Living sicker and dying younger: U.S. health continues to lag

American men are dead last and American women are second to last in life expectancy for residents of 17 high-income countries, likely as a result of inadequate healthcare, unhealthy behaviors, adverse economic and social conditions, all shaped by the country's public policies and social values, according to a report from the National Research Council and the Institute of Medicine.

The 378-page report, called U.S. Health in International Perspective: Shorter Lives, Poorer Health, highlights how the U.S. lags behind countries such as Japan, Spain and France. The U.S. ranked last among 17 countries in male life expectancy and ahead of only Denmark in female life expectancy. The male life expectancy as of 2007 for U.S. men was 75.64 years, while for women it was 80.78 years. Men in Switzerland had the longest life expectancy—79.33 years—while women in Japan were expected to live the longest at 85.98 years.

The report also describes how the U.S. fares worse than the average in at least nine health areas: adolescent pregnancy and sexually transmitted infections; chronic lung disease; disability; drug-related deaths; HIV and AIDS; heart disease; infant mortality and low birth weight; injuries and homicides; and obesity and diabetes.

The problem has been worsening over time and cuts across a number of demographic characteristics, including age, wealth and race. “I personally was stunned by how pervasive the disadvantage was across so many topic areas,” said Dr. Steven Woolf, professor of family medicine at Virginia Commonwealth University in Richmond and chairman of the panel that wrote the report, speaking at a media teleconference. “Something fundamentally is going wrong for the U.S. to lose ground” so widely over time, Woolf said.

The authors of the report say that the tools to fix the problem largely are available, but public awareness of the U.S.' lagging position needs to be boosted before changes will take place at the governmental and societal levels. “Little is likely to happen until the American public is informed about this issue,” the authors wrote in a brief on the report. They suggest that an organized media and outreach campaign is needed to raise awareness, with one of the goals being to stimulate a “thoughtful national discussion about what actions the country is willing to take to achieve the health gains that other countries are enjoying.”

Other countries may also offer examples of how the U.S. could improve, according to the report brief.