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August 29, 2012

Sue Ducat
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From Health Affairs


More Avoidable Deaths in the US Than in Three European Countries


Bethesda, MD -- Amenable mortality—deaths that could have been avoided with timely and appropriate health care—accounts for 21 percent of deaths among men and 30 percent of deaths among women under the age of 75 in several high-income countries. A new study from Health Affairs, released today as a Web First, compared mortality rates in the Unites States, France, the United Kingdom, and Germany between 1999 and 2007. It found that amenable mortality had declined by 18.5 percent in the United States compared to 36.9 percent in the United Kingdom, 27.7 percent in France, and 24.3 percent in Germany. As a result of the slower improvement, the United States now has higher amenable mortality rates than the other three countries.

In Amenable Mortality—Deaths Avoidable Through Health Care—Progress In The US Lags That Of Three European Countries


By Ellen Nolte and C. Martin McKee


Nolte is director of the Health and Healthcare policy program at RAND Europe; McKee is a professor of European public health at the London School of Hygiene and Tropical Medicine.


The study, which will also appear in the journal’s September issue, was supported by a grant from the Commonwealth Fund.


The principal source for the data about the three European countries was the World Health Organization mortality database, and the US data came from the Centers for Disease Control and Prevention. The study compares data on cause of death for amenable causes with other causes, including treatable cancer and heart disease, which the authors consider 50 percent preventable for this age group. Some key study findings, which explain the lower decline in US rates compared to other countries:


  • Lack of progress in the United States relative to other countries was observed in mortality rates among men attributed to surgical conditions and medical errors. Among those 65 to 74, the mortality rates per 1,000 men were unchanged between 1999 and 2007, while there were declines in other countries: 0.46 fewer deaths per 100,000 a year in Germany, 2.22 in the UK, and 3.11 in France.

  • Women between 65 and 74 experienced a decline in mortality rates from circulatory conditions other than heart disease in all four countries between 1999 and 2007, but the pace of change was the smallest in the United States (4.33 fewer deaths per 100,000 per year compared with 4.8 in France, 8.64 in Germany, and 11.56 in the United Kingdom).

  • Mortality from treatable cancers for men fell at similar rates in all four countries during that time period: with deaths per 100,000 declining 2.64 per year in France, 2.69 in the United States, 2.73 in the United Kingdom, and 3.46 in Germany.

  • For both sexes, the US rates of decline for those under age 65 lagged well behind the other three countries, widening the gap over the decade.

“We show that the lagging progress of the United States compared to other countries, as measured by amenable mortality, is largely driven by elevated amenable mortality among those younger than age 65,” concluded the authors. “However, we also observed a slowing of improvement among older Americans, relative to their peers in the other countries we studied….A recent comparison of factors…showed that many Americans failed to obtain recommended treatment for common chronic conditions….[T]here is no reason why all Americans cannot benefit equally from living in a country with the most expensive health care system in the world.”

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.

The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.