NEW YORK — Poor health care is responsible for a slower rise in longevity for people in the United States than those in Canada and 11 other developed countries with universal coverage, U.S. researchers said Thursday.
The study by a team at New York’s Columbia University formed the conclusion after ruling out other commonly cited culprits, such as obesity, smoking, traffic accidents and a U.S. murder rate that is among the highest in the developed world.
“The U.S. doesn’t stand out as doing any worse in these areas than any of the other countries we studied, leading us to believe that failings in the U.S. health-care system, such as costly specialized and fragmented care, are likely playing a large role in (a) relatively poor performance on improvements in life expectancy,” said study co-author Peter Muennig, who’s also a health-policy expert.
The study — published in the journal, Health Affairs — comes as Democrats and Republicans, campaigning ahead of congressional elections next month, are arguing over the impact of health-care reforms spearheaded by U.S. President Barack Obama.
Democrats say they will provide more people with access to affordable health care. Many Republicans have pledged to repeal the reforms, claiming they will lead to a deterioration of a system that they argue provides the best health care in the world.
The researchers compared U.S. health-care spending and mortality statistics with those of Australia, Austria, Belgium, Britain, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden and Switzerland.
The study found that life expectancy and health-care costs from 1975 to 2005 rose in all the countries, but costs climbed faster in the United States, while longevity rose more slowly.
More broadly, the researchers reported that the United States was fifth among the leading industrialized countries in 1950 with respect to life expectancy at birth for women. But figures as recent as last month show the United States ranked 49th for male and female life expectancy combined.
Many defenders of the private, insurance-centred U.S. health-care system blame lifestyle factors for the discrepancy.
But the study found that the prevalence of obesity has grown more slowly than in other nations, while the number of smokers has declined more rapidly.
It also determined that the number of deaths from traffic accidents and homicides had remained stable over time, meaning they were also unlikely to account for the relative fall in survival rates.
Health-care spending per capita in the United States rose at nearly twice the rate of the other countries between the years 1970 and 2002. One recent estimate puts it at $7,290 per person — well over twice the median expenditure of industrialized nations.
“The unusually high medical spending is associated with worsening, rather than improving, 15-year survival (rates)” of people aged 45-65, the researchers said.
They suggest fast-rising spending on health care could be “choking off public funding on more important life-saving programs,” while also driving up the number of people with “inadequate health insurance.”
All of the “control” countries provide universal health-care coverage, whereas 15 per cent of the U.S. population is currently uninsured.
To make sure America’s relatively more diverse population did not skew comparisons, the researchers studied statistics for only white people — and found a similar pattern of lagging U.S. longevity.
“Relative survival gains for non-Hispanic whites between 1995 and 2005 were the lowest among nations in each category,” it said. “Forty-five-year-olds in Australia, Italy, Canada, and — for women — Japan experienced the largest survival gains in this decade.”
From 1975 to 1985, the United States ranked third in survival gain among 45-year-old men, behind only Australia and Canada, the study found.
For every other group, and in every subsequent decade, the United States was no higher than eighth in overall survival gains.
The United States did little better in international comparisons of mortality.
“Americans live 5.7 fewer years of ‘perfect health’ — a measure adjusted for time spent ill — than the Japanese,” the survey noted.
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