October 2013

Americans die sooner and experience higher rates of disease and injury than people in other high-income countries. Addressing the U.S. health crisis requires further study of the role of underlying social values, personal behaviors, education patterns, and public policies, according to experts gathered for a Capitol Hill briefing on September 25.

During the event, co-sponsored by AERA, leaders in the health, behavioral, and social sciences reviewed findings from the report U.S Health in International Perspective: Shorter Lives, Poorer Health, released in January 2013 by the National Research Council and the Institute of Medicine. The participants offered insights into how NIH and other public health agencies can respond.

“Behavioral and social science findings are the key to determining recommendations for improving U.S. health,” said Dr. Steven Woolf, director of the Center for Human Needs at Virginia Commonwealth University. “The answer is not in test tubes or in laboratory science. It’s out there in the community.”

Key education findings from the report included:

·         Other countries are outpacing the United States in the education of young people.

·         Education is a key influential health factor.

·         Preschool enrollment is lower in the United States than in most high-income countries.

·         The United States ranks well in educational attainment by adults of all ages, but other countries (including emerging economies) are outpacing the United States in the educational attainment of young people (e.g., in graduation rates).

·         Years of school completed is one of the best predictors of life expectancy in the United States.

“These problems are multifactorial and will require multi-sector collaboration that we have not done in order to turn this around,” said Dr. Janine Clayton, director of the NIH Office of Research on Women’s Health.

The report called for several next steps:

·         Intensified efforts to improve public health by addressing the specific conditions responsible.

·         Implementation plans that involve a societal commitment of effort and resources to meet goals.

·         An organized media and outreach campaign to raise awareness about the U.S. health disadvantage to stimulate a national discussion.

·         A study of successful policies that countries with superior health status have found useful and that might be adapted for the United States.

In conclusion, Robert Kaplan, director of the NIH Office of Behavioral and Social Sciences Research, observed that no single factor explains the discrepancy in life expectancy between the United States and other high-income countries, but that behavioral and social factors appear to be important contributors to the differences.

U.S. Health in International Perspective: Shorter Lives, Poorer Health can be downloaded electronically for free, or purchased in hardcopy, from the National Academies Press.