Want to have some fun with numbers? Check out a brand new “Death Risk Rankings” website, which was sent my way today by Dr. Paul Fischbeck of Carnegie Mellon University in Pittsburgh. He and his colleagues have compiled data and made a user-friendly interface that allows you to compare the risk of dying within periods of time at various ages of various causes. It also allows the user to set variables like sex and race as well as age. Very cool.
So what did learn in my first pass through the data?
If you’re a 50- to 59-year-old man (guess how old I am), your chances of dying in the next ten years are better if you live in the U.S. than in Europe: 7.8 percent versus 8.2 percent. However, all of the difference was due to a single factor: the higher rate of cancer deaths in Europe, which is undoubtedly due to the much higher rate of smoking.
But the situation is completely reversed if you’re a 50- to 59-year-old woman. For late middle-aged women, the chances of dying in the next ten years is much higher in the U.S.: 4.7 percent versus 3.9 percent. Cancer death rates are almost exactly the same in the two regions, but U.S. women over 50 are much more likely to die of heart disease, diabetes, infectious diseases and respiratory diseases — in short, everything that a good health care system that stresses prevention can help.
And did you know that if you reach age 80, your chances of dying in the next year are about one in ten? I was initially disturbed by that number. But after thinking about it for a few moments, I realized that if I were 80, I’d probably think those were pretty good odds. Moreover, if I still have the energy to play 18 holes of golf at age 80, I’ll probably think I have a pretty good chance of beating them. And if I didn’t have the energy to play 18 holes, who’d want to live anyway?
Merrill Goozner has been writing about economics and health care for many years. The former chief economics correspondent for the Chicago Tribune, Merrill has written for a long list of publications including the New York Times, The American Prospect and The Washington Post. His most recent book, “The $800 Million Dollar Pill – The Truth Behind the Cost of New Drugs ” (University of California Press, 2004) has won acclaim from critics for its treatment of the issues facing the health care system and the pharmaceutical industry in particular. You can read more pieces by Merrill at Gooznews.com, where this post first appeared.
Doctor David … thank you for that well researched reply. I’m so sick of listening to pundits on both sides of the political aisle who pitch their opinions as facts. The American populace is too often like “sheep to slaughter” when it comes to making informed decisions.
I went to a town hall meeting a few weeks back, hosted by my Congressman, and I was appalled by the lack of knowledge on both sides (i.e. those for and those against.) The questions asked about the health care reform bills were stunning. When someone in the audience asked how many people there had taken the time to read the House version of this bill, only a small number of hands went up … of the 500-600 in attendance. (Even the Congressman didn’t raise his hand!)
How in the world can we hope to have a cogant and informed discussion when folks haven’t even read what is be proffered by those in D.C.? It’s ludicrous to even begin to think that we’ll make a decision of this magnitude having only listened to whatever TV or talk show talking head we tend to lean toward.
It’s down right scary folks!
Read .. call your congress person/representative and find out what’s really going on. KNOW what the bills say and what they don’t. Don’t be misled …
Actually, comparisons of US health care in particulary compared with Europe is difficult. Some parts of the US are far healthier (e.g. Utah) than others and some parts have a greater committment to health of its citizens than others. We know about Massachusettes for instance with universal health coverage. But New York City recently spent about $250 million to update Harlem Hospital to according to New York Mayor Mike Bloomberg, “…Harlem Hospital will among the most technologically advanced hospitals–public or private–in the city,”
Meanwhile the citizens of Los Angeles, another wealthy city, let Martin Luther King Hospital run into disrepair and terrible medical standards and instead of making the committment that New York City did to fix the problems with the hospital closed the hospital instead.
In fact, I think it would make a great television special comparing the New York’s committment to health care of its poorer citizens and Los Angeles’s committment to health care of its poorer citizens. Besides the hospital refurbishing vs. closing, the teen smoking rate in New York City is 8.5%, 200,000 adults have quit smoking since 2000, calories of all foods in chain restaurants are posted.
According to the Institite of Medicine, 50% or 1/2 of health is determined by life sytle issues (smoking, obesity and lack of excercise, achohol and traffic accidents, firearms, ….). 20% or 1/5 of health is determined by environment such as air pollution which according to the cited studies prematurely kills 20,000 to 50,000 per year and of course also causes asthma particulary among the poor in inner cities. 20% or 1/5 of health is determined by genetics and only 10% or 1/10 of health is determined by access to care.
Below is some detail of a recent major multi-year epidemiological study comparing cancer survival in the US vs. Europe. Since many of the blog readers do not have direct access to journals I have listed sources that quote from the journal article.
One will note that about 1/5 more men survive cancer in US than in Europe (66.3% vs. 47.3%)
and 7/100 women (62.9% vs. 55.8%) including 1/5 more men surviving prostate cancer (99.3% vs. 77.5%)
and 1/10 more women surviving breast cancer (90.1% vs. 79.0%).
An economist would appreciate the reference at the from a paper in the National Bureau of Economic Research (NBER) that demonstrates that the difference in health care in the US vs. Europe is that we have a far more obese and unhealthy population who live a far less healthy lifestyle than people in Europe.
Table 1. Five-Year Relative Survival Rates for Cancer of Different Sites, US and European Cancer Registries*
5-year survival rate (%)
Site The first number is US. The second is Europe.
Prostate 99.3 77.5
Skin melanoma 92.3 86.7
Breast 90.1 79.0
Corpus uturi 82.3 78.0
Colorectum 65.5 56.2
Non-Hodgkin lymphoma 62.0 54.6
Stomach 25.0 24.9
Lung 15.7 10.9
All malignancies (men) 66.3 47.3
All malignancies (women) 62.9 55.8
Survival Rates Significantly Higher in United States Than in Europe
One of the reports compares the statistics from Europe with those from the United States and shows that for most solid tumors, survival rates were significantly higher in US patients than in European patients. This analysis, headed by Arduino Verdecchia, PhD, from the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, Italy, was based on the most recent data available. It involved about 6.7 million patients from 21 countries, who were diagnosed with cancer between 2000 and 2002.
The age-adjusted 5-year survival rates for all cancers combined was 47.3% for men and 55.8% for women, which is significantly lower than the estimates of 66.3% for men and 62.9% for women from the US Surveillance, Epidemiology, and End Results (SEER) program ( P < .001).
Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: international comparisons.
National Cancer Intelligence Centre, Office for National Statistics, London, UK.
“There were wide differences in survival across Europe, with rates in the UK well below the average, but all European rates were far below those in the USA.”
Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.
I’m not sure I agree that this is “very cool”. Ok, some of the statistics might be quite interesting, but personally I wouldnt want to know what risk I have of dying at a particuler age, it seems a little weird.