U.S. Health Gains Starting to Slow: Study
Rates of early death, prenatal care, smoking stable in recent years; obesity way up
MONDAY, Dec. 12, 2005 (HealthDay News) -- The overall health of Americans -- from rates of infant mortality to smoking to vaccination -- has improved 18.4 percent since 1990, but the rate of improvement is now slowing considerably.
During the 1990s, Americans' health improved at an annual rate of 1.5 percent. But since 2000, that rate has slowed to 0.3 percent annually.
"This is concerning to all of us in the health-care community and should be of equal concern to all Americans," said Dr. Georges Benjamin, executive director of the American Public Health Association. "We must find ways to reverse this negative trend."
Benjamin spoke at a news conference Monday to announce the results of the 16th annual America's Health Rankings, 2005 report, issued by the United Health Foundation, the American Public Health Association and the Partnership for Prevention.
The United States lags behind many other nations in a variety of indicators, and ranks 28th in healthy life expectancy. In Japan, which has the highest healthy life expectancy, a newborn can expect to live five additional, healthy years compared to a child born in the United States.
"It's clear we have a lot to do," Benjamin said.
The report assesses the nation as a whole as well as each state, using 18 measures of health. The measures include smoking, infant mortality rates, per capita public health spending and immunization rates.
It's the second report in less than a week to weigh in on the health of Americans. Last week, Health, United States, 2005, from the U.S. Department of Health and Human Services, issued a similar message: Gains in health care and well-being continue, but at a slower pace than before.
That report found that while life expectancy has hit an all-time high, baby boomers on the cusp of their Medicare years face increasing problems with high blood pressure and obesity.
According to the new report, premature death (years of potential life lost prior to age 75 per 100,000 people) dropped 15 percent from 8,716 in 1990 to 7,398 in 2000. Between 2000 and 2005, however, premature death increased.
One of the worst pieces of news carried by the report is an increase in the prevalence of obesity, from 11.6 percent of the population in 1990 to 23.1 percent in 2005.
"That's more than a doubling of the percent of people who are obese," said Dr. Reed Tuckson, vice president of United Health Foundation. "This is of extraordinary significance."
There has been a 30 percent overall decline in the prevalence of smoking since 1990, with most of that drop occurring in the early 1990s. From 1993 to 2003, there were few measurable improvements made. Today, tobacco remains the No. 1 preventable cause of death and disease in the United States and almost 21 percent of Americans still smoke.
Gains in prenatal care have followed a similar trajectory, with improvements during the early-to-mid 1990s and a leveling off by 2000. Since last year, the percentage of women receiving adequate prenatal care increased by only 0.7 percent.
The teenage pregnancy rate decreased by 28 percent between 1990 and 2000. The teenage birth rate decreased by 33 percent from 1991 to 2004 to hit a record low.
Infant mortality in the United States was 6.7 per 1,000 live births, compared with 2.3 in Hong Kong and 3.0 in Japan. "These are dramatically different numbers," Tuckson said. "We've got to get really busy."
Since last year's report, the number of children living in poverty increased in 25 states and the percentage of uninsured individuals has increased in 26 states. Today, more than 15 percent of the U.S. population lacks health insurance.
High school graduation rates have dropped from 72.9 percent in 1990 to 68.3 percent in 2005. Mississippi, Alabama and Kentucky had the greatest percentage of children living in poverty. Such socioeconomic measures are considered to be related to health status, the researchers said.
On the positive side, since 1990, the nation has experienced a 40 percent decrease in the rate of motor vehicle deaths and in the incidence of infectious disease; a 24 percent decline in violent crime; and an 18 percent decline in the rate of deaths from cardiovascular disease.
Minnesota topped the list as the healthiest state, followed by Vermont, New Hampshire, Utah, Hawaii and North Dakota.
The least healthy states were Tennessee (48), Louisiana (49) and Mississippi (50).
Twenty-nine states, including Tennessee, Oklahoma and South Carolina, lag behind the national rate of improvement.
Oregon, Vermont, California, Alaska and New York have improved more than 25 percent since 1990.
"We really look at this report as defining that healthiness is the product of the combination of a number of forces working together," Tuckson said.
Added Benjamin: "Our hope is that the data found in this report will be used as a call to action to mobilize individuals, employers, community leaders, public officials and all others who play an increased role in protecting and advancing their own health and the health of the nation as a whole."
View the full report at United Health Foundation.