Being poor and chronically ill is lethal in the US

U.S. Performs Worst on Potentially Preventable Death Rates Compared to France, Germany, and the U.K.; U.S. Also Improving at Slowest Pace

New York, NY, August 29, 2012—The United States lags three other industrialized nations—France, Germany, and the United Kingdom—in its potentially preventable death rate, and in the pace of improvement in preventing deaths that could have been avoided with timely and effective health care, according to a Commonwealth Fund–supported study published as a web first online today in Health Affairs. Between 1999 and 2006/2007, the overall potentially preventable death rate among men ages 0 to 74 dropped by only 18.5 percent in the United States, while the rate declined by nearly 37 percent in the U.K. For women, the rate fell by 17.5 percent in the U.S. but by nearly 32 percent in the U.K.

In "In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In the US Lags That of Three European Countries," Ellen Nolte, Director of Health and Healthcare at RAND Europe and Martin McKee, Professor of European Public Health at the London School of Hygiene & Tropical Medicine analyzed amenable mortality trends. Amenable mortality is a measure of deaths before age 75 that could potentially have been prevented by timely access to appropriate health care. The research also looked at death rates for those under 65, as well as deaths between ages 65 and 74 from conditions like treatable cancer, diabetes, infections, and heart disease.

While the pace of improvement was slower in the U.S. for both age groups, the lag was most pronounced among American men and women under age 65, who are more likely to be uninsured and have problems with access to care than those 65 and older, who are eligible for Medicare. By comparison, France, Germany, and the U.K. all provide affordable, universal coverage to their populations regardless of age. “These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care” said Nolte, lead author of the study.

COMMENT: In the US, a country of about 300 million people, about 47 million do not have health insurance.  Health care is fungible.  When you have to choose between filling your hypertension medication prescription and paying your rent, you pay the rent to avoid being homeless.  There have been innumerable studies showing that as copayments increase, medication use for chronic diseases falls.  This study then just documents the natural consequence of that decrease in preventative medicine: increased death rates.  The ACA will help considerably by adding millions of people to the insured roles assuming that the Republicans do not unravel it.  But for now having a chronic disease and being poor is a lethal combination in the US.