Charted: Female mortality trends in 21 high-income countries

by Adrianna McIntyre

This chart isn’t new—it’s from an Institute of Medicine report published in January—but I’d never seen it. It came up during an ARM session I attended on Sunday. I think it’s stunning. And dismal.

figure1-8

The chart examines probability of survival until age 50 among women from 1980 to 2006. See those red dots? That’s the US. See those gray dots? Those are all of our peer countries. We’ve been lagging from the start—but while expected survival has increased over the last few decades, so has the gap between the US and other developed nations.

So, what’s up with that? The researchers consider this part of a phenomenon they call the “U.S. health disadvantage”, and the study attempts to disentangle underlying causes of premature death. On general (not gender-specific) mortality trends in the US relative to other nations:

… [T]he results show that the United States loses a larger number of years of life to all of the major disease and injury groupings than do the other peer countries. Although communicable diseases and nutritional conditions are no longer a leading cause of premature deaths in most high-income countries, the United States still fares poorly in this category. The gap in years of life lost from noncommunicable diseases—which includes heart disease, cancer, and other conditions not caused by infections—is also large. For both males and females, cardiovascular disease and congenital anomalies together account for more than half of the U.S. excess mortality from noncommunicable diseases. Diabetes, digestive diseases, and respiratory diseases also contribute to the gap.

And speaking specifically to females:

The causes of the excess years of life lost by U.S. females are more diverse. Homicide, motor vehicle accidents, and nontransportation-related accidents also play an important role, contributing a total of 37 percent of the excess years of life lost in the United States. For intentional injuries, the excess comes from homicide alone, because U.S. women lose fewer years of life to suicide than women in other peer countries. Noncommunicable diseases are more important for women, contributing 29 percent of the U.S. excess in years of life lost compared with 18 percent for men. Of this 29 percent, 9 percent comes from cardiovascular disease and the remaining 20 percent from all other noncommunicable diseases. Perinatal conditions also affect females more than males: they contribute 19 percent to the U.S. excess in years of life lost among females and 13 percent among males.

Those trends are helpfully illustrated in chart form:

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A key point: one of the panelists asked the audience, quasi-rhetorically, how many thought health care delivery reform would solve all of these problems. Not a single hand was raised. A thoughtful discussion of social determinants of health ensued.

An audience member later turned the question back on the panel, during the session’s Q&A. He asked how many of them believed health care could offer nothing to improve mortality trends. Again, not a single hand. It’s some food for thought.

The IOM report is 390 pages long. These charts are pulled from pages 47 and 53; there are similar figures for male mortality.

_____________________________
Adrianna is a graduate student in public policy and public health at the University of Michigan.
Follow her on Twitter @onceuponA or subscribe to the blog.

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2 thoughts on “Charted: Female mortality trends in 21 high-income countries

  1. It’s also fascinating that the grey dots converge as time goes on. Other developed countries have closed the gaps *as* they’ve improved mortality rates, suggesting that the initial laggards have been able to make improvements that the US hasn’t.

    It’s interesting to see the differences in causes between females and men. It’s well-established that men die earlier (http://www.npr.org/blogs/krulwich/2013/06/17/192670490/why-men-die-younger-than-women-the-guys-are-fragile-thesis), but it seems that isn’t true for every possible cause of death.

  2. Steve says:

    If by “gaps” you mean inequality within countries, the variation within years is among country averages. The convergence is more likely due to saturation effect, i.e. they’re doing almost as well as it’s possible to do, fewer improvements available to be added.

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