 75... ...
Homicide is the second leading cause of death among U.S. adolescents and young adults aged 15-24 (National Center for Health Statistics, 2012)
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From page 76... ...
76 U.S. HEALTH IN INTERNATIONAL PERSPECTIVE a Males Aged 15-19 120 100 Average for 16 Peer Countries United States Deaths per 100,000 PYO 80 60 40 20 0 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 Year b Males Aged 20-24 120 Fig2-7a.eps 100 Average for 16 Peer Countries Deaths per 100,000 PYO 80 United States 60 40 20 0 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 Year FIGURE 2-7 Transportation-related mortality among adolescent and young adult Fig2-7b.eps males in the United States and average of 16 peer countries, 1955-2004.
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POORER HEALTH THROUGHOUT LIFE 77 a 45 Males Aged 15-19 40 35 Average for 16 Deaths per 100,000 PYO Peer Countries 30 United States 25 20 15 10 5 0 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 Year b 45 Males Aged 20-24 Fig2-8a.eps 40 35 Deaths per 100,000 PYO 30 25 20 Average for 16 Peer Countries 15 United States 10 5 0 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 Year FIGURE 2-8 Violent mortality among adolescent and young adult males in the United States and average of 16 peer countries, 1955-2004. Fig2-8b.eps NOTES: PYO = person years of observation.
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From page 78... ...
maternal mortality ratio was 13.7 per 100,000, the second highest of the 17 peer countries. Unintentional injuries remain the leading cause of death in the United States for ages 25-34 (National Center for Health Statistics, 2012)
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From page 79... ...
SOURCE: Data from the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (2012) , BMI by country.
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From page 80... ...
and have relatively high fasting plasma glucose levels. However, unintentional injuries remain the leading cause of death at this age (National Center for Health Statistics, 2012)
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From page 81... ...
POORER HEALTH THROUGHOUT LIFE 81 a 0.9 Italy 2.8 0.9 Netherlands 1.6 1.1 Austria 2.2 1.1 Portugal 1.9 1.4 Denmark 2.8 1.5 Switzerland 2.9 1.5 Germany 3.0 1.5 Japan 2.3 1.5 Sweden 2.9 1.7 France 2.8 1.8 United Kingdom 2.8 1.9 Finland 3.3 1.9 Norway 3.6 2.1 Australia 3.6 2.2 Canada 3.7 2.2 Spain 2.8 2.3 United States 4.1 5 0 0 5 Females Males Ages 15-24 b 1.7 Netherlands 3.2 2.1 Austria 3.5 2.3 Italy Figure 2-10a 4.9 2.5 Portugal 4.2 2.6 Germany 5.2 2.6 Japan 4.3 2.8 France 4.9 2.9 Switzerland 5.3 3.0 Denmark 5.1 3.0 United Kingdom 4.4 3.0 Sweden 5.0 3.5 Finland 5.5 3.7 Australia 5.7 3.8 Norway 6.0 4.4 Canada 6.4 4.5 United States 7.1 4.7 Spain 6.3 10 5 0 0 5 10 Females Males Ages 25-34 FIGURE 2-10 Self-reported prevalence of diabetes, by age and sex, in 17 peer countries, 2008. SOURCE: Data from the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (2012)
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From page 82... ...
an analysis of cardiovascular risk factors among adults aged 50-54 in the United States and 10 European countries. This c Figure 2-10 age group was selected because it is the beginning of the age range when cardiovascular mortality, the leading cause of death, begins to be important, but mortality has not yet affected the population through selection.
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From page 83... ...
People with disease are automatically categorized as high risk. For those without disease, age- and sex-specific risk is based on having indicators of high blood pressure, diabetes, body mass index, and current smoking.
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From page 84... ...
adults aged 50-74 with those in England and 10 European countries reported that Americans had higher rates of heart disease, stroke, hypertension, diabetes, cancer, lung disease, and limited activity than their European counterparts (Avendano et al., 2009)
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From page 85... ...
health disadvantage. People's emotional and neuropsychiatric health can affect diseases and injurious behavior that claim lives, and of course mental illness is itself an important health outcome (U.S.
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From page 86... ...
is more prevalent in the United States than in other high-income countries is still unclear. Crossnational studies of mental illness are limited because of inconsistencies in diagnostic criteria and disease classifications,19 survey administration methods, and measured covariables (e.g., demographic characteristics, risk factors, treatment)
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From page 87... ...
More specifically, when compared with the average for other high-income countries, the United States fares worse in nine health domains: adverse birth outcomes; injuries, accidents, and homicides; adolescent pregnancy and sexually transmitted infections; HIV and AIDS; drug-related mortality; obesity and diabetes; heart disease; chronic lung disease; and disability.
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From page 88... ...
Deaths that occur before age 50 are responsible for about twothirds of the difference in life expectancy between males in the United States and other high-income countries and about one-third of the difference for females. Americans reach age 50 in poorer health than their counterparts in other high-income countries, and as older adults they face greater morbidity and mortality from chronic diseases that arise from risk factors (e.g., smoking, obesity, diabetes)
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From page 89... ...
The United States enjoys some health advantages, including a suicide rate that is at or below the OECD average, low cancer mortality rates, and possibly greater control of blood pressure and serum lipids. And despite objective measures to the contrary, American adults are more likely than others to rate their health as good.
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From page 90... ...
health disadvantage documented in this and the preceding chapter could arise from problems with health care, individual behaviors, social factors, the environment, or various policies. In Part II of the report, we explore these issues in an effort to explain why, compared with their counterparts elsewhere, Americans face shorter lives and greater illness at almost all ages.
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