Americans die younger than others in rich nations

Americans live sicker and die younger than people in other wealthy countries — and the gap is getting worse over time, a new report shows.

Men in the USA have shorter lives than men in 16 developed nations. American women also fall near the bottom of the list, living 5.2 fewer years than Japanese women, who live the longest.

Americans "have a long-standing pattern of poorer health that is strikingly consistent and pervasive" over a person's lifetime, says the report, from the Institute of Medicine and the National Research Council, independent, non-profit groups that advise the federal government on health.

"The tragedy is not that the United States is losing a contest with other countries," the report says, "but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary."

Family physician Steven Woolf, who chaired the panel that wrote the report, said authors were "stunned by these findings."

The report's most important purpose, Woolf says, is to alert Americans to these problems. "Our sense is that Americans don't really know about this," says Woolf, a professor at Virginia Commonwealth University in Richmond. "I don't think people realize that their children are likely to live shorter lives than children in other countries."

Most of the difference between male Americans' longevity and that of their peers is due to deaths before age 50, with many problems rooted in poor childhood health, according to the report, published online Wednesday.

The USA has had the highest infant mortality rate of any developed country for several decades, due partly to a high rate of premature birth. With more than one in five American children living in poverty, the USA also has the highest child poverty rate, the report says.

The USA ranks at or near the bottom in nine key areas of health: low birth weight; injuries and homicides; teen pregnancy and sexually transmitted infections; HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and general disability.

These poor outcomes are especially depressing, because the USA spends twice as much on healthcare -- about $9,000 per person -- as other industrial countries, says Gerard Anderson of the Johns Hopkins School of Public Health, who was not involved in the report.

Authors examined health by income and race, Woolf says, to ascertain whether Americans' overall low health scores were mostly due to the poor health among minorities and low-income Americans. Many studies have noted stark disparities in health between whites and blacks, for example.

Yet even wealthy, white Americans fare worse than their equally wealthy counterparts in other countries, Woolf say.

Well-educated Americans — with medical insurance and healthy habits, such as avoiding tobacco and obesity — are still sicker than their peers abroad.

The USA fares better in comparison with other nations in a few measures, such as cancer death rates and greater control of cholesterol and blood pressure, the report says.

Authors say a number of factors likely contribute to Americans' poor health.

Although fewer Americans smoke and drink heavily, they have many other bad habits, the report says. Americans consume more calories per person and are more likely to abuse drugs; less likely to wear seat belts and more likely to be in a traffic accident; and they e more likely to use a firearm in acts of violence.

Investing in early childhood education could help to reverse these trends, says David Howard, an associate professor at the Emory University School of Public Health in Atlanta. Better-educated people have an easier time navigating the medical system and applying health information to their lives, Howard says.

Thomas McInerny, president of the American Academy of Pediatrics, says the report is a reminder that "we need to do a better job of prevention," intervening very early in life to make sure kids are healthy, such as through high-quality day care.

In particular, McInerny is concerned about new research on chronic, "toxic stress" — caused by poverty, violence, neglect or other lasting traumas. Unlike temporary obstacles, which can build character, long-term "toxic stress" can damage children for a lifetime.

"It's becoming increasingly clear that the first 1,000 days of life are critically important for children's development, and can determine the course of their life span from then on," McInerny says. "Investing in children in the first three years of life provides higher returns, for improving their productivity as adults, compared to intervening later."

McInerny points to nurse home visiting programs, which provide one-on-one support and education to high-risk mothers, as one of the most successful ways to prevent child abuse and improve academic success.

"We already know what to do," Woolf says. "It's more a matter of having the resolve and resources to actually do it."