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World Health Systems Facts

US: Health System Outcomes

US: Health System Outcomes - World Health Systems Facts

Health System Overview
Political System
Economic System
Population Demographics
Health System Rankings
Health System Outcomes
Health Expenditures
Health System Financing
Coverage and Access
Costs for Consumers
Health System Resources and Utilization

Medical Personnel
Medical Training
Long-Term Services & Supports
Health Information and Communications Technologies
Pharmaceuticals
People With Disabilities
Aging
Social Determinants & Health Equity

Affordable Care Act
Medicaid
Medicare
Veterans Health Administration
Various US Health System Proposals
Health System History
Health System Challenges


Life Expectancy at Birth, 2022: 78.20
Infant Mortality Rate, 2022 (per 1,000 live births): 5.04
Under-Five Mortality Rate, 2022 (per 1,000 live births): 5.92

Source: United Nations, Department of Economic and Social Affairs, Population Division (2023). Data Portal, custom data acquired via website. United Nations: New York. Accessed 12 May 2023.


Life Expectancy at Birth (2019): 78.5
Maternal Mortality Ratio (per 100,000 live births) (2017): 19
Neonatal Mortality Rate (per 1,000 live births) (2020): 3
Probability of Dying from any of Cardiovascular Disease, Cancer, Diabetes, Chronic Respiratory Diseases Between Age 30 and Exact Age 70 (%) (2019): 13.6%

Source: World health statistics 2022: monitoring health for the SDGs, sustainable development
goals
. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.


Neonatal Mortality Rate (Deaths Per 1,000 Live Births) (2019): 4
Infant Mortality Rate (Deaths Per 1,000 Live Births) (2019): 6
Under-5 Mortality Rate (Deaths Per 1,000 Live Births) (2019):
  Male: 7; Female: 6

Note: “Under-5 mortality rate – Probability of dying between birth and exactly 5 years of age, expressed per 1,000 live births.
“Infant mortality rate – Probability of dying between birth and exactly 1 year of age, expressed per 1,000 live births.
“Neonatal mortality rate – Probability of dying during the first 28 days of life, expressed per 1,000 live births.”

Source: United Nations Children’s Fund, The State of the World’s Children 2021: On My Mind – Promoting, protecting and caring for children’s mental health, UNICEF, New York, October 2021.


Maternal Deaths Per 100,000 Live Births, 2020: 21

Source: Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO.


Adverse events in hip and knee surgeries: post-operative pulmonary embolism (PE) or deep vein thrombosis (DVT), 2018 (Rate per 100,000 Discharges):
— PE: 477.6; DVT: 465
Obstetric trauma, vaginal delivery with and without instrument, 2019 (Crude rate per 100,000 hospital discharges):
— With Instrument: 11.1; Without Instrument: 1.8
Asthma hospital admission in adults, 2019 (Age-sex standardized rates per 100,000 population): 37.1
Chronic obstructive pulmonary disorder (COPD) hospital admission in adults, 2019 (Age-sex standardized rates per 100,000 population): 194.1
Congestive heart failure (CHF) hospital admission in adults, 2019 (Age-sex standardized rates per 100,000 population): 411.7
Diabetes hospital admission in adults, 2019 (Age-sex standardized rates per 100,000 population): 226.0

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


General Mortality Rate Per 1,000 Population (2016):
Total: 4.9; Male: 5.9; Female: 4.0
Communicable Diseases Mortality Rate Per 100,000 (2016):
Total: 28.3; Male: 31.9; Female: 25.2
Noncommunicable Diseases Mortality Rate Per 100,000 Population (2016):
Total: 417.8; Male: 492.1; Female: 353.4
External Causes Mortality Rate Per 100,000 Population (2016):
Total: 46.5; Male: 68.1; Female: 25.3
Lung Cancer Mortality Rate Per 100,000 Population (2016):
Total: 27.8; Male: 33.4; Female: 23.2
Colorectal Cancer Mortality Rate Per 100,000 Population (2016):
Total: 11.4; Male: 13.6; Female: 9.5
Ischemic Heart Diseases Mortality Rate Per 100,000 Population (2016):
Total: 79.2; Male: 106.3; Female: 56.0

Source: Pan American Health Organization. Core Indicators 2019: Health Trends in the Americas. Washington, D.C.: PAHO; 2019.


“Life expectancy at birth has climbed, rising from 75.7 years in 1995 to 78.6 in 2017, an increase of 3.8% (Table 1.3). The gain for males exceeds that for females. Life expectancy at age 65 has risen even faster – 15% for males and 9% for females. Accordingly, mortality from all causes fell by over 20%. Much of this was due to a 42% reduction in mortality for circulatory diseases. Infant mortality rates fell by nearly 30%, but maternal mortality actually rose.

“Between 2014 and 2017 life expectancy did decline slightly, from 79.8 to 79.7 years. The decline was even greater among Black, non-Hispanic males, falling by 0.7 years over this period. The largest declines, however, were among working-age Whites who had not completed college – largely part of the opioid crisis and called ‘deaths of despair’ by the researchers who first discovered the trend, Anne Case and Angus Deaton (Karma, 2020).

“Of the 36 OECD countries, the US is in the bottom quartile in life expectancy, at 78.7 years in 2015, about two years below the median (Table 1.4). The only countries that are lower have per capita GDPs about half that of the US: Estonia, Hungary, Latvia, Lithuania, Mexico, Poland, the Slovak Republic and Turkey. The relative position of the US has fallen over time. As recently as 1980 US life expectancy was at the median, exceeding countries such as Austria, Belgium, Germany and the United Kingdom.

“A similar pattern exists with respect to infant mortality (Table 1.5). Overall death rates per 1000 live births declined by 34% between 1990 and 2015, to 5.9. The reductions were similar for neonatal deaths (under 28 days) and post-neonatal deaths (28 days to 11 months). There are, however, notable differences according to race / ethnicity, with rates for Whites, Hispanics / Latinos and Asians / Pacific Islanders significantly lower than those for Blacks / African Americans. Rates for the latter are more than twice that of Whites (CDC, 2017a).

“A conundrum that appears in many (but not all) US health indicators is the relatively good statistics for Hispanics and Latinos, whose overall infant mortality rates are slightly lower than Whites. This is sometimes termed the Latino ‘health paradox’. While Latinos have very high uninsurance rates, as well as lower incomes and educational levels on average, compared to Whites, many health indicators are nevertheless comparable to their wealthier, better educated and insured counterparts (Vega, Rodriquez & Gruskin, 2009). Latino smoking rates are also much lower than non-Hispanic Whites and African Americans (American Lung Association, 2020).”

Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.


“In recent years there has been increasing recognition that the healthcare system is not the main contributor to people’s health. Other factors – sometimes called ‘social determinants of health’ – include a vast array of cultural and environmental factors and are often far more important. A list of such factors is lengthy and includes parents’ education, poverty, family upbringing, language barriers, neighbourhood effects, racial segregation, safety, workforce issues, social capital and a host of environmental factors such as clean air and water. Moreover, these factors interact with one another. Higher incomes make it possible, for example, to avoid dangerous jobs and having to live in dangerous neighbourhoods. These social determinants form a backdrop for the data reported below on health status in the US.

“The US has experienced marked increases in life expectancy and reductions in most types of mortality in recent decades. Nevertheless, as other high-income countries have shown similar trends, the US has not gained in relative standing and continues to rank near the bottom with regard to such indicators as overall life expectancy, infant mortality and potential years of life lost.”

Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.


“An international statistic that receives much attention is mortality amenable to healthcare, which is defined as ‘premature deaths from causes that should not occur in the presence of timely and effective health care’ (Nolte & McKee, 2011). Over 30 causes of death have been defined as amenable to healthcare interventions, which can be summarized as ‘childhood infections, treatable cancers, diabetes, cerebrovascular disease and hypertension, and complications of common surgical procedures’. In addition, the measure includes half the deaths from ischaemic heart disease as amenable. For most of these conditions, only deaths occurring before the age of 75 were considered, although in a few instances lower age thresholds were used (e.g. cervical cancer before the age of 45).

“A related statistic is preventable mortality, which is defined as deaths that should have been avoided by public health interventions, ‘such as behaviour and lifestyle factors, socioeconomic status and environmental hazards’ (Eurostat, 2018). Fig. 7.11 shows both amenable and preventable mortality for the United States and seven other high-income countries between 2000 and 2017. The United States shows the highest rates for both measures. In 2016 the gap between the United States and the next highest country was quite considerable for amenable mortality. While amenable mortality rates have been generally declining for all of the countries, they fell faster elsewhere. In 2001, for example, the United States and the United Kingdom had nearly identical rates.

“There is a new index available that is a refinement of amenable mortality, called the Healthcare Access and Quality (HAQ ) index. It was developed in collaboration with researchers all over the world. Like mortality amenable to healthcare, the HAQ rates countries on their success in keeping people alive from afflictions that should not cause death if treated in a timely and high-quality manner by a country’s healthcare system. It purports to improve on amenable mortality in three ways: (1) to improve data comparability across countries by accounting for discrepancies in cause of death; (2) to better account for health risks, especially in cardiac deaths, that may be due to individual risk factors rather than access to and quality of care; and (3) to go beyond high-income countries to examine HAQ for 195 countries (GBD 2015 Healthcare Access and Quality Collaborators, 2017). As is the case with amenable mortality, the US index is considerably lower than in the other comparison countries.”

Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.


World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated May 23, 2023 by Doug McVay, Editor.

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