Photo by Kindel Media.

The term “avoidable death” is defined as the death of a person less than 80 years old which could have been prevented by normal healthcare interventions. Statistics on avoidable death numbers are used in part to assess a healthcare system’s efficiency. The rate of avoidable deaths is on the rise in the US but is declining in 40 other high-income countries. Coupled with a steady decline in life expectancy occurring in the US, researchers are looking for answers that will reverse these disturbing trends. 

Examples of avoidable deaths include traffic accidents, deaths from diseases preventable by vaccines, deaths from treatable conditions like appendicitis and sepsis, and deaths from conditions that could have been prevented by early detection, such as tuberculosis, coronary artery disease, and some forms of cancer. 

A stark comparison: US vs. other nations

On average, deaths in US states increased by 32.5 per 100,000 people.

According to a study published by researchers from the Brown University School of Public Health and Harvard University, avoidable deaths are increasing in all 50 US states, some more than others. On average, these deaths in US states increased by 32.5 per 100,000 people, while in the European Union, avoidable death decreased by 25.2 per 100,000, and in countries in the Organization for Economic and Cooperative Development (OECD countries include Australia, Japan, Iceland and 35 other high-income nations) the rate dropped by 22.8 per 100,000. 

There are marked differences in the rising rates in the US from state to state, with New York’s avoidable deaths rising by 4.8 per 100,000 people while West Virginians experienced a rise of 99.6 per 100,000. 

More spending, worse outcomes?

The research looked at healthcare expenditure as a measure of the trends but found no correlation between a state’s spending and its rate of increase. However, the numbers tell another story in other countries, where increased spending in Spain, Turkey, Canada, and Japan, for example, resulted in higher drops in avoidable death rates. The fact that the US as a whole spends more per capita on healthcare than any other country in the study, makes the data quite perplexing, according to lead study author Irene Papanicolas. 

She adds: “There’s been a lot of discussion about preventable deaths in the U.S. such as drug-related deaths or suicides, which do account for a big proportion of this trend. However, we found that deaths from nearly all major categories are increasing.” 

Searching for solutions

Disease prevention, lifestyle factors, and socio-economic issues will need to be looked at.

Papanicolas suggests that the next step in narrowing the gap between the US and other countries will involve studying what other countries are doing to promote the decline of avoidable death. Disease prevention, lifestyle factors, and socio-economic issues are some of the subjects that will need to be looked at. 

Further research on the related topic of life expectancy is showing a steady decline in the US at a rate of .9 years per annum. The data, which calls for big-picture investigations into the flaws of US healthcare delivery, shows that while the whole world’s life expectancy dropped during the first year of the Covid-19 pandemic, most countries on an economic par with the US  rebounded to their former trend of steady increase. 

Steven Woolf, director emeritus of Virginia Commonwealth University’s Center on Society and Health, foresaw the disturbing trend over ten years ago, well before the pandemic, when he published a 400-page report along with colleague Laudan Aran, entitled “US Health in International Perspective: Shorter Lives, Poorer Health.”  The alarm sounded by the study has mostly gone unheeded, even as life expectancy rates have dropped to 76.1 years (as of January 1, 2023), while the rest of the world’s high-income countries are averaging 82.4 years. 

The US ranks below the Czech Republic, Lebanon, and Cuba. 

Contributing factors to early death

The predictive 2013 study found numerous contributing factors, many pointing to high numbers of early deaths, including not only of those under the age of 50, but shockingly, American children are less likely to live to 5 years of age than their peer-country counterparts. Even relatively healthy people, non-smokers of healthy weight, were found more likely to die at an earlier age than similar populations in other countries. 

Politicians and social activists have pointed to the lack of universal healthcare and gun violence as contributing factors in addition to the more widely acknowledged health declines caused by sedentary lifestyles, obesity and metabolic disease, and the opioid epidemic. Regardless of the cause, Woolf, as well as former National Institute on Aging Director John Haaga, are frustrated by the resistance of American policymakers to compare US healthcare practices with those of other countries where healthcare delivery is leading to both increased lifespan and decreased avoidable death numbers. 

The future of U.S. Healthcare

With the defunding of Health and Human Services agencies and the corresponding reduction in research they carry out as directed by the Trump administration, it is unclear whether these alarming shifts in US healthcare will be addressed. 

Talk to your healthcare provider about ways you can reduce your chances of avoidable and premature death.  

Ann Constantino, submitted on behalf of the SoHum Health’s Outreach department.