A new study from Columbia University’s Mailman School of Public Health, What Changes in Survival Rates Tell Us About US Health Care,  has shocking findings about the life expectancy in the US.  The study found 15-year survival rates for men and women ages 45 and 65 have fallen in the US compared with 12 other countries over the past 30 years.  From 1975 – 2005, the US was making steady gains in the 15 year survival rate, but other countries have made even greater gains which has caused us to slip in the ratings.  The most disturbing finding is the per capita health care spending in the US increased at more than twice the rate of the comparison countries.

“It was shocking to see the U.S. falling behind other countries even as costs soared ahead of them, but what really surprised us was that all of the usual suspects—smoking, obesity, traffic accidents, homicides, and racial and ethnic diversity are not the culprits. 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 this relatively poor performance on improvements in life expectancy.”  Peter Muennig, MD, MPH, assistant professor of Health Policy and Management at the Mailman School of Public Health.

The study analyzed  health spending, behavioral risk factors,  and 15-year survival rates for men and women ages 45 and 65 in the U.S. and 12 other nations — Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom.

White women in the US, age 45, had the worst performance in the study—by 2005 their 15-year survival rates were lower than that of all the other countries.  In 2005 the 15 year survival rate for a white woman in the US was lower than the rate from 1975 for Swiss, Swedish, Dutch or Japanese women.  How can 35 years of medical advances, technology and increased health spending produce these results?

The study took into account risk factors and behavior such as smoking.  Actually smoking had declined in the US at a faster rate than other countries, while our survival rate sank.  The obesity rates versus other countries have been consistent since 1975 since the US was ahead in this category throughout the years.

In 1950, the United States was fifth among the leading industrialized nations with respect to female life expectancy at birth, surpassed only by Sweden, Norway, Australia, and the Netherlands. The last available measure in 2008 of female life expectancy had the United States ranked at forty-sixth in the world.

Studies come out on a daily basis and sometimes the statistics can be overwhelming and possibly interpreted in different ways.  But to just look at that one statistic again (from CIA World Factbooks):

• In 1950 the US was 5th in the world for female life expectancy

• In 2008 the US is 46th for female life expectancy at 81.13 years

In forty-five other countries in the world, women live longer than here in the US with Macau in the #1 spot with female life expectancy of 87.45 years.  France is in the #7 spot with 84.23 years.  Canada is #10 with 83.81 years.  The US barely ranked above Ecuador, Poland and Cuba.

Quantity of care obviously does not produce quality of care.  While the US can outspend other countries on health care, we steadily decline in the length of our lives.  Is our rising health care costs actually causing us to die sooner?  Our health care system has become fragmented and reliant on high priced specialty care for every illness.  Instead of going to one doctor for your health and well being, you may have to go to several different specialists for each illness or symptom.  The study concluded that this fragmented care is raising our costs and decreasing our quality of care.

“We speculate that the nature of our health care system—specifically, its reliance on unregulated fee-for-service and specialty care—may explain both the increased spending and the relative deterioration in survival that we observed.”  from the What Changes in Survival Rate Tell Us about US Health Care study