IOM Report: Why do Americans Live Shorter, Unhealthier Lives?

Americans live shorter and unhealthier lives compared with peer countries, according to a new report by the Institute of Medicine and the National Research Council.

The report, "U.S. Health in International Perspective: Shorter Lives, Poorer Health," compares life expectancy and health in the United States with 16 peer countries — other high-income democracies — using data primarily from the late 1990s through 2008. The peer countries include Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and the United Kingdom.

The United States spends more per person on healthcare than any other country, according to the report. However, Americans die at younger ages and have poorer health from birth through adulthood. The U.S. lags other countries in at least nine health indicators compared with the average of peer countries, according to the report:

1.    Infant mortality and low birth weight
2.    Injuries and homicides
3.    Adolescent pregnancy and sexually transmitted infections
4.    HIV and AIDS
5.    Drug-related deaths
6.    Obesity and diabetes
7.    Heart disease
8.    Chronic lung disease
9.    Disability

The exceptions to Americans' poorer health are lower cancer death rates and better control of blood pressure and cholesterol levels. In addition, Americans who live to 75 tend to live longer than people in the 16 peer countries.

The report's authors identified several possible reasons for Americans' worse health:

1. Health systems. The United States has a larger uninsured population and less access to primary care.
2. Health behaviors. While Americans are less likely to smoke than people in peer countries, they consumer more calories per person and have higher rates of drug abuse, among other behaviors.
3. Social and economic conditions. On average, Americans' income is higher than in other countries. However, the U.S. has higher levels of poverty and income inequality and lower rates of social mobility, according to the report.
4. 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 obesity," the authors wrote.

The authors concluded that more awareness among the U.S. public is needed to trigger changes in the U.S. public health system to improve health and stymie rising healthcare costs.

More Articles on U.S. Health vs. Other Countries:

How Does U.S. Healthcare Quality Fare Against 10 Countries?
A Look From Within: Why Are U.S. Healthcare Costs so High?

U.S. Outspends 12 Industrialized Nations on Healthcare, But Quality Lags

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