Thursday, January 10, 2013

Fwd: qotd: U.S. Health in International Perspective: Shorter Lives, Poorer Health

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-------- Original Message --------
Subject: qotd: U.S. Health in International Perspective: Shorter Lives,
Poorer Health
Date: Thu, 10 Jan 2013 16:01:07 -0800
From: Don McCanne <>
To: Quote-of-the-Day <>

National Research Council
Institute of Medicine
January 2013
U.S. Health in International Perspective: Shorter Lives, Poorer Health

The United States is among the wealthiest nations in the world, but it
is far from the healthiest. Although Americans' life expectancy and
health have improved over the past century, these gains have lagged
behind those of other high-income countries. This health disadvantage
prevails even though the United states spends far more per person on
health care than any other nation.

To gain a better understanding of this problem, the National Institutes
of Health (NIH) asked the National Research Council and the Institute of
Medicine to convene a panel of experts to investigate potential reasons
for the U.S. health disadvantage and to assess larger implications. The
panel's findings are detailed in its report, U.S. Health in
International Perspective: Shorter Lives, Poorer Health.

The panel was struck by the gravity of its findings. For many years,
Americans have been dying at younger ages than people in almost all
other high-income countries. This disadvantage has been getting worse
for three decades, especially among women.

When compared with the average of peer countries, Americans as a group
fare worse in at least nine health areas:

* infant mortality and low birth weight

* injuries and homicides

* adolescent pregnancy and sexually transmitted infections

* HIV and AIDS

* drug-related deaths

* obesity and diabetes

* heart disease

* chronic lung disease

* disability

Many of these conditions have a particularly profound effect on young
people, reducing the odds that Americans will live to age 50. And for
those who reach age 50, these conditions contribute to poorer health and
greater illness later in life.

The United States does enjoy a few health advantages when compared with
peer countries, including lower cancer death rates and greater control
of blood pressure and cholesterol levels. Americans who reach age 75 can
expect to live longer than people in the peer countries. With these
exceptions, however, other high-income countries outrank the United
States on most measures.

Why are Americans so unhealthy?

The panel's inquiry found multiple likely explanations for the U.S.
health disadvantage:

* Health systems. Unlike its peer countries, the United States has a
relatively large uninsured population and more limited access to primary
care. Americans are more likely to find their health care inaccessible
or unaffordable and to report lapses in the quality and safety of care
outside of hospitals.

* Health behaviors. Although Americans are currently less likely to
smoke and may drink alcohol less heavily than people in peer countries,
they consume the most calories per person, have higher rates of drug
abuse, are less likely to use seat belts, are involved in more traffic
accidents that involve alcohol, and are more likely to use firearms in
acts of violence.

* Social and economic conditions. Although the income of Americans is
higher on average than in other countries, the United States also has
higher levels of poverty (especially child poverty) and income
inequality and lower rates of social mobility. Other countries are
outpacing the United States in the education of young people, which also
affects health. And Americans benefit less from safety net programs that
can buffer the negative health effects of poverty and other social

* Physical environments. U.S. communities and the built environment are
more likely than those in peer countries to be designed around
automobiles, and this may discourage physical activity and contribute to

The tragedy is not that the United States is losing a contest with other
countries, but that Americans are dying and suffering from illness and
injury at rates that are demonstrably unnecessary. Superior health
outcomes in other nations show that Americans can also enjoy better health.

"U.S. Health in International Perspective: Shorter Lives, Poorer Health"
- Full 405 page report can be downloaded for fee at this link:

Comment: The United States is sick, literally and figuratively. We have
the most expensive health care system, yet the worst health outcomes of
the wealthier nations. The failures are not only with our health system
but with much broader sociopolitical institutions.

In response to these glaring deficiencies, this NRC/IOM report places an
emphasis on further research to better define the problem and identify
interventions that would help. Research is fine, but we do not need to
wait any longer when so many of the deficiencies our already in our face.

The brief paragraph above on health systems confirms the pressing need
for an effective universal insurance system, along with an expansion of
our primary care infrastructure. Enacting the PNHP single payer model
would finally set us in the right direction toward a high-performance
health care system.

The social and economic conditions, physical environments, and health
behaviors demonstrate a crying need for much more effective
sociopolitical public policies. Not only do we need a reinforcement of
our public health system, we also need greater public action in
education, community planning, and especially responsible government
policies to correct the gut-wrenching social and economic injustices
that permeate our society.

From the opponents of reform we continue to hear that we have the
greatest health care system in the world and that we have the very best
health outcomes. Download this highly credible report so that you will
have it readily available to expose these liars for what they are. Also
use it to educate politicians on the broad spectrum of urgent public
policies that we so desperately need.

And while we're at it, we need to fire the politicians who are
promulgating these cruel lies.

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