CLEVELAND, Ohio – The United States may lead the world in known coronavirus-related deaths not only because it is one of the largest countries, but also because it is among the least healthy among comparable nations when it comes to things like obesity, diabetes, hypertension and heart disease.
Health and Human Services Secretary Alex Azar pinned part of the blame for the high number of U.S. deaths now approaching 100,000 on the health of Americans heading into the crisis, saying last week on CNN’s State of the Union that the U.S. had a “significantly disproportionate burden of comorbidities … (including) obesity, hypertension, diabetes.”
Placing the United States so low for key health measures might sound like hyperbole to some people who don’t follow medical trends closely, but there is research that backs up the claim.
“Yes. Absolutely” in comparison to the top economic countries, said Dr. Scott Frank, a Case Western Reserve University School of Medicine professor in the department of Population and Quantitative Health Science.
“Nothing has demonstrated the point more than COVID. It has really exposed cracks in the U.S. health care system. It is more like fissures than cracks.”
Frank pointed to research published by healthaffairs.org that shows the U.S. with higher rates than Europe for heart disease (21.8% to 11.4%), high blood pressure (50% to 32.9%), diabetes (16.4% to 10.9%) and obesity (33.1% to 17.1%), among other factors.
And the Peterson-Kaiser Family Foundation’s Health System Tracker lists the United States worse than each of 11 other countries of similar economic size and wealth for problems associated with cardiovascular disease, chronic respiratory diseases and diabetes. This is based on disease burden, a measure that takes into account premature deaths and years of productive life lost due certain health issues.
Frank, the former health director for Shaker Heights, said the United States should not rank so poorly: “It is an indictment of the U.S. health care system, not the U.S. population.”
That was a point raised by Azar, during his CNN interview.
“Unfortunately,” Azar said, “the American population is a very diverse … It is a population with significant unhealthy comorbidities that do make many individuals in our communities, in particular African American, minority communities particularly at risk here because of significant underlying disease health disparities and disease comorbidities — and that is an unfortunate legacy in our health care system that we certainly do need to address.”
The World Health Organization in 2011 published a Global Atlas on cardiovascular disease, ranking the United States better than most European countries for lower tobacco and alcohol use, and for physical activity, but placing the U.S. worse off than most of Europe for healthy diets, diabetes and obesity.
Just over one-fourth of the reported COVID-19 deaths worldwide have been in the United States.
Tracking of coronavirus deaths by Johns Hopkins University on Friday placed reported U.S. deaths at 94,702, about the same as the next three countries combined – United Kingdom (36,124), Italy (32,486) and France (28,218).
But since the United States is the third largest country in the world with 330 million people, the U.S. death rate per 100,000 people of 28.95 ranks behind several others.
Among those with higher rates are Belgium (80.42 per 100,000), Spain (59.8), the United Kingdom (54.33) and Italy (53.76). Countries with lower rates include Germany (9.89), Canada (16.91), Switzerland (22.29), Japan (0.61) and Australia (0.4), among others.
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