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	<title>State of Health Blog from KQED News &#187; Mortality</title>
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	<description>A window into health in California</description>
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		<title>Best Health System in the World?</title>
		<link>http://blogs.kqed.org/stateofhealth/2013/01/09/best-health-system-in-the-world/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=best-health-system-in-the-world</link>
		<comments>http://blogs.kqed.org/stateofhealth/2013/01/09/best-health-system-in-the-world/#comments</comments>
		<pubDate>Thu, 10 Jan 2013 00:25:08 +0000</pubDate>
		<dc:creator>Lisa Aliferis</dc:creator>
				<category><![CDATA[Policy]]></category>
		<category><![CDATA[Longevity]]></category>
		<category><![CDATA[Mortality]]></category>
		<category><![CDATA[SDOH]]></category>
		<category><![CDATA[Social Determinants of Health]]></category>

		<guid isPermaLink="false">http://blogs.kqed.org/stateofhealth/?p=9850</guid>
		<description><![CDATA[        <media:content url="http://blogs.kqed.org/stateofhealth/files/2013/01/PregnantExamGenericGetty.jpg" medium="image" />
If one big thing you want out of life is to live a long time in good health, the U.S. is not doing such a great job, says a major report from the National Research Council and the Institute of Medicine, entitled "Shorter Lives, Poorer Health."

There's no explaining it away. A panel of physicians and researchers from around the country found a health disadvantage at all ages -- from birth to 75 -- when compared against people in 16 other "high income" countries. <a href="http://blogs.kqed.org/stateofhealth/2013/01/09/best-health-system-in-the-world/">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
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			<content:encoded><![CDATA[<div id="attachment_9865" class="wp-caption alignleft" style="width: 310px"><a href="http://blogs.kqed.org/stateofhealth/files/2013/01/PregnantExamGenericGetty.jpg"><img class="size-medium wp-image-9865" title="American children are less likely to live to age 5 than children in other high-income countries. (Photo: Comstock)" src="http://blogs.kqed.org/stateofhealth/files/2013/01/PregnantExamGenericGetty-300x200.jpg" alt="American children are less likely to live to age 5 than children in other high-income countries. (Photo: Comstock)" width="300" height="200" /></a><p class="wp-caption-text">American children are less likely to live to age 5 than children in other high-income countries. (Photo: Comstock)</p></div>
<p>If one big thing you want out of life is to live a long time in good health, the U.S. is not doing a good job, says a major report from the National Research Council and the Institute of Medicine, entitled &#8220;<a href="http://www.nap.edu/openbook.php?record_id=13497&amp;page=1" target="_blank">Shorter Lives, Poorer Health</a>.&#8221;</p>
<p>There&#8217;s no explaining it away. A panel of physicians and researchers from around the country found a health disadvantage at all ages &#8212; from birth to 75 &#8212; when compared against people in 16 other &#8220;high income&#8221; countries.</p>
<p>The breadth and scale of this report is something: 405 pages of analysis across diseases, ages and incomes groups.</p>
<div class="module pull-quote right half">&#8220;The rule is we&#8217;re worse on everything.&#8221;</div>
<p>Even well-off Americans, &#8220;those who have health insurance, college educations, higher incomes and healthy behaviors,&#8221; according to the press release, seem to be in worse health than their counterparts in the other well-off countries.</p>
<p>Dr. Steven Woolf, chair of the panel that wrote the report, said they were &#8220;struck by the gravity&#8221; of what they learned. &#8220;Americans are dying and suffering at rates that we know are unnecessary because people in other high-income countries are living longer lives and enjoying better health. What concerns our panel is why, for decades, we have been slipping behind.&#8221;</p>
<p>Pretty sobering.<span id="more-9850"></span></p>
<p>This study builds on a <a href="http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=13089" target="_blank">2011 report</a> that looked at people over 50, but that report largely blamed past smoking history and obesity for the shorter longevity of older Americans. Today&#8217;s news broadens to include younger Americans, news which is a &#8220;tragedy&#8221; according to Woolf. &#8220;I don&#8217;t think most parents know that, on average, infants, children, and adolescents in the U.S. die younger and have greater rates of illness and injury than youth in other countries.&#8221; (The report includes a depressing <a href="http://sites.nationalacademies.org/DBASSE/CPOP/DBASSE_080393#deaths-from-communicable-maternal-perinatal-nutritional-conditions" target="_blank">interactive chart</a> that compares the U.S. to other countries by disease.)</p>
<p>UCSF&#8217;s Dr. Paula Braveman was on the panel and repeatedly used the word &#8220;shocked&#8221; in an interview today to discuss the findings. Still, she said there were a couple bright spots. The U.S. does better on cancer and stroke mortality, but &#8220;the rule is we&#8217;re worse on everything,&#8221; she told me.</p>
<p>The U.S. is famous for spending significantly more per capita on health care than any other country, &#8221;about 90% higher than in many other countries that we would consider global competitors,&#8221; according to the <a href="http://www.kff.org/insurance/upload/7670-03.pdf" target="_blank">Kaiser Family Foundation</a> (see pg. 7). But the panel was unanimous, Braveman said, in its agreement that these health disparities go beyond the health care system itself.</p>
<p>Yes, the panel acknowledges obesity and other unhealthy behaviors as drivers of poor health. But they also point to a multitude of other factors, including the <a href="http://blogs.kqed.org/stateofhealth/2012/04/17/smoking-or-schools-which-is-more-important-to-your-health/" target="_blank">social determinants of health</a> &#8211; things like high rates of poverty, income inequality and the (poor) quality of schools &#8212; as well as social policy that can contribute dramatically to poor health outcomes.</p>
<p>&#8220;I&#8217;m hoping this will shake people up enough that they will finally be willing to consider what we have to learn from other countries,&#8221; Braveman says. &#8220;I think coming to grips with the fact that we&#8217;re the bottom of the heap on health, I&#8217;m hoping that that will make people willing to take a look at what&#8217;s being done in other countries and what we can learn from that.&#8221;</p>
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			<media:title type="html">American children are less likely to live to age 5 than children in other high-income countries. (Photo: Comstock)</media:title>
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