NEW YORK -- All over the world, people are dying from common diseases with well-known treatments.
The newly created Healthcare Access and Quality Index shows how well countries use their healthcare systems to stop preventable deaths. The inaugural version of the index finds huge disparities both between countries, and within them. Access to quality healthcare, the study shows definitively, is often the difference between life or death. For Americans, the results aren’t heartening.
“What we have found about health care access and quality is disturbing,” said Dr Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington and senior author of the study, published in The Lancet. “Having a strong economy does not guarantee good healthcare.”
At the top of the list for countries with high socio-demographic indicators, Andorra -- that tiny little principality wedged between France and Spain -- scored a 95 out of 100. Nordic countries -- Iceland (94), Sweden (90), and Norway (90) -- also scored high on the list. Australia, a country with publicly funded and universal healthcare recently praised by US President Donald Trump, also scored a 90. America, meanwhile, scored only 81, putting it behind countries such as France, Canada, and the UK, but ahead of Saudi Arabia and Russia.
“America’s ranking is an embarrassment, especially considering the US spends more than $9,000 per person on health care annually, more than any other country,” Dr Murray said. “Anyone with a stake in the current health care debate, including elected officials at the federal, state, and local levels, should take a look at where the US is falling short.”
Not all diseases kill Americans with equal power, however. Despite recent skepticism about the efficacy of vaccines, diseases that they prevent -- like tetanus and measles -- kill significantly fewer Americans than those that require on-going prevention and care, like hypertension and diabetes (both of which kill far fewer people in Andorra). Meanwhile, maternal and neonatal disorders are also much more likely to kill Americans than people elsewhere.
Scores were assessed on a scale of 1-100. Researchers chose 32 causes of death preventable through access to high-quality healthcare listed by co-authors Professor Martin McKee and Dr. Ellen Nolte, and then mapped those against data from the Global Burden of Diseases, Injuries, and Risk Factors Study. The GBD, as it’s called, is a widely cited, worldwide observational epidemiological study that’s been examining mortality trends from 1990 to the present.
The researchers then adjusted their analysis to account for variations in death rates not easily attributable to lack of personal healthcare, and measures of personal healthcare access and quality. The rankings were separated to draw comparisons between countries of similar socio-demographic make-ups.
The study, funded by the Bill & Melinda Gates Foundation, lists a number of limitations, including any that are applicable to the larger GBD study, and that not all countries have reliable statistics. They note that “achieving 100 does not mean that additional improvement is not possible".