It is generally accepted among health services researchers that the United States outspends all other high-income countries in terms of healthcare, yet Americans have been dying at younger ages than their peers in the majority of high-income countries for many years. However, many questions and misconceptions remain about what accounts for this paradox. A report released in January by the National Academy of Sciences, entitled, “U.S. Health in the International Perspective: Shorter Lives, Poorer Health,” tackles this problematic puzzle in a comprehensive and systematic comparison of the United States and 16 other peer countries in the Organisation for Economic Co-Operation and Development (OECD). Among the many analyses and tables included in the report, several striking findings emerge:
- Life Expectancy: In 2007, life expectancy for U.S. males was 3.7 fewer years than men in Switzerland, the top-performing country. Similarly, the difference in life expectancy between females in the U.S. and Japan was 5.2 years. Even worse—this difference has been growing (especially for women) for the last three decades.
- Pervasive and Widespread Disadvantage: All age groups under 75 were affected, and the health disadvantage was observed for multiple diseases, biological and behavioral risk factors, and injuries (e.g. even advantaged Americans--those who are white, insured, college-educated or upper income--are in worse health than their respective OECD peers).
- Nine Specific Problem Areas: Birth outcomes, injuries and homicides, adolescent pregnancy and sexually transmitted infections, HIV and AIDS, drug-related mortality, obesity and diabetes, heart disease, chronic lung disease and disability are all areas where Americans as a group fare worse in health outcomes in comparison to other OECD countries.
- “Return on investment”: The United States spends twice as much per capita on healthcare compared to the median per capita spending for all OECD countries (in 2009, the United States spent $7,690 per capita vs. the median of $3,223). Specifically, healthcare spending accounted for 17.9 percent of the U.S. gross domestic product in 2010.
- Researchers, national research agencies, and international research entities partner to harmonize data collected worldwide to align outcomes/indicators and standardize data collection methodologies (e.g. NIH and the National Center for Health Statistics partnering with the World Health Organization)
- Research-funding agencies support the development of more refined analytic methods and innovative study designs for cross-national research.
- Research-funding agencies fund a coordinated portfolio of research devoted to further understanding interplay of factors contributing to the U.S. health disadvantage and identifying potential solutions.