Today’s Managing Health Care Costs Number is 42.9%
JAMApublished data on changes in mortality this week –both all causes and from specific conditions – from 1969 to 2013 – and the results are very heartening. All cause mortality is down by 42.9%. Likelihood of Americans under 75 dying of heart disease and stroke plummeted; likelihood of dying of diabetes and cancer and unintentional injuries decreased significantly, and likelihood of dying of chronic obstructive lung disease rose. The latter might be that the positive impact of smoking cessation has a longer lead period for lung disease than for cardiovascular disease.
This data isn’t perfect – it’s based on what physicians put in death certificates – and we all know that these can be notoriously unreliable. Even so, this is great news. Men dying in the 40s of heart disease was commonplace when I trained in the mid 1980s, and it’s close-to-unheard of today.
Much of the lower mortality is not related to care within the medical system. It’s related to public health interventions that have given us cleaner air and dramatic reductions in smoking rates. We need to continue to focus on what public health interventions could lead to the next big improvement in American’s health. The US continues to lag other developed countries in life expectancy. Improved access to care will help – but decreasing economic disparities will be critical too. Mortality rates are far higher for those facing economic insecurity, and addressing that economic insecurity will be critical to continuing to lengthen (and improve) lives.
