Dehry Sarah E, Krueger Patrick M
Department of Health & Behavioral Sciences, University of Colorado Denver, Campus Box 188, P.O. Box 173364, Denver, CO 80217-3364 USA.
University of Colorado Population Center, University of Colorado Boulder, Boulder, USA.
Popul Res Policy Rev. 2023;42(2):27. doi: 10.1007/s11113-023-09762-6. Epub 2023 Mar 22.
The U.S. is exceptional among high-income countries for poor survival outcomes. Understanding the distribution of excess deaths by age, sex, and cause of death, is essential for bringing U.S. mortality in line with international peers. We use 2016 data from the World Health Organization Mortality Database and the Human Mortality Database to calculate excess deaths in the U.S. relative to each of 18 high-income comparison countries. The U.S. experiences excess mortality in every age and sex group, and for 16 leading causes of death. For example, the U.S. could potentially prevent 884,912 deaths by achieving the lower mortality rates of Japan, the comparison country yielding the largest number of excess deaths, which would be comparable to eliminating all deaths from heart disease, unintentional injuries, and diabetes mellitus. In contrast, the U.S. could potentially prevent just 176,825 deaths by achieving the lower mortality rates of Germany, the comparison country yielding the smallest number of excess deaths, which would be comparable to eliminating all deaths from chronic lower respiratory diseases and assault (homicide). Existing research suggests that policies that improve social conditions and health behaviors are more likely to bring U.S. mortality in line with peer countries than policies that support health care access or new biomedical technologies. Achieving the death rates of peer countries could result in mortality reductions comparable to eliminating leading causes of death.
The online version contains supplementary material available at 10.1007/s11113-023-09762-6.
在高收入国家中,美国的生存结果较差,情况特殊。了解按年龄、性别和死因划分的超额死亡分布情况,对于使美国的死亡率与国际同行保持一致至关重要。我们使用世界卫生组织死亡率数据库和人类死亡率数据库2016年的数据,来计算美国相对于18个高收入对照国家中每个国家的超额死亡情况。美国在每个年龄和性别组以及16种主要死因方面都存在超额死亡率。例如,通过达到日本较低的死亡率,美国有可能预防884,912例死亡,日本是产生超额死亡人数最多的对照国家,这相当于消除心脏病、意外伤害和糖尿病导致的所有死亡。相比之下,通过达到德国较低的死亡率,美国有可能仅预防176,825例死亡,德国是产生超额死亡人数最少的对照国家,这相当于消除慢性下呼吸道疾病和袭击(杀人)导致的所有死亡。现有研究表明,改善社会状况和健康行为的政策比支持医疗保健获取或新生物医学技术的政策更有可能使美国的死亡率与同侪国家保持一致。实现同侪国家的死亡率可能会使死亡率降低幅度相当于消除主要死因。
在线版本包含可在10.1007/s11113 - 023 - 09762 - 6获取的补充材料。