A study by researchers at the Brown University School of Public Health found that avoidable mortality rose across all U.S. states from 2009 to 2021, while it declined in most other high-income countries.
PROVIDENCE, R.I. [Brown University] - When a person dies, clinicians often look at the cause of death to determine whether it could have been avoided, either by medical prevention such as vaccines or by treatments like antibiotics. These types of deaths are known as avoidable mortalities, and in most high-income countries around the world, the number is going down.
But in the United States, avoidable deaths have been on the rise for more than a decade, according to a new study by researchers at the Brown University School of Public Health and Harvard University, who examined mortality trends across U.S. states and 40 high-income countries. Their findings were published in JAMA Internal Medicine.
The team compared mortality data from all 50 U.S. states with data from countries in the European Union and the Organization for Economic Cooperation and Development, whose 38 members include Australia, Japan and Iceland. They found that between 2009 to 2021, avoidable mortality in the U.S. kept getting worse, while avoidable mortality in the EU and OECD improved (with the exception of the period of time during COVID-19 pandemic from 2019 to 2021).
The findings suggest that deep-seated issues in the American health care system and public policy may be contributing to worsening health outcomes, said lead study author Irene Papanicolas, a professor of health services, policy and practice at Brown's School of Public Health.
"We've known for some time that life expectancy has been getting worse in the U.S., but now we can see that the country is on a different trajectory from other high-income countries," said Papanicolas, who is also the director of the Center for Health System Sustainability. "Other countries are getting better at reducing avoidable deaths through prevention and treatment, but in the U.S., these deaths are growing."
The researchers compared mortality data from individual U.S. states to data from high-income countries of similar scale, and also used aggregate data to compare the U.S. overall to the aggregates of other countries.
On average, avoidable mortality increased across the U.S. by 32.5 avoidable deaths per 100,000 people. By contrast, avoidable mortality decreased in EU countries by 25.2 avoidable deaths per 100,000 people and decreased in OECD countries by 22.8 avoidable deaths per 100,000 people.
"It's a bit shocking," Papanicolas said. "What we found is that while avoidable mortality varies by state, all U.S. states are getting worse."
