A major new study has found that people in the United States are dying at much higher rates than people in other wealthy countries, and the gap has been growing for many years.
Researchers say millions of deaths in America might have been prevented if the country had health outcomes similar to nations such as Australia, Canada, France, Japan, and the United Kingdom.
The study was led by researchers at Boston University School of Public Health and published in JAMA Network Open. Scientists examined death records from 1999 to 2022 and compared the United States with 17 other high-income countries.
The researchers discovered that the United States had far more deaths from heart disease, stroke, diabetes, dementia, drug overdoses, alcohol-related illness, and several other health conditions.
They estimated that more than 12.7 million Americans died during this period who might have survived if the United States had death rates similar to other wealthy nations. The researchers called these people “missing Americans.”
One of the biggest findings was the major role played by cardiovascular disease. Conditions such as heart disease, high blood pressure, and stroke were responsible for a large share of the extra deaths in the United States.
Although many people often focus on drug overdoses or violence when discussing American health problems, the study showed that heart and metabolic diseases actually caused far more deaths overall.
The researchers found that cardiovascular disease remained the leading cause of excess deaths during almost the entire study period. In 2022 alone, cardiovascular and metabolic diseases together made up more than half of all excess American deaths.
The study also found that drug poisonings, alcohol-related illness, and suicide became increasingly important causes of excess deaths, especially among younger adults and men.
Drug overdose deaths rose sharply after 2013, largely because of fentanyl entering the illegal drug supply. By 2022, drug poisonings caused more than 130,000 excess deaths in the United States compared with other wealthy countries.
The researchers also found higher death rates in the United States from homicide, HIV/AIDS, transportation accidents, respiratory illness, and COVID-19.
The COVID-19 pandemic made the situation even worse. From 2020 to 2022, COVID became one of the leading causes of excess deaths in the United States and also appeared to contribute to worsening outcomes from other diseases.
Scientists say the findings point to deeper social and economic problems inside the country. Study author Dr. Jacob Bor explained that differences in living conditions, healthcare access, stress, diet, housing, education, and economic inequality may all increase the risk of disease.
The study suggests that many health problems do not begin inside hospitals. Instead, they often begin with long-term social conditions that affect people’s daily lives.
Researchers also looked at years of life lost, which measures how many years people lose when they die early. Drug overdoses caused especially large losses because many victims were younger adults.
Interestingly, the study also found a few areas where the United States performed better than some peer countries. Death rates from several cancers, excluding lung cancer, were lower in the United States, which researchers partly linked to strong cancer screening and treatment systems.
Still, overall mortality rates remained much higher in America than in other wealthy nations.
The study covered more than 63.5 million deaths over the 23-year period. By 2022, overall death rates in the United States were 38% higher than in comparable countries.
Researchers say more work is needed to understand why excess deaths increased especially quickly after 2010. However, they believe policy changes aimed at improving public health, reducing inequality, improving nutrition, increasing preventive care, and addressing addiction could help reduce future deaths.
Some experts also point to newer medicines such as GLP-1 drugs for obesity and diabetes as possible tools for reducing cardiovascular disease in the future.
The researchers emphasized that many countries with healthcare systems no better than the United States still achieve better health outcomes. This suggests that medical technology alone cannot solve the problem.
Instead, broader social policies may play an important role in helping people live longer and healthier lives.
In reviewing the findings, this study provides one of the clearest pictures yet of why Americans die earlier than people in many other wealthy countries.
The research is especially important because it shows that the problem is not caused by a single disease. Instead, multiple long-term health and social problems are combining to create a much larger national crisis.
The findings also challenge the idea that advanced healthcare technology automatically leads to better population health. The study strongly suggests that prevention, healthier lifestyles, stronger public health systems, and social support may be just as important as medical treatment itself.
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Source: Boston University School of Public Health.
