A Population-Based Study Comparing Child (0-4) and Adult (55-74) Mortality, GDP-Expenditure-on- Health and Relative Poverty in the UK and Developed Countries 1989-2014. Some Challenging Outcomes

Abstract

Important Results: Highest average 1980-2014 %GDPEH is USA 12.6%, the lowest UK 7.0%. European average 8.5% a UK to European odds ratio 1:1.21.Widest Income Inequality was USA 15.9 times, UK 13.8 was third, European average 8.5times.Child Mortality fell in every country but eleven signifi cantly better than Britain. Highest was USA 1383pm the UK fourth at 967pm. European average 728pm yielded a European to UK odds ratio of 1:1.33.Income Inequality and CRM signifi cantly correlated (RHO=+0.6188 p<0.001) and lowest Private: Public %GDP ratio and highest CMR (Rho=+0.3805 p<0.05).Adult Mortality fell substantially in every country but UK signifi cantly greater reductions than Seventeen counties. European average 9545pm to UK 10,754pm gave a European to UK odds ratio of 1:1.13. Conclusion: Implications;Britain's results suggest a higher priority is given to adult health than children. The socio-economic context in which UK Child health operates appears to disadvantage UK children, indicating the need to address income inequalities and at least match European average health funding.

Mortality in the USA, the UK and Other Western Countries, 1989–2015: What Is Wrong With the US?

“…One surprising finding was that only 54% of total U.S. health expenditure came from “Private” sources, which highlights the considerable funds coming from federal and state provision, yet as the U.S. system is still based on an insurance model, there remains the problem of limited or underinsured people not having their health needs met. 1,6,11,16–18,24,25 Indeed, it has long been known that American health is more expensive in part because of over-prescription, overuse of high-tech measures, and higher administrative costs—in effect, “spending more and getting less.” 6,9–11,30–34 Although it has been recognized that the not-for-profit systems are less costly, 33 it is still being argued that the Obama Reform was “no cure for what ails us”; 35 although this is possibly complicated by interactive socioeconomic factors, 14–18,24–27 it is predominately because health care is delivered via an insurance system that needs to make a profit. 7,32,33…”

“…It is readily acknowledged that a complex range of interactive, multiple causes influence national mortality rates, [15][16][17] but relative poverty is especially linked to child mortality, although the underlying mechanism is not fully understood. [15][16][17][24][25][26][27] Lifestyles and what might be described as the local "geography" of American states are other factors. [27][28][29] However, placing these results within the context of each nation's fiscal investment to health poses the question of comparative effectiveness of the different countries.…”

“…1,6,11,[16][17][18]24,25 Indeed, it has long been known that American health is more expensive in part because of over-prescription, overuse of high-tech measures, and higher administrative costs-in effect, "spending more and getting less." 6,[9][10][11][30][31][32][33][34] Although it has been recognized that the not-for-profit systems are less costly, 33 it is still being argued that the Obama Reform was "no cure for what ails us"; 35 although this is possibly complicated by interactive socioeconomic factors, [14][15][16][17][18][24][25][26][27] it is predominately because health care is delivered via an insurance system that needs to make a profit. 7,32,33 The 3 null hypotheses are rejected as the United States had significantly higher mortality rates than the 20 OWC and, compared to the United Kingdom, had significantly higher rates for child and adult mortality and for most of the global diagnostic categories.…”

“…36 Then there is the issue of relative poverty, as the United States has long had the widest income inequality of all 21 Western countries, which might be reflected in the high infectious disease and perinatal deaths, as again the United States has long had the highest rates of child mortality (0-4) in the OWC, which is related to relative poverty. [15][16][17][25][26][27]37 The differential results in HIV and external deaths-especially the higher suicide, transport, and assault deaths-appear to mirror differing societal lifestyles. One notable difference between the other nations is the extent of gun-related deaths in America linked to suicide and homicide, 38,39 conservatively estimated at more than 30,000 p.a., which far exceeds any other Western country.…”