Abstract
This population-based study compares U.S. effectiveness with 20 Other Western Countries (OWC) in reducing mortality 1989–1991 and 2013–2015 and, responding to criticisms of Britain’s National Health Service, directly compares U.S. with U.K. child (0–4), adult (55–74), and 24 global mortality categories. World Health Organization Age-Standardized Death Rates (ASDR) data are used to compare American and OWC mortality over the period, juxtaposed against national average percentages of Gross Domestic Product (GDP) Expenditure on Health (%GDPEH) drawn from World Bank data. America’s average %GDPEH was highest at 13.53% and Britain’s the lowest at 7.68%. Every OWC had significantly greater ASDR reductions than America. Current U.S. child and adult mortality rates are 46% and 19% higher than Britain’s. Of 24 global diagnostic mortalities, America had 16 higher rates than Britain, notably for Circulatory Disease (24%), Endocrine Disorders (70%), External Deaths (53%), Genitourinary (44%), Infectious Disease (65%), and Perinatal Deaths (34%). Conversely, U.S. rates were lower than Britain’s for Neoplasms (11%), Respiratory (12%), and Digestive Disorder Deaths (11%). However, had America matched the United Kingdom’s ASDR, there would have been 488,453 fewer U.S. deaths. In view of American %GDPHE and their mortality rates, which were significantly higher than those of the OWC, these results suggests that the U.S. health care system is the least efficient in the Western world.
Highlights
This population-based study compares U.S effectiveness with 20 Other Western Countries (OWC) in reducing mortality 1989–1991 and 2013–2015 and, responding to criticisms of Britain’s National Health Service, directly compares U.S with U
We argue that one key health-related outcome is reducing amendable mortality rates
All mortality rates are drawn from World Health Organization (WHO) annual mortality data, updated December 2018, to compare the United States and the 20 OWC on the WHO’s world population Age-Standardized-Death-Rates (ASDR) per million, which are total death rates controlled for population and age, using a standardized method adjusting for population demographics.[13]
Summary
All mortality rates are drawn from WHO annual mortality data, updated December 2018, to compare the United States and the 20 OWC on the WHO’s world population Age-Standardized-Death-Rates (ASDR) per million (pm), which are total death rates controlled for population and age, using a standardized method adjusting for population demographics.[13]. It should be noted that for the global category External Deaths, we report on each separate diagnostic group because of their frequency and because they reflect psychosocial factors and lifestyles in society. The percentage of GDPEH that comes from “Private” sources is shown to give an indication of the “Public/Private” funding configuration of each country.[6]. We used the SPSS statistical package from which Confidence Intervals (to Æ95% significance) are calculated to compare changes in ASDR over the period between the United States and the OWC, all controlled for total population.[13] The comparison between U.S and U.K. current child (0–4) and adult (55–74) mortalities and the 24 global mortality categories are based on the average of years 2013–2015 in rates pm. A series of U.K. to U.S odds ratios are calculated for each of the current rates of the global diagnostic mortality categories
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