What's Killing Americans in the Prime of Life?

Abstract

This article compares health outcomes in the United States with those prevailing in other nations, in terms of survival during the prime of life, ages 15 to 59 years. To seek to explain U.S. mortality excesses, age-gender-cause– specific mortality rates are compared for the United States and nine economically comparable nations, using World Health Organization national survival statistics (life tables) and age-gender–specific mortality rates by major causes. Additional data were drawn from the U.S. National Center for Health Statistics. Compared with other nations in the WHO's mortality database, in the United States 15-year-old girls rank 38th and 15-year-old boys rank 34th in their likelihood of reaching age 60. U.S. adults ages 15 to 64 years have higher total mortality than those in the nine other developed nations selected for the study (and in more nations as well), for both genders and for all the five decades of life considered. The authors identify the specific causes of excess U.S. mortality. Despite huge expenditures for medical care, U.S. citizens have embarrassingly high death rates during the prime of life. Nine issues are highlighted that may illuminate ways to improve health in the United States.

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