Health of the United States: How are we doing?
America’s Health Rankings annual report provides plenty of information on a wide range of health measurements.
One the nation’s top public health reports has made some changes due to the COVID-19 pandemic. This year’s America’s Health Rankings breaks from the report’s 30-year tradition and does not present an official ranking of healthiest states, but it does provide plenty of information on a wide range of health measurements.
Officials with the rankings, published by the United Health Foundation, said that some of the data used in the report predates the COVID-19 pandemic. Because of this and given the dramatic effect that the pandemic is having on health among Americans, the report does not assign overall health rankings for states for the past year. However the ongoing health trends documented by the report do provide a context for what to expect as the country continues to deal with, and recover from, one of the biggest health threats in our nation’s history.
Related: Health care after the pandemic: Emerging issues for 2021
“The issues we are seeing in this year’s report will be compounded further by the current COVID-19 pandemic. For years to follow, we expect that COVID-19 will impact almost every health and socioeconomic measure included in this report,” said Rhonda Randall, MD, chief medical officer of UnitedHealthcare Employer & Individual and advisor to America’s Health Rankings. “Having year-over-year trends is critical during a public health crisis, something that a record number of users are finding given the significantly increased traffic to the America’s Health Rankings website. Making this data available is incredibly important so that a comprehensive view of our nation’s health can be taken into context during the COVID-19 pandemic.”
Key findings show a mix of challenges and improvement
The health rankings report looks at numerous health measurements, and includes an analysis of social determinants of health, such as housing and economic hardship. The report, which was created in partnership with the American Public Health Association, features 74 measures of population health, covering social and economic factors, physical environment, clinical care, behaviors, and health outcomes data.
The study said the nation is making progress on certain key health markers. The 2020 report shows a reduction in the prevalence of multiple chronic conditions, for example. This is due in part to a reduction in cardiovascular disease among Americans.
However, other areas continue to be problematic—for example, obesity reached a record high in the country in 2019. At the same time Americans have been exercising more—between 2017 and 2019, there was a 13% increase in the number of adults who reported exercising.
In addition, uninsurance has increased in the U.S.—the data shows a 7% increase in uninsured Americans between 2016 and 2019. And mental health issues continue to be a challenge, with more Americans reporting frequent mental distress (an 11% increase from 2018 to 2019), and a continuing increase in suicide rates between 2009 and 2018.
Higher spending, worse outcomes
The study underscores a common finding of public health measurements: when compared to other nations, the U.S. pays much more for health care, while getting much less in the way of results. The study found that the U.S. spends the most for health care—by a lot—when compared with the other 36 member countries of the Organization for Economic Co-operation and Development (OECD).
“The average spending on health in OECD countries was $3,984 U.S. dollars per capita,” the report said. “The United States spent almost three times that amount, totaling $10,637 U.S. dollars per capita in 2018 (No.#37 out of the 37 OECD countries). Switzerland (No. 36), which spent the second most on health among OECD countries, still spent two-thirds the amount the United States spent in 2018.”
In the measurement of health outcomes, the U.S. fared poorly. Two common measurements of population health–infant mortality and life expectancy–illustrate the relatively poor outcomes of the U.S. system. In the measurement of infant mortality, the U.S. ranked 33 out of the 37 OECD countries, at 5.7 deaths per 1,000 live births—Estonia was ranked first at 1.6; Japan (No.#4) had 1.9 deaths per 1,000 live births. In overall life expectancy, the US ranked 28th out of the 37 OECD countries.
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