Avoidable deaths are increasing in the United States, but fall into many pear countries

When a person dies, doctors often look at the cause of death to determine whether it could have been avoided, either by medical prevention such as vaccines or by treatments such as antibiotics. These kinds of deaths are known as avoidable mortality, and in most countries with a high income around the world the number drops.

But in the United States, avoidable deaths have increased for more than a decade, according to a new study by researchers from the Brown University School of Public Health and Harvard University, who investigated mortality trends in US states and 40 countries with high incomes. Their findings were published in Jama Internal Medicine.

The team compared mortality data of all 50 US states with data from countries in the European Union and the organization for economic cooperation and development, of which 38 members are Australia, Japan and Iceland. They discovered that between 2009 and 2021 the avoidable mortality in the US was still getting worse, while the avoidable death in the EU and OECD improved (with the exception of the period during COVID-19 Pandemie from 2019 to 2021).

The findings suggest that deep-rooted issues in the American health care system and public policy can contribute to deteriorating health results, said capital author Irene Papanicolas, a professor of health services, policy and practice at the Brown’s School of Public Health.

“We have known for some time that life expectancy in the US has gotten worse, but now we can see that the country has a different process than other countries with a high income,” said Papanicolas, who is also the director of the Center for Health System Sustainability. “Other countries are getting better in reducing avoidable deaths due to prevention and treatment, but these dead grow in the US.”

The researchers compared mortality data from individual US states with data from countries with a high income of comparable scale, and also used aggregated data to compare the US generally with the aggregates of other countries.

On average, avoidable mortality increased by 32.5 avoidable deaths per 100,000 people. The avoidable mortality, on the other hand, fell in EU countries with 25.2 avoidable deaths per 100,000 people and decreased in OECD countries with 22.8 avoidable deaths per 100,000 people.

“It’s a bit shocking,” said Papanicolas. “What we have found is that although avoidable mortality varies per state, all American states get worse.”

In New York, for example, the avoidable mortality increased from 2009 to 2019 by 4.9 deaths per 100,000 people; In West Virginia, avoidable mortality increased by 99.6 deaths per 100,000 people.

When the researchers investigated the causes of avoidable deaths (including traffic accidents, diseases that can be prevented due to vaccines, treatable conditions such as sepsis or appendicitis, and disorders prevented by early detection and treatment such as cervix cancer, Ischemic heart diseases of various deaths of them, they have fallen that die of the death of that death. are.

“There has been much discussion about preventing deaths in the US, such as drug -related deaths or suicides, which explain a large part of this trend,” said Papanicolas. “However, we have found that deaths from almost all important categories increase.”

An exception, she noticed, is that death rates from cancer in some American states decrease.

The team found no clear association between health expenditures and avoidable death in the US, which means that states that spend more on healthcare do not necessarily get better. On the other hand, in the countries with high incomes that were evaluated in the study-including Canada, Japan, Spain and Turkey-Was, a connection between higher healthcare expenditure and better results in terms of avoidable mortality.

These findings are particularly worrying, Papanicolas said, because the US spends more on health care per head of the population than any other country in the analysis.

“The results indicate systemic factors that the US and all states have to do with,” she said.

The analysis included mortality data for people under the age of 75 of the Centers for Disease Control and Prevention and of the World Health Organization. Data for health expenditure came from the US Census Bureau, the Centers for Medicare and Medicaid Services, the Office of the Actuary and the WHO Global Health Expenditure database.

This study, which builds on earlier research by this team, serves as a call for action for American policymakers to tackle this growing death splash, Papanicolas said.

In the future, she said, the researchers are planning to investigate what the US can do better.

“It is really interesting to see how the US is different, but where we want to explore afterwards is what other countries can do that the US can do to lower avoidable deaths,” she said.