The United States is falling behind its peers in nearly every cause of premature death, according to a study published in the Journal of the American Medical Association. While the country made strides in some areas, it lags behind the rest of the world in many others, and researchers say that the massive amount of dollars spent on health care aren’t translating into meaningful results.
Researchers looked at the number of premature deaths between 1990 and 2010, and found that even though the average life expectancy for Americans increased from 75.2 to 78.2 the number of premature deaths from diseases such as Alzheimer’s, liver cancer, Parkinson’s disease, and kidney cancer rose sharply. In addition, the number of life years lost to conditions related to drug use disorders increased by 448 percent over the course of the study.
“The United States spends more than the rest of the world on health care and leads the world in the quality and quantity of its health research, but that doesn’t add up to better health outcomes,” Christopher Murray, MD, study author and director of the Institute for Health Metrics and Evaluation (IHME) in Seattle, said in a statement. “The country has done a good job of preventing premature deaths from stroke, but when it comes to lung cancer, preterm birth complications, and a range of other causes, the country isn’t keeping pace with high-income countries in Europe, Asia, and elsewhere.”
The rates of neurological diseases and disorders related to poor diet and exercise skyrocketed over the two decades, according to the study. Alzheimer’s disease, which was ranked as the 32nd-highest cause of years of life lost in 1999, shot to number 9 in 2010. Likewise, diabetes went from number 15 to 7.
Smoking, high blood pressure, poor diet and physical inactivity were some of the major contributors in causing the prevalence of such diseases to increase, researchers said.
“If the U.S. can make progress with dietary risk factors, physical activity, and obesity, it will see massive reductions in death and disability,” Ali Mokdad, MD, study author and head of the U.S. County Health Performance team for IHME, said in a statement. “Unhealthy diets and a lack of physical activity in the U.S. cause more health loss than smoking, alcohol, or drug use.”
Robert Rosenson, MD, director of cardio-metabolic disorders, at Mount Sinai Medical Center in New York City, called the findings “disappointing.”
“It’s quite disappointing that the U.S. is falling behind in outcomes for diseases, such as cardiovascular disease, and especially those diseases with preventable causes,” he said. “We need to make a major effort to make better lifestyle choices daily based on diet.”
The U.S. did make strides in the fight against diseases such as AIDS, which went from the 7th highest cause of years of life lost in 1999 to 23 in 2010, according to the study.
Do The Dollars Make Sense?
The U.S. spends approximately 17.6 percent of its GDP on healthcare, but still has a lower life expectancy than countries such as Japan, which spends 9 percent of its GDP on healthcare.
“The United States spends the most per capita on health care across all countries, lacks universal health coverage, and lags behind other high-income countries for life expectancy and many other health outcome measures,” the researchers wrote in the study. “High costs with mediocre population health outcomes at the national level are compounded by marked disparities across communities, socioeconomic groups, and race and ethnicity groups.”
Amongst its 40 economic peers, the U.S. dropped from 18th in premature deaths in 1990 to 27th in 2010, and the life expectancy at birth fell from 20th to 27th. And while the U.S. slipped, countries such as Australia, Germany, Israel and Italy made strides in reducing their death rate. Japan held on to the number one spot for the duration of the study.
The findings indicate that the U.S. doesn’t need to spend more on health care, but spend smarter instead.
“The best investments for improving population health would likely be public health programs and multisectoral action to address risks such as physical inactivity, diet, ambient particulate pollution, and alcohol and tobacco consumption,” the researchers wrote in the study.
Addressing the problems will require a multi-pronged approach, Harvey Fineberg, M.D., Ph.D., a researcher with the Institute of Medicine in Washington, D.C., wrote in an accompanying editorial, but tackling the problems from all angles could make a big difference in a short amount of time.
“Setting the United States on a healthier course will surely require leadership at all levels of government and across the public and private sectors and actively engaging the health professions and the public,” he wrote. “If all constituents do their parts, the apt subtitle for the next generation’s analysis of U.S. health will be not ‘doing better and feeling worse (still),’ but ‘getting better faster than ever.’”
Parents, teachers and community leaders also need to take charge of children, Dr. Rosenson said, in order to stop them from developing the same problems as the older generations.
“Efforts by communities across our country need to take charge of what we are providing our children to eat at home and at school,” he said. “The costs due to poor eating and disabling health conditions are overtaxing our society. We can’t afford it.”
Source: Everyday Health