Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries

Abstract

IMPORTANCEThe average health outcomes in the US are not as good as the average health outcomes in other developed countries. However, whether high-income US citizens have better health outcomes than average individuals in other developed countries is unknown. OBJECTIVE To assess whether the health outcomes of White US citizens living in the 1% and 5% richest counties (hereafter referred to as privileged White US citizens) are better than the health outcomes of average residents in other developed countries. DESIGN, SETTING, AND PARTICIPANTSThis comparative effectiveness study, conducted from January 1, 2013, to December 31, 2015, identified White US citizens living in the 1% (n = 32) and 5% (n = 157) highest-income counties in the US and measured the following 6 health outcomes associated with health care interventions: infant and maternal mortality, colon and breast cancer, childhood acute lymphocytic leukemia, and acute myocardial infarction. The study used Organisation for Economic Co-operation and Development data, CONCORD-3 cancer data, and Medicare data to compare their outcomes with all residents in 12 other developed countries: Australia,

Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018

“…European mortality rates in 2018 lie below US White American mortality rates for each country and across high-and low-income areas. This US health disadvantage even among economically advantaged groups in high-income US locations has also been shown for a broad set of health conditions (51,52).…”

“…Further details on area definitions and the poverty or deprivation variables used for ranking areas can be found in ref. 51 .…”

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

“…Long before covid-19, the US was at a disadvantage relative to other high income nations in terms of health and survival. 6 37 38 39 40 41 In 2013, a report by the National Research Council and Institute of Medicine showed that from the 1980s, the US had higher rates of morbidity and mortality for multiple conditions relative to other high income countries. 6 A recent report by the National Academies of Sciences, Engineering, and Medicine found that this gap widened further through 2017 and that the greatest relative increase in mortality in the US occurred in young and middle aged adults (aged 25-64).…”

“…Long before covid-19, the US was at a disadvantage relative to other high income nations in terms of health and survival 63738394041. In 2013, a report by the National Research Council and Institute of Medicine showed that from the 1980s, the US had higher rates of morbidity and mortality for multiple conditions relative to other high income countries 6.…”

Is Sociodemographic Status Associated with Empathic Communication and Decision Quality in Diabetes Care?

“…Despite advances in medicine, social and economic factors contribute to 50% of a population's health status 1 (Canadian Institute for Advanced Research, Health Canada, 2002), and some estimate that less than 10-15% of mortality is preventable by medical care, with the remainder being attributed to social factors 2 . For example, citizens living in the 1% or 5% highest income counties in the USA had better health outcomes compared to average US citizens 3 . In contrast, those with lower socio-economic status had a greater prevalence of psychological and chronic health conditions 4 .…”