Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.
Researchers have known for some time that the U.S. fares poorly in comparison with other rich countries, a trend established in the 1980s. But most studies have focused on older ages, when the majority of people die.
The findings were stark. Deaths before age 50 accounted for about two-thirds of the difference in life expectancy between males in the U.S. and their counterparts in 16 other developed countries, and about one-third of the difference for females. The countries in the analysis included Canada, Japan, Australia, Germany and Portugal.
The 378-page study by a panel of experts convened by the Institute of Medicine and the National Research Council is the first to systematically compare death rates and health measures for people of all ages, including U.S. youths. It went further than other studies in documenting the full range of causes of death, from diseases to accidents to violence. It was based on a broad review of mortality and health studies and statistics.
The panel called the pattern of higher rates of disease and shorter lives "the U.S. health disadvantage," and said it was responsible for dragging this country to the bottom in terms of life expectancy over the past 30 years. U.S. men ranked last in life expectancy among the 17 countries in the study, and U.S. women ranked second-to-last.
"Something fundamental is going wrong," said Dr. Steven Woolf, chair of the Department of Family Medicine at Virginia Commonwealth University, who headed the panel.
"This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it's getting worse."
Car accidents, gun violence and drug overdoses were major contributors to years of life lost by Americans before age 50.
The rate of firearm homicides was 20 times higher in the United States than in the other countries, according to the report, which cited a 2011 study of 23 countries.
And though suicide rates were lower in the U.S., firearm suicide rates were six times higher.
Sixty-nine percent of all U.S. homicide deaths in 2007 involved firearms, compared with an average of 26 percent in other countries, the study said.
"The bottom line is that we are not preventing damaging health behaviors," said Samuel Preston, a demographer and sociologist at the University of Pennsylvania who was on the panel. "You can blame that on public health officials, or on the health care system. No one understands where responsibility lies. But put it all together and it is creating a very negative portrait."
Panelists were surprised at just how consistently Americans ended up at the bottom of the rankings.
The U.S. had the second-highest death rate from the most common form of heart disease, the kind that causes heart attacks, and the second-highest death rate from lung disease, a legacy of high smoking rates in past decades. U.S. adults also have the highest diabetes rates.
Youths fared no better. The U.S. has the highest infant mortality rate among these countries, and its young people have the highest rates of sexually transmitted diseases, teen pregnancy and deaths from car crashes. Americans lose more years of life before age 50 to alcohol and drug abuse than people in any of the other countries.