HealthDay News — Americans have worse health than their peers in high-income countries, despite higher healthcare spending, according to a report from the National Research Council and the Institute of Medicine.

American men ranked last in life expectancy among the 17 countries included in the study, and American women ranked second to last, Steven Woolf, MD, professor of family medicine at the Virginia Commonwealth University in Richmond, Va., and colleagues reported in the 378-page study, Shorter Lives, Poorer Health.

The researchers compared death rates and health outcomes among Americans from birth to age 75 with populations from other high-income democracies, including Canada, Japan, Australia, France, Germany and Spain. Historical trends were reviewed beginning in the 1970s, with most of the data in the report coming from the late 1990s through 2008.

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Coined the “American health disadvantage,” deaths before age 50 years accounted for about two-thirds of the difference in life expectancy between U.S. men and their counterparts in other developed countries, and about one-third of the difference between women.

“Americans who do reach age 50 generally arrive at this age in poorer health than their counterparts in other high-income countries, and as older adults they face greater morbidity and mortality from chronic diseases that arise from risk factors that are often established earlier in life,” Woolf and colleagues wrote.

Americans fared worse in nine key areas of health, including infant mortality and low birth weight, injuries and homicides, teenage pregnancies and sexually transmitted infections, HIV/AIDS prevalence, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease, and disability.

In particular, the researchers found Americans ranked highest in the following areas:

  • Adolescents pregnancies and sexually transmitted infections
  • Prevalence of HIV among 15- to 49-year-olds
  • Years of life lost to alcohol and drug abuse before 50 years of age
  • Obesity rates
  • Diabetes from age 20 years onward

Mortality associated with guns and car accidents were also much higher in the United States compared with the other countries. American homicides attributable to firearms were 69% in 2007 compared with an average of 23% in all the other countries.

A health system with a relatively large uninsured population, poor health behaviors — including high calorie consumption and higher rates of drug abuse — poor socioeconomic conditions and physical environments designed around cars, are some of the factors the researchers hypothesize contribute to these trends.

“If we fail to act, the disadvantage will continue to worsen and our children will face shorter lives and greater rates of illness than their peers in other rich nations,” Woolf said in a press release.

Despite shortcomings in many health outcomes, there were several areas where American’s fared better, including cancer screening and survival rates, BP and cholesterol control, lower smoking rates and more seniors older than 75 years living longer. U.S. hospital mortality and suicide rates were comparable to those in other countries.

The researchers called for public health campaigns to raise public awareness and encourage a national debate. New research and better collaboration between research agencies are necessary to better understand U.S. health disadvantages and determine the best strategies to improve outcomes, they added.