Monday, July 22, 2013

First Comprehensive Analysis Of Disease Burden In US In Over 15 years

This is one neat map. It was developed by the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, which authored this new report in JAMA (free)...

The State of US Health, 1990-2010, Burden of Diseases, Injuries, and Risk Factors, Journal of the American Medical Association, 10 July 2013

They found that the US lags behind 34 of the world's rich nations (the OECD) on many measures of health, despite spending the most:
  • "Improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations."
  • "The United States spends the most per capita on health care across all countries."
  • "[The US] lacks universal health coverage."
  • "[The US] lags behind other high-income countries for life expectancy."
  • "High costs with mediocre population health outcomes at the national level are compounded by marked disparities across communities, socioeconomic groups, and race and ethnicity groups."
  • "In some US counties, life expectancy has decreased in the past 2 decades, particularly for women."
  • "[The US] has higher than OECD mean rates for a number of leading diseases and injuries, such as COPD [lung diseases, e.g. chronic bronchitis, emphasema], road injury, diabetes, Alzheimer disease, and interpersonal violence."
An interesting finding: There has been an increase in this country in disability, not the kind that kills but the kind that significantly impacts quality of life:
"Morbidity and chronic disability now account for nearly half of the health burden in the United States. The key contributors to this burden, however, are not the same as the major diseases and injuries contributing to premature mortality. Mental and behavioral disorders [including substance abuse], musculoskeletal disorders [e.g. back, muscle, joint pain], vision and hearing loss, anemias, and neurological disorders [e.g. dementia, Alzheimer's and Parkinson's disease] all contribute to the increases in chronic disability."
We have funneled money into research of diseases we die from - heart disease and cancer - but not so much into diseases that maim us. What did they find was at the root of this increase in disability? Diet:
"Diet is a more important factor associated with disease burden than either physical inactivity or high BMI."
The map is interactive and can show life expectancy and other measures, by gender and county, over the last 25 years. (Clicking it will take you to the map on their site.)

Healthcare in the US is not about health, it's about making money. The business of disease is lucrative.

Here's Campbell speaking in his latest book, Whole:
"Something is fundamentally wrong with the way we do medicine -- the so-called health-care system in the United States doesn't really have much to do with health. Instead it's more properly called a disease-care system, because it just reacts to and manages disease, producing the expensive and disappointing outcomes we've come to tolerate and expect."

1 comment:

Bix said...

Again with the "dietary patterns"... Speaking about limitations of prior studies, they lamented the reductionist focus and addressed the need for research in dietary patterns.

"... because each component of diet is analyzed separately, the complex relationships among components of diet may not be fully considered or understood, which might overestimate the effects of each component. For example, individuals who consume large amounts of fruit also may consume less sodium."