Younger Americans die earlier and live in poorer health than their counterparts in other wealthy countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health in the United States.
Researchers have known for some time that the U.S. fares poorly in comparison with other developed countries, a trend established in the 1980s. But most studies have focused on older ages, when the majority of people die.
The new findings were stark.
Deaths that occur before age 50 accounted for about two-thirds of the difference in life expectancy between U.S. males and those in 16 other developed countries, and about one-third of the difference for females.
The other countries: Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands and the U.K.
“The pervasiveness of the problem was really staggering,” Dr. Steven Woolf, a family medicine professor at Virginia Commonwealth University and chairman of the panel that wrote the report, told Bloomberg News. “I don't think American parents know their children will live a shorter life.”
The report called for more study of other countries' strategies and immediate action against clear threats such as obesity, saying that “with lives and dollars at stake, the United States cannot afford to ignore this problem.”
Conducted by the Institute of Medicine and the National Research Council, the study was the first to systematically compare death rates and health measures for people of all ages, including U.S. youths. It went further than other research in documenting the full range of causes of death, from diseases to accidents to violence.
The panel called the pattern of higher disease rates and shorter lives “the U.S. health disadvantage,” and said it was responsible for dragging the country to the bottom in terms of life expectancy over the past 30 years.
U.S. men ranked last in life expectancy among the 17 countries, U.S. women second-to-last.
“Something fundamental is going wrong,” Woolf said. “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind. ... And it's getting worse.”
Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50.
Gun violence was a prominent feature of the report, a finding that takes on extra urgency coming less than a month after the massacre of 26 people, most of them children, at an elementary school in Newtown, Conn.
“One behavior that probably explains the excess lethality of violence and unintentional injuries in the United States is the widespread possession of firearms and the common practice of storing them (often unlocked) at home. The statistics are dramatic,” the report said.
The rate of firearm homicides was 20 times higher in the U.S. than in the other countries, it said; 69 percent of all U.S. homicides in 2007 involved firearms, compared with an average of 26 percent in the other countries.
The U.S. has about six violent deaths per 100,000 residents. None of the 16 other countries was anywhere close to that ratio. Finland was closest with about two per 100,000.
For many years, Americans have been dying at younger ages than people in almost all other wealthy countries. In addition to the effect of gun violence, Americans consume the most calories and are in more accidents that involve alcohol. Americans also suffer higher rates of drug-related deaths, infant mortality and AIDS.
Researchers noted that the U.S. has a large uninsured population compared to other countries with comparable economies, and more limited access to primary care. And although U.S. income is higher on average than that of the other wealthy countries, the U.S. has a higher level of poverty, especially among children.
The researchers said American culture probably plays an important role.
“We have a culture in our country that, among many Americans, cherishes personal autonomy and wants to limit intrusion of government and other entities on our personal lives and also wants to encourage free enterprise and the success of business and industry. Some of those forces may act against the ability to achieve optimal health outcomes,” Woolf said.
“The bottom line,” said Samuel Preston, a demographer and sociologist who also was on the panel, “is that we are not preventing damaging health behaviors. You can blame that on public health officials or on the health care system. No one understands where responsibility lies. But put it all together and it is creating a very negative portrait.”
This report includes material from the Associated Press.