Daily Archives: January 10, 2010

Health Care Reform, Accountability, Disparity

I got some good news for the weekend, an opinion piece that I wrote together with some of the other post-graduate fellows at IHME was published online as a Science e-letter. It is titled U.S. Health Care Reform: The Case for Accountability and it’s about the measuring the outputs, outcomes, and impacts of the reform, whatever shape they end up taking.

The part that I was especially interested in adding to the discussion appears in paragraphs 3 and 4, about what these some of these statistics look like currently:

Disparities in health outcomes in the U.S. are unacceptable. A healthy life expectancy at birth in the U.S. ranks behind 28 other developed countries (1). Sizable groups in the United States have mortality risks resembling those in sub-Saharan Africa (2), including urban blacks between the ages of 15 and 64 living in counties with high homicide rates.

On average, Asian women lived 21 years longer than high-risk urban black males in 2001 (2). Although life expectancy for most American women increased between 1983 and 1999, life expectancy for women in 180 counties in areas such as Appalachia, the Deep South, the southern Midwest, and Texas decreased by 1.3 years (3).

I made some figures to accompany this, which Science didn’t print, so I’ve included them for you here:

Probability of a 45 year-old male dying before age 65, 2001, from Murray et al., Eight Americas: Investigating mortality disparities across races, counties, and race-counties in the United States. PLoS Medicine 2006.

Female life expectancy in US counties, 1961-1999 from Ezzati et al., The reversal of fortunes: Trends in county mortality and cross-county mortality disparities in the United States. PLoS Medicine 2008.


Filed under global health, science policy