A new study released in Health Affairs found that out of nineteen industrialized nations, the U.S. ranked dead last in preventable deaths. Here is the Abstract:
We compared trends in deaths considered amenable to health care before age seventy-five between 1997–98 and 2002–03 in the United States and in eighteen other industrialized countries. Such deaths account, on average, for 23 percent of total mortality under age seventy-five among males and 32 percent among females. The decline in amenable mortality in all countries averaged 16 percent over this period. The United States was an outlier, with a decline of only 4 percent. If the United States could reduce amenable mortality to the average rate achieved in the three top-performing countries, there would have been 101,000 fewer deaths per year by the end of the study period.
While the reasons for the U.S. performance are many, IMO one of the primary factors is that the U.S. does not allocate adequate resources to preventive medicine and public health. We have noted before on this blog the 2006 statistics that 96% of U.S. health care dollars are spent on acute care and biomedical research, with only 1-2% expended on preventive medicine and public health. Almost by definition, acute care does little to prevent morbidities that over time are productive of higher mortality.
This study adds to the copious data finding that the U.S. health care system is mediocre at best as compared to other industrialized nations. Some of this data is methodologically flawed, but there remains ample evidence to conclude that as to overall population health, the U.S. has much room for improvement. And a significant portion of the improvement, IMO, ought to come in increased resources and attention paid to preventive medicine and public health, since there is excellent evidence that such interventions are likely to have a much greater effect on population health than acute care interventions.