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50+: Live Better, Longer

U.S. Lagging Other Countries on Many Health Measures

Report finds some gains, but also many areas where Americans' health is slipping
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The biggest causes of early death in the United States continue to be heart disease, lung cancer, stroke, chronic obstructive pulmonary disease and road injuries, with little change in those killers over time.

The biggest causes of disability are low back pain, depression and other musculoskeletal disorders. Mental problems such as depression and anxiety now comprise about one quarter of all disability in the United States.

The study also found some bright spots. Thanks to powerful new medications, HIV and AIDS, which were the 11th leading causes of death and disability in 1990, dropped to 32 in 2010. Road injuries -- such as traffic accidents, once the fourth leading cause of death and disability -- now rank ninth. Birth defects are also taking less of a toll on health. They ranked 20th in 1990, but have dropped to 29th, thanks, in part, to mandatory fortification of grain products with folic acid, which has reduced the number of babies born with devastating neural tube defects, according to the report.

"We have been gradually improving over the last 20 years, but other countries have progressed even more rapidly, and our relative standing compared to other wealthy countries has actually declined," said Dr. Harvey Fineberg, president of the Institute of Medicine, who wrote an accompanying editorial on the study.

From 1990 to 2010, average life expectancy increased in the United States by three years -- from 75.2 years to 78.2 years for both sexes combined. But other prosperous countries saw larger gains over that period.

Ireland gained 5.1 more years, on average. South Korea gained 7.6 years of life expectancy on average. And life expectancy in Australia grew by an average of 4.6 years.

Murray said Australia makes an interesting comparison to the United States. Both are countries of immigrants with culturally diverse populations. Australia spends half as much as the United States on health care each year. Despite that, Australians are less likely to die prematurely or become disabled than Americans. They also have lower rates of major killers like heart disease, lung cancer, violence and diabetes, he noted.

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