NLM Director’s Comments Transcript
U.S.’ Health Status Declines: 08/19/2013

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Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.

A pioneering, comprehensive comparison of national health measures recently published in the Journal of the American Medical Association, suggests life expectancy improved within the U.S. from 1990-2010. Compared to developed nations, however, the U.S. declined in some key health areas during the two decades assessed in the study.
The findings (from a very large group of health researchers called the U.S. Burden of Disease Collaborators) report life expectancy for American adults increased from 75.2 years in 1990 to 78.2 years in 2010. A separate measure of healthy life expectancy (based on length of life and levels of illness at different ages) also increased for American adults -- from 65.8 in 1990 to 68.1 years in 2010.
The results (derived from the massive Global Burden of Disease study that compared 291 diseases and injuries and 67 risk factors or clusters of risk within 187 nations) additionally find the U.S.’ all-cause death rates at all ages improved during the study’s 20 year assessment period.
Conversely, compared to 34 developed nations (among the 187 surveyed), the U.S.’ ranking for age-standardized death rates fell from 18th to 27th (or close to last) place. Similarly, the U.S.’ comparative ranking of age-standardized years of life lost to premature mortality fell from 23rd to 28th (or close to last place). The U.S.’ comparative ranking of age-standardized number of years lived with a disability declined from 5th to 6th place. The U.S.’ comparative life expectancy at birth fell from 20th to 27th (or near last place) and the U.S.’ comparative ranking for healthy life expectancy dropped from 14th to 26th (or close to last place).
An editorial that accompanied the study (written by the President of the Institute of Medicine [IOM]) explains (and we quote): ‘… by every measure including death rates, life expectancy, and diminished function and quality of life as assessed by the (study’s) authors, the U.S. standing compared with 34 Organisation for Economic Co-operation and Development countries declined between 1990 and 2010’ (end of quote).
The IOM’s Dr. Harvey Fineberg praises the study’s groundbreaking efforts to detail the burden of disease in the U.S. (and other nations) and explains the study’s conceptual framework, organization, and methods represent what he calls (and we quote) a ‘monumental construction’ and… ‘a herculean task’ (end of quote).
Dr. Fineberg explains the study enables more meaningful comparisons of health measures between, among and within nations over time. He writes (and we quote): ‘it is scalable up and down – up to global regions and the world and down to states, counties, and municipalities’ (end of quote). In fact, some of the initial news reports about the study’s findings emphasized health status differences between U.S. regions instead of the results that compared the U.S. to 34 developed nations.
Dr. Fineberg especially commends the authors’ measures of health risk factors, which he explains will become more valuable as scientists overlap them with predictors of illness in the future. For example, Dr. Fineberg explains (and we quote) ‘genetic, metabolic, physiologic, behavioral, environmental, and social factors will be traced through defined pathways to disease and premature mortality’ (end of quote).
In terms of enhancing health prevention, the study’s hundreds of collaborators (from across the U.S) conclude their findings suggest (and we quote) ‘the best investments for improving population health would likely be public health programs and multisectoral action to address risks such as physical inactivity, diet, ambient particulate pollution, and alcohol and tobacco consumption’ (end of quote).
Overall, MedlinePlus.gov’s health statistics health topic page provides other gateways that assess the U.S.’ health status, such as the National Center for Health Statistics’ findings, which are found in the ‘overviews’ section.
A link to the U.S. Centers for Disease Control and Prevention’s fast stats about American health can be found in the ‘start here’ section of MedlinePlus.gov’s health statistics health topic page.
MedlinePlus.gov’s health statistics health topic page also contains research summaries, which are available in the ‘research’ section. Links to the latest pertinent journal research articles are available in the ‘journal articles’ section. You can sign up to receive updates about health statistics as they become available on MedlinePlus.gov.
To find MedlinePlus.gov’s health statistics health topic page, type ‘health statistics’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘health statistics (National Library of Medicine).’
The current study coupled with findings about the global economic impact of mental health (discussed in our last podcast) provide an unprecedented, compelling snapshot of health in the U.S. (and other nations) as well as new ways to interpret current challenges and assess future progress. Let’s hope the increased capacity to provide an overview of the nation’s and world’s health fosters renewed efforts to improve it.
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