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posted: 7/15/2013 5:00 AM

Americans living longer, but still lag global peers

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By Patricia Sullivan
The Washington Post

Life expectancy in the United States is going up, but chronic disabilities, including many caused by bad food choices, smoking, obesity, physical inactivity and alcohol abuse, account for a larger portion of health issues in the United States compared with its economic peers around the world, according to a new study by a global collaboration of scientists.

Since 1990, many childhood diseases are less prevalent, and there has been a dramatic reduction in sudden infant death syndrome, according to the study. There has also been a significant drop in death and disability from HIV/AIDS, and there are lower mortality rates for people of every age.

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But other countries are improving faster. Americans in 2010 could expect to live 78.2 years, up from 75.2 years in 1990, but that was 27th among the 34 nations considered its economic peers. The United States also ranked 27th in high body mass index, an indicator of obesity, and 29th on blood sugar.

"The United States spends more than the rest of the world on health care and leads the world in the quality and quantity of its health research, but that doesn't add up to better health outcomes," said Christopher Murray, director of the University of Washington's Institute for Health Metrics and Evaluation, and one of the study's lead authors. "The country has done a good job of preventing premature deaths from stroke, but when it comes to lung cancer, preterm birth complications and a range of other causes, the country isn't keeping pace with high-income countries in Europe, Asia and elsewhere."

"The State of U.S. Health, 1990-2010," published by the Journal of the American Medical Association is "a landmark study, the first comprehensive box score of American health that's been published," said Howard Bauchner, JAMA's editor-in-chief.

In a related study examining each county in the United States, researchers at the University of Washington found that more people are running, biking and exercising. But so many others are becoming obese that the increased physical activity has had little impact on the average health of Americans.

In 2010, 678,282 Americans died because of dietary risks, the study said, outpacing the 465,651 who died that year of smoking-related diseases. High blood pressure, obesity, physical inactivity, high blood sugar and high cholesterol claimed 1.4 million others.

"If the U.S. can make progress with dietary risk factors, physical exercise and obesity, it will see massive reductions in death and disability," said Ali Mokdad, a University of Washington professor who worked on the studies. "Unhealthy diets and a lack of physical activity in the U.S. cause more health loss than alcohol or drug use."

The "State of U.S. Health" study is the first comprehensive analysis of disease burden in the country in more than 15 years. It said chronic disabilities in 2010 accounted for nearly half of all life-shortening health issues. Mental and behavioral disorders alone made up 27 percent of what researchers call "years lived with disability," meaning the time spent in less-than-optimal health. The biggest contributors are depression, anxiety, drug use and alcoholism.

Researchers said they hope communities across the United States will use the online archive, at www.healthmetricsandevaluation.org, to look at their statistics and address their challenges.

"Success stories tell us changes in life expectancies are possible," Murray said. "Success stories within the country tell us progress can be made. ... Improving diet, stopping tobacco use and increasing physical activity can work."

The doctors also acknowledged that pharmaceutical and medical interventions have improved since 1990, citing more widespread use of vaccines that have helped control influenza, statins that address cardiovascular issues and improvements in cancer treatment.

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