U.S. Ranks Last Among Industrialized Nations for Preventable Deaths, Study Finds

The United States places last among nineteen industrialized countries when it comes to deaths that could have been prevented by access to timely and effective health care, a new report funded by the Commonwealth Fund finds.

Published in the latest issue of Health Affairs, the study, Measuring the Health of Nations: Updating an Earlier Analysis, finds that while other nations dramatically improved their preventable death rates between 1997-98 and 2002-03, the United States improved its rate only slightly. If the United States had performed as well as France, Japan, and Australia — the top three countries in the survey — there would have been 101,000 fewer deaths per year by the end of the study period.

Authored by Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine, the report, which looked specifically at deaths "amenable to health care before age 75," found that while other countries saw these types of deaths decline by an average of 16 percent, the United States experienced only a 4 percent decline. "It is difficult," Nolte and McKee write, "to disregard the observation that the slow decline in U.S. amenable mortality has coincided with an increase in the uninsured population."

While the United States ranked fifteenth out of the nineteen countries on the "mortality amenable to health care" measure in 1997-98, it had fallen to last place by 2002-03, with 109 deaths amenable to health care for every 100,000 people, compared to 64 in France and 71 in both Japan and Australia.

"It is startling to see the United States falling even farther behind on this crucial indicator of health system performance," said Commonwealth Fund senior vice president Cathy Schoen. "By focusing on deaths amenable to health care, Nolte and McKee strip out factors such as population and lifestyle differences that are often cited in response to international comparisons showing the United States lagging in health outcomes. The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference."