How does US life expectancy compare with that of other industrialized nations today? - Answers
Life expectancy in the United States is ranked 32nd in the world below most other industrialized
nations. Americans experience higher rates of disease, injury, and health-damaging behaviors
that do men and women in other high-income countries.
How did US life expectancy compare with that of other industrialized nations fifty years ago? -
Answers The past 50 years have witnessed remarkable gains in life expectancy and 16 other
country members of the Organization for Economic Cooperation and Development (OECD).
However, improvements have occurred at various paces across nations. Life expectancy gains
in the US have not kept pace with gains in other countries.
What are some of the causes of mortality that are particularly high in the US compared with the
other OECD countries? - Answers Mortality rates from infectious diseases; complications of
pregnancy, childbirth and the puerperium; and conditions originating in the perinatal period are
higher in the United States than in nearly all other OECD countries.
Name at least three factors that may contribute to the US/OECD gap in health outcomes. -
Answers The four mechanisms for the explanations for the US/OECD gap are: Medical care and
public health, individual behaviors, social/demographic factors and physical environment.
Medical and public health specific factors are access to health care insurance, quality of
medical care, and quality of public health system.
Individual behavior specific factors are: tobacco use, obesity, diet, physical inactivity, alcohol
and other substance use, sexual practices, violence (especially firearm suicide and homicide),
and automobile reliance.
Social/demographic factors specific factors are socioeconomic inequality and poverty, racial
disparities and residential segregation, and social integration and social interactions.
Physical environmental factors specific factors are built environment (urban design, transport
infrastructure, land-use mix, urban planning and design), and food environment.
How do non-fatal health outcomes in the US population compare to those in the other OECD
countries? - Answers a. Compared with most other countries, Americans have higher prevalence
of low birth weight, traffic injuries and HIV incidence. Americans are more likely to rate their own
health as good than are men and women in other high-income countries. Americans also have
higher prevalence of preterm births and poor maternal health; adolescent pregnancy and
sexually transmitted infections; and overweight, obesity, and diabetes during childhood and
middle age. Older Americans report a higher prevalence of heart disease, stroke, hypertension,
diabetes, obesity, lung disease, and limitation with basic instrumental activities of daily living
than do their European counterparts at ages 50 and above.
, Explain the idea of the "eight Americas." How do mortality rates in the eight Americas compare
to the other OECD nations? - Answers The eight Americas are subdivisions of the United States
into eight race-county combinations. Large differences were found in life expectancy among
these groups. For young and middle-aged males and females, mortality in the disadvantaged
Americas is up to two times worse than that in the worst OECD country. Disparities across US
regions have grown since the 1980s, a factor that has contributed to the overall US lag in life
expectancy.
Explain the concept of GDP. How much does the US spend on health care as a fraction of GDP?
What do our peer nations spend as a fraction of their GDP? - Answers Gross domestic product
is the best way to measure a country's economy. GDP is the total value of everything produced
by all the people and companies in the country. The US spent roughly 16% of its GDP on
healthcare in 2014. Whereas our peer nations spent between 8-10%.
How does the US health care system rank internationally? On what measures are we faring
reasonably well? On what measures do we rank poorly? - Answers The US ranks last in health
care system performance among the 11 countries included in this study. The US ranks last in
Access, Equity, and Health Care Outcomes, and next to last in Administrative Efficiency, as
reported by patients and providers. Only in Care Process does the U.S. perform better, ranking
fifth among the 11 countries.
What explains the link between poverty, depression, and anxiety? - Answers a. People who live in
poverty are at increased risk of mental illness
b. Incidence of depression
i. ◦31% of Americans living under the poverty line
ii. ◦15.8% of those not in poverty
c. Those living in poverty are also more likely to experience asthma, diabetes, heart attacks, and
other physical health problems
d. What explains these disparities?
i. ◦Poverty is tied to stressful lives, difficult childhoods, and more ACEs
ii. ◦Possible over-diagnosis of mental illness
How do levels of anxiety, depression, and substance use differ between teenagers from low-
income vs. high-income families? What explains these results? - Answers a. Cohort I (affluent
suburban high schoolers)
i. ◦Significantly higher rates of use of cigarettes, alcohol, marijuana, and hard drugs compared to
national norms & inner-city samples