A study tracking health over two decades finds a striking gap in the United States between length of life and quality of life.
Americans are living sicker, longer, compared with populations in many other developed countries, where people are making strides in extending their years of good health.
While life expectancy has increased, the stretch of life lived free of disease and infirmity has not kept pace. One big reason, according to researchers: unhealthy diets in a land of plenty, is now a greater risk to the population than smoking.
“The state of US health, 1990–2010: burden of diseases, injuries and risk factors,” published July 10 in JAMA, represents a thorough accounting of the health of Americans and how it compares with the big picture in other wealthy countries. For a nation that spends more than any other on medical care per person, the key conclusion is sobering: “high costs with mediocre population health outcomes.”
The findings are mixed for Canada, which has also dropped in some world health rankings, although not as dramatically and from fairly lofty heights. Canadian life expectancy at birth, for example, rose to 80.6 years, a gain of more than three years from 1990. But that places Canada 12th among 34 developed countries, down from fifth just 20 years ago. Similarly, the expected period of good health has risen to 69.7 years, up by more than two years, but nine other countries have done better.
In that time, US life expectancy at birth (now 78.2 years) dropped to 27th from 20th, and the expected years of healthy living (68.1 years) sank to 26th from 14th.
The US health care system remains strong when it comes to saving people from strokes, breast cancer and colorectal cancer in particular, said Dr. Christopher Murray, lead author of the study and director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.
But in a measure of years of life lost to 25 diseases and injuries, the US performed poorly on 15 of them. Lung cancer, heart disease, chronic kidney disease, road injuries and injuries from violence are among them.
Canada achieved average rankings for the most part, excelling in the treament of stroke and hypertensive heart disease, lagging on poisonings and Alzheimer disease.
“Although there’s been progress in extending life in the US, our progress has not kept up with the average of high-income countries,” Murray said. “We have generally slipped.”
“Perhaps the most surprising to us is that the number one contributor as a risk factor to the burden of disease in the US is the composition of diet. That’s even larger now than tobacco in the US.”