14 DAY TRIAL // A new Commonwealth Fund-supported study, concluded that the life expectancy of Americans continues to fall behind other countries', and the phenomenon has nothing to do with obesity, smoking, traffic fatalities, and homicide.
The study was carried out by Peter Muennig and Sherry Glied at Columbia University, who focused on several aspects like health spending, behavioral factors like obesity and smoking and 15-year survival rates for both men and women, aged 45 and 65 in the US and 12 other nations, including Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom.
Between 1975 and 2005, the United States have made progress in the 15-year survival rates, but so did the other countries, and their gains were even higher, which led the Us to go down in country ranking, even if individual health spending has doubled compared to the other countries' rate.
For men and women aged 45 and 65, the 15-year survival rates have fallen compared to the other 12 countries, in the past 30 years, and the tendency was worse for 45 year old American white women, who had the lowest 15-year survival rate by 2005.
This survival rate is so low, that it did not even surpass that of Dutch, Japanese, Swedish or Swiss women, back in 1975.
The 15-year life expectancy rate in en also dropped from the 3rd pace in 1975 to 12th in 2005.
For a correct classification of the countries, the researchers also compared the risk factors, and they found very small differences between the US and the other countries.
What is rather intriguing is that the Us had faster declines in smoking, between 1975 and 2005, than most of the countries did.
As for obesity, Americans are more likely to be obese, but apparently that was also the case back in 1975, when the US were better ranked in life expectancy, and the percentage of obese people actually grew more in the other countries, during the considered time period.
In terms of traffic accidents and homicide, the researchers found that these criteria did not influence significantly the 15-year life expectancy rate.
After these observations, the scientists concluded that the only culprit for this downtrend was the flawed health system, with its fee-for-service payments and high spending on specialty care, without any improvements in life expectancy.
Muennig, assistant professor at Columbia University's Mailman School of Public Health, said that “it shocking to see the US falling behind other countries even as costs soared ahead of them.
“But what really surprised us was that all of the usual suspects—smoking, obesity, traffic accidents, and homicides—are not the culprits.
“The US doesn't stand out as doing any worse in these areas than any of the other countries we studied, leading us to believe that failings in the US health care system, such as costly specialized and fragmented care, are likely playing a large role in this relatively poor performance on improvements in life expectancy."
Commonwealth Fund President Karen Davis stressed that “this study provides stark evidence that the US health care system has been failing Americans for years” and that “ it is unacceptable that the US obtains so much less than should be expected from its unusually high spending on health care relative to other countries.”
She added that “the good news is that the Affordable Care Act will take significant steps to improve our health care system and the health of Americans by expanding health insurance, improving primary care, and holding health care organizations accountable for their patients' overall health and ensuring the coordination of primary care and specialty care to eliminate errors, waste of patients' time, and wasteful duplication of tests and services.”
The study entitled “What Changes in Survival Rates Tell Us About US Health Care” was published today on The Commonwealth Found website.