Americans living longer, but feeling worse

Many with private insurance dissatisfied with coverage
Many with private insurance dissatisfied with coverage

HealthDay News -- Americans are living longer, but experience higher rates of disability and other health problems compared with other developed nations, results of a 34-country population health study indicate.

From 1990 to 2010, overall life expectancy in the United States increased from 75 to 78 years, but so did expected years lost to disability (9.4 to 10.1 years), Christopher J.L. Murray, MD, DPhil, of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle and colleagues reported in the Journal of the American Medical Association.

U.S. ranking on several health measures fell, including life expectancy at birth (from No. 20 to No. 27), life years lost to premature death (from 23rd to 28th), healthy life expectancy (from 14th to 26th) and on age-standardized death rate (from 18th to 27th), compared with other wealthy countries during the same time period,

In terms of years living with disability, the United states dropped from fifth to sixth, with Japan (1), Mexico (2), South Korea (3), Spain (4) and Chile (5) scoring better out of the 34 comparable countries.

Low back pain, major depressive disorder, other musculoskeletal disorders, neck pain and anxiety disorders were the top five conditions in a list of 30 health problems among those living with disability in 2010. This ranking did not change from 1990.

Other major causes of disability included diabetes (ranking 8th on the list), asthma (10th), Alzheimer disease (12th), ischemic heart disease (16th) and stroke (17th).

"[M]orbidity and chronic disability now account for nearly half of the U.S. health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations," the researchers wrote.

In 2010, the diseases and injuries with the largest number of years of life lost due to premature mortality were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease and road injury.

The rate of premature death due to drug use, chronic kidney disease, kidney cancer and diabetes also increased, with diabetes jumping from 15th to 7th in terms of life years lost and Alzheimer disease moving from 32nd to 9th.

The report, called the Global Burden of Disease 2010, quantified the health affects of 291 diseases and injuries, 1,160 clinical sequelae and 67 risk factors to determine those that contribute to the greatest losses in health and life to better target public health campaigns and medical care.

Several avoidable risk factors contribute to the rising U.S. disease burden, including poor diet, tobacco and alcohol use, obesity, hypertension, high blood sugar and physical inactivity, the researchers determined.

Although physical activity increased, obesity rates have continued to rise across the board, with obesity rates declining in just nine U.S. counties from 2001 to 2009.

In an accompanying editorial, Harvey Fineberg, MD, PhD, president of the Institute of Medicine, noted that despite U.S. health expenditure increasing to a level "that would have seemed unthinkable a generation ago," the nation's health has fallen behind those in other wealthy nations.

"Setting the United States on a healthier course will surely require leadership at all levels of government and across the public and private sectors and actively engaging the health professions and the public," Fineberg wrote.

References

  1. Murray CJL et al. JAMA 2013; doi:10.1001/jama.2013.13805.
  2. Fineberg HV. JAMA. 2013; doi:10.1001/jama.2013.13809.
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