Damning report on state of U.S. health care

The landmark study compared the U.S. with 34 other developed countries. The U.S. does not stack up as well as other developed nations on a number of health indices, including rates of heart disease, lung cancer and diabetes.

by Mary Budinger — 

A recent study in the Journal of the American Medical Association reports that Americans are living longer these days — an average of 78.2 years now — but we are sicker. Our senior years are increasingly marked by chronic illness or disability. The landmark study compared the U.S. with 34 other developed countries. The U.S. does not stack up as well as other developed nations on a number of health indices, including rates of heart disease, lung cancer and diabetes.

Lead researcher Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, said the study looks at both causes of death and premature mortality in more than 290 different diseases. It puts them together in a comprehensive analysis and shows the contributing factors to loss of a healthy life. He outlined key findings:

• The U.S. spends the most on health care but has mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
• The U.S. ranks poorly for the causes of premature death. There is an increasing shift toward more individuals with a major disability — from mental disorders and substance abuse to bone and joint diseases.
• On the risk-factor front, the big surprise is that diet is the leading risk factor in the U.S. It is greater than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar and physical inactivity.

The U.S. outspends other developed countries by more than 50 percent when it comes to health care. However, the expenditures have consistently shown to have little to no effect on improving overall health outcomes. “Despite a level of health expenditures that would have seemed unthinkable a generation ago, the health of the U.S. population has improved only gradually and has fallen behind the pace of progress in many other wealthy nations,” wrote Harvey V. Fineberg, president of the Institute of Medicine, in an editorial accompanying the report.

The top five most common disabilities are lower back pain, major depressive disorder, other musculoskeletal disorders, neck pain and anxiety disorders.

The leading causes of premature death are heart disease, lung cancer, stroke, chronic obstructive pulmonary disease and road injuries, such as motor vehicle crashes. Rates of other causes of premature death are on the rise, compared to 20 years ago: drug use, chronic kidney disease, kidney cancer, diabetes and Alzheimer’s disease, which rocketed from 32th to 9th place.

The researchers concluded that while many chronic disabling conditions play only a limited role in premature death, they are major drivers of health care costs. “We are not very good at preventing them or curing them and only mildly good at treating them,” Murray said.

The baby boomer generation — those born between 1946 and 1964 — are sicker than their parents were at the same age, despite medical advances in recent decades. Baby boomers are living longer than their parents did, but their health is worse, largely because of the public health consequences of the ongoing obesity epidemic.

Of the five most common disabilities listed in the new study, three are derived from pain. According to Valley chiropractor Chris Serafini, D.C., lower back pain affects about 80 percent of people at some point in their lives.

“Over time, intervertebral disks lose flexibility and shock-absorbing capability, “Serafini explained. “This decreased ability to handle shock increases stress on the components of the spine. The lower back vertebrae and pelvis areas bear a lot of weight, and this is where the majority of motion occurs for the lower body so those structures wear out quicker. The spine (and skeletal system) is mechanical, and all structures that are mechanical need maintenance and repair, just like your car, or they break down over time. The main structures affected when it comes to low back pain are the discs, vertebrae/bones and nerves. Even people who work out are affected by it, because generally the pain and disability are not a muscle, ligament or tendon problem.”

Many people do not think about the structural alignment of their body until it screams in pain and, by then, some damage is often done. Americans are prompted to see a dentist regularly, for example, but we tend not to think about maintaining the bones and nervous system that allow us to walk upright.

The U.S. spends the most on health care but has mediocre outcomes and ranks about 27th for life expectancy among its peer countries.

Heart disease is the most common cause of death, and that comes as no surprise to Valley cardiologist Jack M. Wolfson, D.O. “The Standard American Diet (SAD) is the fundamental problem,” he said. “Add to this the fact that Americans are bathed in chemicals from the womb to death. Heart disease and many other chronic illnesses are preventable if we avoid the two things that cause most disease: poor nutrition and chemicals. Eat plenty of organic vegetables and nuts/seeds, along with free-range, grass-fed meats. Avoid pollutants such as toxic metals, artificial food additives and household chemicals.”

Wolfson also said it does not surprise him to see drug use claiming more lives. “According to the American Medical Association, drugs are at least the fourth-leading cause of death in the U.S. Drugs have many side effects and when ingested in combination, any complication is possible. In addition, doctors have very little time set aside to review a patient’s drug list.”

The new study is the first comprehensive analysis of disease burden in the United States in more than 15 years. It is one of three new papers by the Institute being released simultaneously at the request of first lady Michelle Obama, who plans to present the findings to mayors of U.S. cities in an invitation-only event at the White House as part of her campaign to improve the nation’s health.

Mary Budinger is an Emmy award-winning journalist who writes about integrative medicine.

Reprinted from AzNetNews, Volume 32, Number 4, August/September 2013.