Thursday, July 11, 2013

Fwd: qotd: The State of US Health: Older but Sicker

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Subject: qotd: The State of US Health: Older but Sicker
Date: Thu, 11 Jul 2013 11:45:53 -0700
From: Don McCanne <>
To: Quote-of-the-Day <>

July 10, 2013
The State of US Health, 1990-2010
By US Burden of Disease Collaborators


To measure the burden of diseases, injuries, and leading risk factors in
the United States from 1990 to 2010 and to compare these measurements
with those of the 34 countries in the Organisation for Economic
Co-operation and Development (OECD) countries.


We used the systematic analysis of descriptive epidemiology of 291
diseases and injuries, 1160 sequelae of these diseases and injuries, and
67 risk factors or clusters of risk factors from 1990 to 2010 for 187
countries developed for the Global Burden of Disease 2010 Study to
describe the health status of the United States and to compare US health
outcomes with those of 34 OECD countries.


US life expectancy for both sexes combined increased from 75.2 years in
1990 to 78.2 years in 2010; during the same period, HALE (healthy life
expectancy) increased from 65.8 years to 68.1 years. The diseases and
injuries with the largest number of YLLs (years of life lost due to
premature mortality) in 2010 were ischemic heart disease, lung cancer,
stroke, chronic obstructive pulmonary disease, and road injury.
Age-standardized YLL rates increased for Alzheimer disease, drug use
disorders, chronic kidney disease, kidney cancer, and falls. The
diseases with the largest number of YLDs (years lived with disability)
in 2010 were low back pain, major depressive disorder, other
musculoskeletal disorders, neck pain, and anxiety disorders. As the US
population has aged, YLDs have comprised a larger share of DALYs
(disability-adjusted life-years) than have YLLs. The leading risk
factors related to DALYs were dietary risks, tobacco smoking, high body
mass index, high blood pressure, high fasting plasma glucose, physical
inactivity, and alcohol use. Among 34 OECD countries between 1990 and
2010, the US rank for the age-standardized death rate changed from 18th
to 27th, for the age-standardized YLL rate from 23rd to 28th, for the
age-standardized YLD rate from 5th to 6th, for life expectancy at birth
from 20th to 27th, and for HALE from 14th to 26th.

Conclusions and Relevance

From 1990 to 2010, the United States made substantial progress in
improving health. Life expectancy at birth and HALE increased, all-cause
death rates at all ages decreased, and age-specific rates of years lived
with disability remained stable. However, morbidity and chronic
disability now account for nearly half of the US health burden, and
improvements in population health in the United States have not kept
pace with advances in population health in other wealthy nations.

Comment: According to The Washington Post (July 10), Thomas R. Frieden,
director of the Centers for Disease Control and Prevention "noted that
the United States is among the last of its economic peers in offering
universal health care, and it is late in making societal changes to
address the risks that needlessly shorten lives." He said, "The good
news is these are things we can do something about. If you look at the
county-by-county charts, it shows in communities where they took
improvements in health seriously, they were able to see dramatic

With our great wealth, we can do both. We can offer universal health
care, and we can expand public health programs, including fostering
societal changes that address our health risks. But first we need to
elect legislators and administrators who support these goals. It's
really up to us.

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