« Pre-Kindergarten in San Antonio | Main | Why Don't We Know More Precisely What To Do? »



Feed You can follow this conversation by subscribing to the comment feed for this post.

I did not read the report due to length and access. However, I scanned all the press and blog coverage and have a good feel for the findings.

Observation and question:
On mortality <50yo, report conveys that 2/3 of attributable risk due to public health issues like guns, accidents, etc.

Given rates of death in younger demographic contribute to overall life expectancy, as cited, significant wake up call for public health investment. We emphasize obesity and other modifiable risks, but surprisingly, the difference between US and OECD stems from things we know about, but overlook. The collective sum of all the poisonings, shootings, car crashes add up. I was surprised much of the disparity rested in those issues.

(I cite overall life expectancy due to its use as "gold standard" for HC quality between countries, even if misapplied as a metric.)

Given the absolute levels of death from CVD, cancer, etc. (large), as compared to non-medical occurrences of "youth," (small), does the delta between USA vs other actually stem from non-clinical issues? Does the cure reside there and have we directed our efforts in the wrong places?

Of course, by posting here, a bias presents, but I think you get the crux of my question. I am very interested in the answer.

The difference between the US and the other countries studied is the presence of a cohesive "health system". They have one, we do not. The simple solution is to get a national health system -- is this really so difficult? I suspect the author of this blog or many other individuals could outline a great system in an afternoon.

Brad and Ralph: Thanks for reading and for your comments. Brad: I know that the Committee was also surprised at how much of the differences were from non-clinical causes like injuries. Ralph: I think we do need a more systematic approach to improvement, but I can't design it in an afternoon. I hope you aren't referring only to national health CARE systems which have many advantages but alone are not adequate. I suspect that a greater level of social spending to health care spending may be partly responsible, which could be considered a HEALTH system. But even if we knew exactly what the right investment balance would be (stay tuned for Wednesday's blog) finding common ground to make it happen will probably take a generation of afternoons. Let's hope the report is a wake up call to get us moving on a serious population health improvement strategy.

The comments to this entry are closed.

Recent Posts