Why Do Americans Have Shorter Life Expectancy and Worse Health Than Do People in Other High-Income Countries?

Avendaño, Mauricio; Kawachi, Ichiro

doi:10.1146/annurev-publhealth-032013-182411

Cited by 163 publications

(151 citation statements)

References 88 publications

(119 reference statements)

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“…And a series of comparative research studies strongly suggests that social capital, social integration, and informal social control-in families, schools, communities, and neighbourhoods-are on average less developed and more unequally distributed in the US than in comparable nations; with areas of concentrated poverty and cumulative disadvantage in American cities exhibiting very serious levels of disorganisation and endemic social problems (Messner & Rosenfeld 1997;Avendano & Kawachi 2014;Darroch et al 2001;Banks et al 2010;38 Because it focused on parallel developments in the US and the UK, rather than contrasts between them, Garland (2001) said little about the role of America's distinctive political system in shaping penal policy. For a detailed discussion of that issue, see Garland (2010).…”

Section: Social Structure Social Organisation and Social Problemsmentioning

confidence: 99%

Penal power in America: Forms, functions and foundations

Garland¹

2017

JBA

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Abstract:In this article I discuss the exercise of penal power in contemporary America with a view to explaining its historical causes, its contemporary forms and functions, and its social foundations. I argue that the leading characteristic of American penality today is not degradation, retribution, racial caste-making, or neoliberal discipline but instead the imposition of penal controls. The remainder of the article develops some hypotheses about the social and political roots of that distinctive form of punishment. Re-connecting penal controls with patterns of crime and violence, I highlight the deficits of social control and social capital that set America off from comparable nations and I trace the sources of these deficits to the structure and operation of certain American institutions as well as the limited capacities and patterned dispositions of the American state.

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Section: Social Structure Social Organisation and Social Problemsmentioning

confidence: 99%

Penal power in America: Forms, functions and foundations

Garland¹

2017

JBA

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“…In countries such as Australia, the United Kingdom, and Canada, health expenditures represent about 10% of GDP; in the United States, this number is closer to 17% (The World Bank, 2015). Paradoxically, outcomes in the United States are worse than elsewhere (Avendano & Kawachi, 2014), a clear indicator that there is waste in the system. A recent study showed that older people with diagnosed chronic diseases face catastrophic health expenditure even in some of the wealthiest countries in Europe (Arsenijevic et al, 2016).…”

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confidence: 99%

Untitled

2017

TIM Review

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“…This far exceeded the next highest spender, France, by 50% [1]. Yet despite this expenditure, the US reported poorer health outcomes comparatively, with shorter life expectancy and a greater prevalence of chronic conditions [2]. This raised several questions about the successes and failures of the healthcare system, and whether the various players in the system were getting the bang for their buck.…”

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confidence: 99%

Value-Based Healthcare in Residency Training: a Perspective from Singapore

Tan

2017

Med.Sci.Educ.

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Value-based health care aims to achieve the best outcomes at the lowest cost. Many leading health systems worldwide have already begun to restructure care delivery guided by value-based concepts. Residency training programs will play a key role in the transition to value-based healthcare. However, incorporating value-based healthcare into residency programs has received little attention. This commentary introduces an approach developed in Singapore which encompasses structured teaching, clinical teaching, and evaluations. We elaborate on how educators can use avenues such as quality improvement initiatives and journal clubs to introduce concepts of valuebased healthcare to residents. The curriculum is then reinforced by allowing residents to apply value-based concepts in their clinical rounds and multidisciplinary meetings. Lastly, we give examples of how residents can be assessed with a value-based healthcare component in their in-training examinations and posting evaluations. This approach contributes to a wellplanned and smoothly executed educational program in valuebased healthcare for residents, which will be a keystone in the long-term success of the value-based healthcare model. Keywords Value . Value-based . Healthcare . Residency . International . SingaporeAs the leading nation in medical innovation, the United States (US) continues to influence healthcare delivery in developed nations worldwide. In recent years, debates on US healthcare spending and reform give pause for thought. Prior to introduction of the Affordable Care Act, the US spent $9086 per capita on healthcare in 2013, expending 17.1% of its gross domestic product (GDP). This far exceeded the next highest spender, France, by 50% [1]. Yet despite this expenditure, the US reported poorer health outcomes comparatively, with shorter life expectancy and a greater prevalence of chronic conditions [2]. This raised several questions about the successes and failures of the healthcare system, and whether the various players in the system were getting the bang for their buck.Leading US healthcare providers are now uniting under a new shared goal: value. What is value in healthcare? In our opinion, Michael E. Porter and Elisabeth Teisberg conceptualized value most clearly. In their framework, value is defined as the health outcomes achieved that matter to the patient relative to the cost of achieving those outcomes. Improving value requires either improving one or more outcomes without raising costs or lowering costs without compromising outcomes, or both [3]. Value-based health care delivery makes achieving high value its central tenet and aims to achieve the best outcomes for each specific medical condition at the lowest cost [4]. This is a paradigm shift from a traditional fee-forservice model which incentivizes higher patient volumes and looks at process measures which tend to reflect compliance to guidelines rather than health outcomes. A value-based model focuses on creating value for patients by increasing transparency of health outcome...

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Why Do Americans Have Shorter Life Expectancy and Worse Health Than Do People in Other High-Income Countries?

Cited by 163 publications

References 88 publications

Penal power in America: Forms, functions and foundations

Penal power in America: Forms, functions and foundations

Untitled

Value-Based Healthcare in Residency Training: a Perspective from Singapore

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