The Hurrider I Go the Behinder I Get: The Deteriorating International Ranking of U.S. Health Status

Abstract

The health of societies can be measured by a range of mortality indicators, and comparisons of national parameters with those of other societies can be symbolic of health status and progress. Over the past century, health outcomes have been steadily improving almost everywhere in the world, but the rates of improvements have varied. In the 1950s, the United States, having among the lowest mortality and other indicators of good health, ranked well among nations. Since then, the United States has not seen the scale of improvements in health outcomes enjoyed by most other developed countries, despite spending increasing amounts of its economy on health care services. Trends in personal health-related behaviors are only part of the explanation. Structural factors related to inequality and conditions of early life are important reasons for the relative stagnation in health. Reversing this relative decline would require a major national coordinated long-term effort to expose the problem and create the political will to address it.

Psychometric properties of the Birth Satisfaction Scale-Revised (BSS-R) for US mothers

“…In the 1950s the U.S. claimed an unrivaled success in regards to their high ranking of health outcomes, including maternal-newborn, among other industrialized nations, primarily in Europe. However, over the past several decades, a spiraling decline of overall health outcomes including maternal-newborn outcomes has been observed (Bezruchka, 2012;Clark, Belfort, Byrum, Meyers, & Perlin, 2008). Maternity care in the US is dominated by costly procedures and ritual-based intensive clinical practice; yet, maternal-newborn outcomes remain poor when compared to other industrialized nations (Bezruchka, 2012;MacDorman & Matthews, 2009;Stones & Arulkumaran, 2014).…”

“…Numerous maternal care experts consider this US phenomenon an American paradox of "doing more while accomplishing less" (Childbirth Connections, 2014). The cesarean rate continues to remain high at 32.8% and contributes to the deteriorating national ranking (Bezruchka, 2012;MacDorman & Matthews 2009;Martin, Hamilton, Osterman, Curtin, & Matthews, 2013). In 2012 over 98% of births occurred in the hospital, however, only 7.6% were attended by certified nurse midwifes (Martin et al, 2013).…”

Global Family Medicine: A ‘UNIVERSAL’ Mnemonic

“…Strong evidence-our dismal record at successfully lowering overall rates of morbidity and mortality at home 40 (even with extraordinarily high medically related expenditures in contrast with other countries 41 ), coupled with ample validation of family medicine's role as an appropriate alternative to this failure 42,43 -belies this suggestion. Although all global medical practitioners risk being sucked into the vortex of transmitting inappropriate models of medical care to environments where they are neither sustainable nor feasible-such actions can actually do grievous harm to the general health of the population by encouraging priorities incompatible with the local realities of those most in need-global family physicians have the potential to understand this susceptibility and minimize untoward consequences.…”

The Path to Health Equity Through Multidisciplinary Collaboration

“…1 It is difficult to ignore that U.S. population health outcomes compare poorly with those measured in other highincome countries around the world. 1 At the most fundamental level, the life expectancy for people living in the most affluent neighborhoods may be decades longer than for people living in low-income communities. 2 People who are disadvantaged and/or living in poverty unduly suffer from increased burdens of illness in relation to those who are economically, educationally or socially well off.…”