U.S. performs poorly on preventable death rates

European researchers said America lags behind other industrialized nations, particularly in reducing death rates among the nonelderly and in the pace of improvement.

By — Posted Sept. 7, 2012

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Americans younger than age 65 have higher chances of dying from preventable conditions than those in other industrialized nations, according to a new study.

The study, sponsored by the Commonwealth Fund and published online by Health Affairs, concluded that the U.S. ranked behind the United Kingdom, France and Germany on avoidable mortality rates, and that it also was progressing at the slowest pace to improve these statistics (link).

“Despite spending about twice as much per person each year on health care as France, Germany or the U.K. — $8,400 in 2010 — the U.S. is increasingly falling behind these countries in terms of progress in lowering the potentially preventable death rate,” Commonwealth Fund President Karen Davis said in a statement.

In conducting their research, Martin McKee, professor of European public health at the London School of Hygiene & Tropical Medicine, and Ellen Nolte, director of the health and health care at RAND Europe, looked at “amenable mortality trends.” These are deaths that could have been avoided before age 75 through effective and timely access to care. The researchers also analyzed the death rates for individuals younger than age 65 and those between the ages of 65 and 74 who had died from treatable cancer, heart disease, diabetes and infections.

In 2007, the most recent year for which data were reported for the study, “amenable mortality was highest in the United States, with rates almost twice as those seen in France,” the study’s researchers found. Declines in preventable death rates in the U.S. were half of those in the United Kingdom. For U.S. men and women up to age 74, avoidable mortality rates decreased by just 18.5% and 17.5%, respectively, from 1999 to 2007, compared with 37% and 32% in the U.K.

The least amount of progress in reducing avoidable death rates was seen in those younger than age 65. Between 1999 and 2007, “Americans under age 65 during this period had elevated rates of amenable mortality compared to their peers in Europe,” the study concluded.

U.S. men and women in this age group were more likely to have no health insurance and struggle more with care access issues than those eligible for Medicare. “However, we also observed a slowing of improvement among older Americans, relative to their peers in the other countries we studied,” the authors stated.

Failure to reduce circulatory conditions other than heart disease, such as hypertension, was cited as the main driver behind the poor U.S. performance rates on preventable deaths. The nation also has had a lack of progress in preventing avoidable deaths that arise from medical errors and surgical complications.

The U.S. fared better on mortality rates for treatable cancers. Although deaths from these conditions had similar declines in all four countries studied, rates were lowest in the U.S. among men in the older-age categories. U.S. women, in the meantime, “experienced the lowest levels of mortality from treatable cancers, closely followed by French women,” according to the study.

Davis said the health system reform law’s efforts to close access-to-care gaps should help improve avoidable mortality levels in the United States.

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