Americans are dying at higher rates than people in other wealthy countries from a widening range of chronic diseases, in addition to drug overdoses, suicides and homicides, a new study finds.
The study, which examined U.S. mortality data from 1999 to 2023 and compared it with 16 other high-income countries, found rising death rates from conditions including hypertensive disease, endocrine and metabolic disorders, alcoholic liver disease, neurological diseases and genitourinary diseases.
Researchers said the findings indicate that the U.S. mortality gap with comparable wealthy nations cannot be explained solely by what are commonly described as “deaths of despair”, such as drug overdoses, suicides and homicides.
The study’s corresponding author, Dr Steven Woolf of Virginia Commonwealth University’s School of Medicine, found that the rising death rates from chronic and other diseases have contributed to a widening life expectancy gap between the U.S. and other high-income countries.
The researchers analysed data from the United Nations, U.S. Mortality Database, Centers for Disease Control and Prevention and Organization for Economic Co-operation and Development.
According to the findings, U.S. life expectancy ranked 38th among countries with populations of more than one million in 2023. The study also found that residents of 60 countries faced a lower risk of dying before age 40 than Americans.
External causes of death, particularly drug overdoses, suicides and homicides, remain major contributors to excess mortality in the U.S. However, researchers found that these causes do not fully account for the country’s health disadvantage compared with other wealthy nations.
Among adults aged 25 to 44, all-cause mortality increased by 71.2 per cent between 2010 and 2021. The rise included deaths from overdoses and other external causes, as well as early-onset diseases such as hypertensive disease, endocrine and metabolic disorders and alcoholic liver disease.
Middle-aged adults also experienced higher mortality from several of the same conditions, alongside increases in deaths from nervous system and genitourinary diseases.
Among older adults, mortality from neurological diseases and endocrine and metabolic disorders also increased.
Since 2010, the researchers said the widening mortality gap between the U.S. and comparable countries has increasingly been driven by circulatory diseases, respiratory illnesses, nervous system diseases, endocrine and metabolic disorders and external causes.
Also Read: UCH tops Nigerian health institutions in 2026 SCImago rankings
The COVID-19 pandemic further widened the gap, becoming a leading cause of death among middle-aged and older adults. However, researchers noted that deaths from non-COVID conditions continued even after the pandemic’s acute phase subsided.
Experts who spoke to Newsweek said problems with access to health care, affordability and preventive care could be contributing to the trend.
Mónika López Anuarbe, a professor of economics at Connecticut College and health economist affiliated with the college’s Public Health Pathway, said the findings highlighted longstanding challenges within the U.S. health care system.
“When trying to understand why the U.S. is where it is in terms of mortality rates, the iron triangle of health care comes to mind: access to care, cost containment and quality of care,” she said.
López Anuarbe said rising health care costs affect insured and middle-class Americans, with some people delaying or foregoing treatment because of the expense.
“When people forgo care because of cost, the probability of addressing a health condition in time decreases, which can lead to higher mortality rates,” she said, adding that affordability had become a barrier even for some insured Americans.
She also pointed to significant differences in life expectancy within states. In Connecticut, for example, she said there is nearly a 30-year gap in life expectancy between residents of East Hartford and Westport.
Jagdish Khubchandani, a professor of public health at New Mexico State University, said the findings raise questions about why the U.S. spends more on health care than any other country while continuing to record higher mortality rates than many of its peers.
He said the mortality gap is largely driven by heart disease, respiratory illnesses, metabolic health problems and external causes, many of which he described as preventable.
Khubchandani said the increase in deaths among working-age adults is linked to drug overdoses, suicides, homicides, alcohol-related liver disease and heart disease associated with high blood pressure.
He said preventive measures, including improving access to naloxone and addressing harmful health behaviours, could help reduce premature deaths.
However, he noted that several barriers continue to limit the effectiveness of preventive measures, including a fragmented health care system, diets dominated by ultra-processed foods and challenges surrounding social safety-net programmes.
Khubchandani also cautioned that simply increasing access to treatment for conditions such as heart disease may not provide a sustainable solution without addressing the broader factors contributing to poor health.
The study concluded that narrowing the mortality gap with other high-income countries would require action on several factors affecting health, including access to medical care, socioeconomic conditions, environmental risks and longstanding health inequalities.
NewsWeek
