How many Americans will die on average annually if the country has death rates in Europe? Much less suggests a new analysis comparing mortality trends before the Covid-19 pandemic.
Despite spending much more than other affluent countries on health care, the United States has relatively higher mortality rates and lower life expectancy – attributed to a plethora of factors, including obesity, opioid overdose, gun violence, suicide, smoking, road accidents and infant death.
As the US does not have a universal healthcare system like most high-income European countries, researchers also think that access to healthcare and medicine is patchwork, a problem exacerbated by pronounced racial and socio-economic differences and the rural-urban separation.
In the latest analysis, the authors worked on the basis of a counter-factual assumption – which if the US has the death rates according to age and gender of an average European country (in this case the combined death rates of France, Germany, Italy , Spain, England and Wales)? – and estimates how many fewer deaths there would be in the US in 2000, 2010 and 2017 under the assumption.
The lead author, Samuel Preston, professor of sociology at the University of Pennsylvania, first compared the death toll between the U.S. and a wider range of European countries in 2010 and found that the U.S. was among the worst among people among 18 75 years. countries considered. “I just decided it would be interesting to update the analysis and was surprised to see how much the excess has grown between then and now,” he said.
In the latest analysis, the authors found that mortality rates in the US have deteriorated significantly since 2000 – and in 2017 alone have resulted in more than 400,000 deaths. In that year, Americans between the ages of 30 and 34 were three times more likely to die than their counterparts in Europe, which researchers said was likely driven by drug overdoses – especially opioids – as well as gun violence.
Paradoxically, in 2017, the US had lower death rates among people over 85 – the country had 97,788 fewer deaths than subject to the European standard. The benefit in this age group has only increased since 2000, according to the analysis published in the journal Proceedings of the National Academy of Sciences.
Preston and his co-author, Dr Yana Vierboom, a researcher at the Max Planck Institute for Demographic Research in Germany, said they were not sure why elderly Americans seemed to be better off. One possible explanation, Vierboom said, was that the US tends to spend more on aggressive care and treatments at the end of their lives.
The analysis also assessed the performance of the U.S. in terms of lost life expectancy – a measure that weighed the number of excess deaths at a given age to the U.S. life expectancy at that age (someone younger has more potential life expectancy than someone otherwise. who is older).
Overall, the U.S. experienced about 13 million life years lost to excessive deaths in 2017, representing an increase of 64.9% since 2000, after adjusting for changes in size and age distribution, the authors found.
Jessica Ho, assistant professor of gerontology, sociology and spatial sciences at the University of Southern California, attributed higher U.S. mortality rates to a combination of behavioral and structural factors.
“Americans often practice poor health behaviors, and this can interact with structural conditions such as rags access to health care to produce poorer results,” she said. ‘For example, high murder rates are related to inequality and residential separation; high firearm deaths are affected by both behavioral factors and the greater availability of guns in the US. ”
Mauricio Avendano Pabon, professor of public policy and global health at King’s College London, suggested that another statement could be the strong government intervention in many dimensions of people’s lives in European countries, such as minimum wage and maternity leave.
‘Of course, this also applies to the US, but in general to a much lesser extent. While one might argue that less intervention increases efficiency and improves economic outcomes, the market is unlikely to emphasize values related to people’s health or inequality. “
The U.S. Centers for Disease Control and Prevention attributed 376,504 deaths to Covid-19 in 2020, a figure that has been overshadowed by the excess deaths and life years in 2017, the analysis found.
Although drug poisoning rates have declined since 2017, the story repeats itself with Covid-19, which in turn had a greater death impact in the U.S. than its European counterparts, said Patrick Heuveline, a professor of sociology at the University of California, Los Angeles. said. , who were not involved in the analysis. Preston was one of his PhD advisers in the late 1990s.
If we look at the period between 31 March 2020 and 31 March 2021 and used the same five European countries as the standard, there were more than one third of the deaths of Covid-19 in the US during the twelve months (36%) excessive deaths . Hillline estimated.
So what does the future hold for the US and its high-income counterparts in Europe? Preston and Vierboom said it was difficult to make sure.
“Historically, the USA was the first to start smoking at very high prices, and then the rest of the world caught up,” Vierboom notes.
‘It seems to be related to drug use, obesity etc. Happens …[the US] is like a sad trendsetter. ‘