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 among women under the age of 75 in several high-income countries. A Health Affairs Web First study released yesterday compares mortality rates in the Unites States, France, the United Kingdom, and Germany between 1999 and 2007.

Ellen Nolte of RAND Europe and C. Martin McKee of the London School of Hygiene and Tropical Medicine 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. The study was supported by the Commonwealth Fund.

Key study findings include:

  • Lack of progress in the United States relative to other countries was observed in male mortality rates 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,” conclude Nolte and McKee. “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.”

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