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U.S. health is lousy compared with peer nations, report says

latimes.com

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Re: U.S. health is lousy compared with peer nations, report says

#61

Post by slurry »

refurb wrote: post #31
RyanMcGreal wrote: post #3

The US is at or very near the worst among OECD countries in: infant mortality, child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarceration rate, rate of assaults, rate of homicides, i…

Dig a bit deeper and you'll see that those statistics don't tell you the whole story. In the US, premature births occur at a much higher rate than other country and account for a large portion of the higher infant mortality rate. Those stats also don't tell you that if you have a premature baby, it's most likely to survive if treated in the US.

> In the US, premature births occur at a much higher rate than other country

Pretty much what you'd expect for a system that doesn't emphasize accessible prenatal care.

Re: U.S. health is lousy compared with peer nations, report says

#62

Post by tptacek »

avalind wrote: post #57
tptacek wrote: post #43

Worth remembering some things here: * The US is thought by some economists to have an artificially high infant mortality because the US is more rigorous about reporting live births than other countries which might write up the same events as stillbirths. * Outcomes in the US for chronic serious illnesses are at or near the top of the rankings. * Life expectancy figures in the US are anchored down by suicides and, mor…

This report[1] claims that the difference in reporting child mortality isn't the chief cause of the difference in infant mortality between the U.S and similarly developed countries. Instead the claim that most of this difference is due to the high percentage of pre-term births in the US compared to other developed countries. [1] http://www.cdc.gov/nchs/data/databriefs/db23.pdf

Isn't a preterm baby which fails to survive exactly the kind of event that wouldn't be documented as an infant mortality at all in a less rigorous country?

Re: U.S. health is lousy compared with peer nations, report says

#63

Post by tptacek »

grecy wrote: post #4
RyanMcGreal wrote: post #3

The US is at or very near the worst among OECD countries in: infant mortality, child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarceration rate, rate of assaults, rate of homicides, i…

If you dig into the statistics [1] you'll see that for the average Joe on the street, daily quality of life in America is below that of all other Developed nations, and is comparable to the upper-end of Developing nations. [1] http://www.oecd.org/statistics/

For instance, because...

Re: U.S. health is lousy compared with peer nations, report says

#64

Post by refurb »

RyanMcGreal wrote: post #52
refurb wrote: post #31

Earlier quoted context omitted.

Dig a bit deeper and you'll see that those statistics don't tell you the whole story. In the US, premature births occur at a much higher rate than other country and account for a large portion of the higher infant mortality rate. Those stats also don't tell you that if you have a premature baby, it's most likely to survive if treated in the US.

I've heard that and am not sure whether the comparative statistics control for this. However, even if it's true, that still leaves child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarc…

Well a number of those you mentioned are connected to childhood mortality: life expectancy at birth, healthy life expectancy among others.

As for the other measures, how you count is important. Without seeing the actual data, it's hard to say exactly how relevant it is.

Re: U.S. health is lousy compared with peer nations, report says

#65

Post by pcurve »

tptacek wrote: post #43

Worth remembering some things here: * The US is thought by some economists to have an artificially high infant mortality because the US is more rigorous about reporting live births than other countries which might write up the same events as stillbirths. * Outcomes in the US for chronic serious illnesses are at or near the top of the rankings. * Life expectancy figures in the US are anchored down by suicides and, mor…

"Outcomes in the US for chronic serious illnesses are at or near the top of the rankings."

This is because we have so many people with chronic serious illnesses that we know what to do with them better (at high costs). This isn't something to be proud of.

Re: U.S. health is lousy compared with peer nations, report says

#66

Post by tptacek »

pcurve wrote: post #65
tptacek wrote: post #43

Worth remembering some things here: * The US is thought by some economists to have an artificially high infant mortality because the US is more rigorous about reporting live births than other countries which might write up the same events as stillbirths. * Outcomes in the US for chronic serious illnesses are at or near the top of the rankings. * Life expectancy figures in the US are anchored down by suicides and, mor…

"Outcomes in the US for chronic serious illnesses are at or near the top of the rankings." This is because we have so many people with chronic serious illnesses that we know what to do with them better (at high costs). This isn't something to be proud of.

That's a pat way to dismiss any ranking of countries for health outcomes.

If you want to come up with a way to produce a low rank for the US on some holistic indicator, you will not have a hard time doing it. Are we the "healthiest" country in the world? Certainly not! We don't even have mandatory military service.

The issue here is that we need to be clear on what lessons we're trying to draw from the rankings. People definitely want to use rankings like this in inappropriate ways. If you want to look at this and say "America has an obesity crisis", nobody credible will argue with you --- but you didn't need this ranking to do that anyways.

On the other hand, if you want to say "America has a crisis of unavailable health care", well, you're wrong. The statistics don't bear that out. We have other health services problems, like bankrupting the uninsured, but measured by effectiveness and outcome, we have a top tier system.

Re: U.S. health is lousy compared with peer nations, report says

#67

Post by dtkuhn »

viraptor wrote: post #42
roc wrote: post #24

Earlier quoted context omitted.

It's not a problem that can be 'hacked'. Much like hunger in the third world: it's a political problem. Practical solutions have long since been developed and proved in other places. The problems persist where they do, because there's no political will to actually implement the solutions in those places.

> It's not a problem that can be 'hacked'. While I agree it's a political problem in general, there's apparently a lot that can be hacked. Starting with lowering the cost of diagnostics and improving the information flow... There were a couple of interesting companies interviewed on Mendelspod ( http://mendelspod.com/ ) - if you're interested in what can be hacked, give it a go. There are also projects like http://nh…

Agree. Patients need better information if we are ever going to be serious health care consumers. Doctors have very little incentive to help us shop for services. Co-payments, lack of reimbursement, etc are all tools used by insurers to reduce cost (combat moral hazard, etc), but very little has been done by patients historically to systematically lower costs.

Re: U.S. health is lousy compared with peer nations, report says

#68

Post by amalcon »

Irregardless wrote: post #21

And yet people from around the world fly here every day to have critical surgeries performed by the world's top doctors in state of the art facilities. News Flash: The U.S. isn't a welfare state. To benefit from everything this country has to offer, you need to pay for it. Yes, it would be better if that didn't apply to healthcare, but there needs to be some method of exclusion when demand is high and supply is low.…

Would you rather wait 2 months just to see a specialist and another 2 months for treatment like patients in nationalized healthcare systems frequently do? (I'm looking at you, Canada and Europe)

I would really prefer not to have to do this. Do you have a suggestion for how I could avoid that wait? I live in the U.S. and those timeframes don't seem particularly high compared to what I'm used to.

Re: U.S. health is lousy compared with peer nations, report says

#69

Post by talmand »

refurb wrote: post #31
RyanMcGreal wrote: post #3

The US is at or very near the worst among OECD countries in: infant mortality, child poverty, child health and safety, life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use, incarceration rate, rate of assaults, rate of homicides, i…

Dig a bit deeper and you'll see that those statistics don't tell you the whole story. In the US, premature births occur at a much higher rate than other country and account for a large portion of the higher infant mortality rate. Those stats also don't tell you that if you have a premature baby, it's most likely to survive if treated in the US.

I can't recall where I read about it, but I seem to remember that in some cases one country may count infant mortality differently than another. For example, one country may mark a baby's death after birth saying it was born while another may not consider the baby that dies soon after birth as not having been born in the first place. When comparing numbers from country to country one has to make sure they are allowing tallying the numbers the same way.

To further your point about statistics not telling you the whole story. I often see statistics that suggest you are more likely to be shot in the US than another country. This suggests that living in the US is a highly dangerous thing and that we all fear being shot on a daily basis. But if you look at the numbers it's generally not as dangerous as it sounds since you are more likely to shoot yourself than be shot by another person. The reason being is that suicide deaths by firearms are often much higher than homicides. The same for the statement I keep seeing that you having a gun in your house increases the likelihood you'll be shot. It's because you're more likely to shoot yourself with it than be shot by someone else.

Statistics can be presented in different ways to support different agendas. You have to be willing to look at the raw numbers objectively and consider how they are tabulated to get any meaning out of them.

Ty Cobb must have sucked at baseball because over his entire career he failed to get a base hit about 65% of the time at bat.

Re: U.S. health is lousy compared with peer nations, report says

#70

Post by [deleted] »

slurry wrote: post #61
refurb wrote: post #31

Earlier quoted context omitted.

Dig a bit deeper and you'll see that those statistics don't tell you the whole story. In the US, premature births occur at a much higher rate than other country and account for a large portion of the higher infant mortality rate. Those stats also don't tell you that if you have a premature baby, it's most likely to survive if treated in the US.

> In the US, premature births occur at a much higher rate than other country Pretty much what you'd expect for a system that doesn't emphasize accessible prenatal care.

[deleted]
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