U.S. Lags Other Nations in Health Outcomes, Despite Leading in Spending

By Chris Adams

The U.S. may lead the world in wealth, military power and Olympic medals. But there’s one area it sorely lags: health outcomes.

Consider the ranking of deaths from non-communicable diseases among the U.S. and its peer nations. Japan comes out on top, with a death rate of 273 per 100,000 people.

The U.S. is 17th, with a rate of 418; it’s behind Portugal, Germany and the United Kingdom.

Why? That’s the focus of research by Dr. Sandro Galea, dean of the Boston University School of Public Health. His book on the subject, “Healthier: Fifty Thoughts on the Foundations of Population Health,” is out in July 2017 (Oxford University Press, Amazon).

In a session with National Press Foundation fellows, Galea described some of the most compelling – and disturbing – statistical findings that put the U.S. public health system in context.

Life expectancy among women in the U.S., for example, used to rank in the middle of the pack among a group of 21 other high-income countries. That was in 1980; the U.S. has inched up since then – but other countries have risen faster, so the U.S.’s relative position has dropped.

“Over the course of the last 35 years, we have drifted to the bottom,” he said.

On a county-by-county ranking in the U.S., the gap in life expectancy can be 20 years.

And it’s not from a lack of spending money on health, Galea said. The U.S. spends more – and that spending is rising faster – than in other countries.

He showed a chart of adults with diabetes by T stop (the T is the Boston area subway system). In a measure of how health care varies widely by neighborhood, often in conjunction with poverty, the diabetes rates went from 2 percent to 11 percent.

And he showed that, according to the data on national health expenditures, medical services only play a small role in people’s overall health – but they get nearly 90 percent of the spending.

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