28th in the World, Baby!

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Aaron Carroll draws our attention today to a new study in JAMA that compares American health outcomes with those in other rich countries. Overall, we’re now in 28th place, sandwiched in between Chile and Poland. The massive chart below shows how we do on treating specific diseases. We’re 31st on diabetes, 16th on breast cancer, 32nd on COPD, and (in our best showing) 8th on colon cancer.

The usual lazy response to studies like this is to claim that Americans are just less healthy than residents of other countries because we’re fat and we lead crappy lifestyles. Maybe so. But that doesn’t explain why we’re not just bad, we’re getting worse:

Between 1990 and 2010, among the 34 countries in the OECD, the US dropped from 18th to 27th in age-standardized death rate. The US dropped from 23rd to 28th for age-standardized years of life lost. It dropped from 20th to 27th in life expectancy at birth. It dropped from 14th to 26th for healthy life expectancy. The only bit of good news was that the US only dropped from 5th to 6th in years lived with disability.

We don’t have the best healthcare in the world. We just don’t. We have the most expensive healthcare in the world and the best-paid doctors in the world, but that’s it. On pretty much every other measure, we suck.

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