US must reform health care industry to improve life expectancy, study says – The Hill

History at a glance

  • The Commonwealth Fund compares US life expectancy data with other major middle- and high-income countries.

  • Mississippi and West Virginia have the lowest life expectancy in the US at 74 years. California and Hawaii have the highest at nearly 81 years.

  • Although the US spends the most on health care compared to other major nations, the average life expectancy here is dramatically lower.

Americans’ life expectancy took a hit with a new report highlighting that despite spending more on health care than any other nation, the US has more preventable deaths than other middle- and high-income countries.

Life expectancy in the US varies dramatically depending on where Americans live, with those in the South having the lowest rates. Mississippi and West Virginia have an average life expectancy of about 74 years, while California and Hawaii are almost 81 years old.

This is according to a report by The Commonwealth Fund, which analyzed data on life expectancy from the Centers for Disease Control and Prevention (CDC) against that of countries that are part of the Organization for Economic Co-operation and Development (OCED). The researchers found that even compared to states that have higher life expectancies, such as California and Hawaii, the US still ranks below other large, developed nations.

For example, in Japan the average life expectancy is 84.4 years, in Spain and Switzerland it is 84 years, and in neighboring Canada it is 82.3 years.

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However, the researchers emphasized that regardless of where Americans live, they are “more likely to die earlier than people in many other countries. And they are more likely to die from factors that could have been prevented with the right care provided at the right time.

The researchers explained that life expectancy is determined by multiple factors, including socioeconomic circumstances, public health systems and policy choices. Health care is a big problem, and one that the U.S. struggles with, ranking last in access to care, administrative efficiency, equity, and health outcomes—even though it spends the most.

From 1980 to 2019, the Commonwealth Fund found that the US spent nearly 17 percent on health care as a percentage of its gross domestic product (GDP). Other countries spend well below this but still score higher in healthcare, such as Switzerland, the UK, Australia, Norway and others.

One major problem identified by the researchers is avoidable mortality, defined as death before age 75 from conditions that are preventable through effective public health and primary prevention or treatable when detected early and provided effective care management.

Deaths from diabetes, certain infections, breast and colon cancer, appendicitis are some examples of avoidable mortality.

The US was found to have much higher avoidable mortality rates, 272 per 100,000 people, than other OCED countries. Mississippi and West Virginia had more than 400 deaths per 100,000 people, more than all other OCED countries, including Mexico, Lithuania, Latvia and Hungary.

From 2019 to 2020, the CDC said the decline in life expectancy in the U.S. can be attributed primarily to deaths from the pandemic, accidents/unintentional injuries, and drug overdose deaths.

Commonwealth researchers have outlined a number of actions the US can take to address alarming levels of life expectancy, starting with offering universal insurance coverage to all Americans with minimal cost barriers.

They also suggested committing to stronger community-based primary care, addressing administrative burdens that can impede access to care, and developing well-resourced social services that can support healthier populations and reduce stress on the system to provide health care.

One major difference highlighted, most other middle- and high-income countries in the OCED offer some form of guaranteed access to health care through universal health care programs.

Posted on August 16, 2022

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