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Analysis: Birth mortality, heart attack deaths worse in U.S. than other wealthy nations

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Analysis: Birth mortality, heart attack deaths worse in U.S. than other wealthy nations

Dec. 28 (UPI) — Infant and maternal mortality rates among the wealthiest people in the United States are higher than those for 12 high-income countries globally, an analysis published Monday by JAMA Internal Medicine found.

In addition, survival rates for affluent U.S. residents with breast or colon cancer, two of the most common forms of the disease, were comparable or worse than those for “average” residents of these other countries, the data showed.

The findings suggest that even “privileged White Americans” have worse health outcomes than all residents of 12 other high-income countries, study co-author Dr. Ezekiel J. Emanuel told UPI.

“I think privileged White Americans should be more concerned and upset about the quality of the care they receive,” at least in part because they pay more for it, said Emanuel, vice provost for global initiatives at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia.

The United States spends more than $3.5 trillion per year on healthcare, 25% more per capita than the next highest-spending country, according to data from the Organization for Economic Cooperation and Development.

For this analysis, Emanuel and his colleagues compared data on health outcomes from the 157 wealthiest counties in the United States to that of all residents in 12 other developed countries: Australia, Austria, Canada, Denmark, Finland, France, Germany, Japan, the Netherlands, Norway, Sweden and Switzerland.

They focused specifically on infant and maternal mortality — the death of mothers or babies during or after childbirth — as well colon and breast cancer and acute myocardial infarction, which is a severe form of heart attack.

The 157 richest U.S. counties have a median household income of approximately $84,000, higher than that for the 12 comparison countries, which ranged from $50,000 to $60,000 annually, the researchers said.

The infant mortality rate in the highest-income counties in the United States is roughly four per 1,000 live births, which is higher than all 12 comparison countries and more than twice that of Finland, which has the lowest rate, the data showed.

Among White women living in the wealthiest counties in the United States, the maternal mortality rate is 10.85 per 100,000 births, according to the researchers.

The worst-performing comparison countries were Canada, with a maternal mortality rate of six per 100,000 births and France, with a rate of five per 100,000 births, the data showed.

For White U.S. residents in the wealthiest counties nationally, the five-year survival rate for colon cancer is 67%, which is comparable to rates for average residents in Canada, Japan, Norway and Switzerland and lower than that for average Australians, at 71%, the researchers said.

However, the five-year survival rate for breast cancer among White U.S. women in the highest-income counties is 92%, which is higher than that for average residents in all the comparator countries, the data showed.

The countries with the next highest breast cancer survival rates among average residents are Australia and Japan, at just under 90%, and Sweden, at 89%, the researchers said.

The 30-day case fatality rate for heart attack among White U.S. residents age 65 and older in the wealthiest counties is just over 12%, higher than rates in the worst-performing comparative countries Norway, at 10%, and Denmark, at 11%, according to the researchers.

“We have to hold health care providers — doctors, hospitals and others — responsible for the quality of care they deliver,” Emanuel said.

“And the fastest way to do that is to link the amount they are paid to the quality for care they provide on these and other key quality measures,” he said.



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