1. Potera, Carol


Two recent studies reveal poor outcomes.


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Most studies of mortality rates focus on older age groups, and the United States has ranked well in the top half among residents over 50. In contrast, Americans have the highest or second-highest under-50 mortality rates when compared with 16 other developed nations, including European countries, Japan, Canada, and Australia.


A study by Jessica Ho, a PhD candidate at the University of Pennsylvania, analyzed statistics from international databases from 2006 to 2008. About one-fifth of deaths in younger American men were due to homicides; car crashes and drug overdoses were next in order. Among women, only 7% of deaths were homicides; pregnancy complications and birth trauma accounted for 19% of the excess deaths, and cardiovascular disease made up 20%.


"More attention should be paid to health and mortality conditions at younger ages," Ho told AJN.


Within the United States, women 75 years old and younger fare worse than men. According to a second study, by Kindig and Cheng, women are dying at higher rates, especially in rural areas and in the South and West. At the same time, men's life expectancy has increased or remained the same, found the analysis of data collected from 3,141 counties from 1992 to 2006. (See Figure 1.)

Figure 1 - Click to enlarge in new windowFigure 1. Mortality in America

Nationwide, women's premature death rate rose in 1,344 counties (43%); in comparison, male mortality rose in only 100 counties (3.4%). Higher smoking rates, obesity, and lower education and income levels may drag down female life expectancy in some areas. The rise in female mortality rates is "striking and discouraging[horizontal ellipsis] despite increasing medical care expenditures and public health efforts," write the authors.


The results suggest that strategies are needed in medical care, public health, and education that emphasize women's health. Nurses are vital contributors to the health care system and to addressing these worsening health outcomes in women, lead author David Kindig, emeritus professor of population health sciences at the University of Wisconsin-Madison School of Medicine, told AJN. -Carol Potera




Ho JY Health Aff (Millwood). 2013;32(3):459-67


Kindig DA, Cheng ER Health Aff (Millwood). 2013;32(3):451-8