|Type of paper:||Problem solving|
|Categories:||Public health Healthcare policy|
a) Where does the United States rank among developed nations in overall mortality? Where does it rank regarding the decrease in mortality between 1980 and 2010? Has there been a recent change in the mortality pattern?
Compared to the other developed nations, the United States of America ranks at the bottom of the chart in the indicators of mortality and life expectancy but exceeds all other developed nations regarding spending in health care. In the organization for economic cooperation and development, the United States of America is ranked at number 29th regarding infant mortality of all the 35 member countries which are all developed nations. The low ranking of the United States of America is disappointing especially due to the countries high expenditure on health compared to the other 35 nations which is approximated to be 16.9% of the country gross domestic product (2016 Annual Report).
Between 1980 and 2000 there has been a significant improvement and application of technology in healthcare which has decreased mortality rate. Healthier lifestyles and healthcare education has also improved life expectancy in the United States of America. Between 1950 and 1995 there was a significant decline in mortality rate Canada, France, Germany, Italy, Japan, the United Kingdom and the United States respectively with the United States of America showing the least decline in mortality rate decline compared to other developed nations (National Research Council, & Committee on Population. 2011).
In the last two decades, there have been significant gains in the reduction of mortality rate in high-income countries compared to the gains by the United States of America for both women and men. The list of countries overtaking the United States of America regarding life expectancy is growing, and the gap between the United States and other developed nations continues to widen (Woolf & Aron, 2013).
b) Where does the United States rank among developed nations in infant mortality? Where does it rank regarding decrease in infant mortality between 1960 and 2010?
The United States of America is ranked number 26 amongst the developed nations. The United States has a high infant mortality rate that is more than double the other developed nations. The reason behind these shocking statistics despite the United States high investment in healthcare in the high deaths of babies born at full term compared to other developed countries (National Center for Health Statistics (U.S.). 2014). In 2010 alone it is estimated that there were 6.1 deaths in every 1000 live births which were found to be higher than the 25 other participating countries. Despite various interventions that have been put in place by the government the number of infant mortalities has continued to persist (Rettner, 2014).
There has been a decline in infant mortality between 1960 and 2010, in the 1900 30% of the infants born in the United States of America did not survive their first birthday. Between 1960 and 2010 there has been a significant decline in infant mortality through the improvement of the public health, clinical medicine and social welfare of the Americans. Between 1912 and 1969 the children bureau was in charge of handling infant mortality problem but did not achieve the desired results. The discovery of antimicrobial agents and safe blood transfusions accelerated the decline in child mortality in the 20th century (MacDorman et al., 2014). Between 1960 and 1970 the Medicaid and other federal programs were in place which increased the access to care and led to further infant mortality decline. However, between 1970 and 1979 the number of infant mortality further reduced with 41% due to new technology in neonatal medicine and slowed down in the mid-1980s. Again, between 1989 and 1991 infant mortality declined at a faster rate with the invention of the artificial pulmonary surfactant which was used to treat respiratory distress in premature infants. Medical care and public health improvements are behind the gradual decline of infant mortality in the last half of the 20th century (CDC. 1999). However, from 2000 to 2005 the rate of infant mortality did not reduce, but there was a 2% decline in infant mortality rate in 2005 to 2006. This is accrued to the high number of preterm birth and preterm-related infant mortality between 2000 and 2005 (MacDorman & Mathews, 2008). Between 2000 and 2010 infant mortality declined by 11% from 6.91 to 6.15 in every 1000 live births (MacDorman et al., 2014).
c) Where does the United States stand in the rank ordering of nations using the Human Development Index (HDI). Briefly describe the HDI, its components, and what you think the value is of such rankings.
The United States of America is ranked number ten in the rank ordering of nations. HDI was created with the aim of establishing criteria to assess the development of nations based on the capabilities of the people and not the economic growth alone (Human Development Report). The HDI can also be used to question the policies of a country which helps to assess the different human development outcomes of nations which are different despite same level GNI per capita of the nations.
The HDI assesses the government policy priorities which measure the average achievement of nations based on the citizen's long life, decent standards of living and knowledge of the people in a country. The health of a nation is measured by the average life expectancy at birth and education can be assessed by the years of schooling while the standard of living is assessed by the gross national income per capita (GNI). Therefore, the positioning of the United States of America at number ten of the ordering shows that there is need to prioritize policies on human development (Jahana & United Nations Development Programme, 2016).
d) Where does the United States stand in the rank ordering of nations with regard to per capita health care costs? Using this and other information that relates health expenditures to health (as measured by international rankings), discuss briefly a hypothesis that could explain the disconnect between expenditures and level of health.
The United States of America ranks at number 37 of the world ordering regarding per capita spending in healthcare per person. This ranking shows that the United States of America spends a huge amount of its gross domestic product on healthcare. The United States spends 8,233$ per year on every American which is more than any other developed nation in the world and 17.6% of the GDP. The United States spends a high percentage of its gross domestic product on healthcare, and there is need to streamline health care delivery policies to ensure that the people benefit from the countries huge health budget per person (World Health Organizations. 2018).
Despite high spending in healthcare, there is little to show off compared to other developed nations the United States of America still has high infant mortality rate and the ratio of physicians to the people is 2.4 which is below average the OECD average of 3.1 in every 1000 people (Eichler et al., 2004). Further, the life expectancy in the United States is below other developed countries such as Japan with an average American living 78.7 years. However, despite having high infant mortality rates, the United States of America has highly invested in healthcare research, and cancer treatment and the country has a five-year survival rate higher than other OECD countries (Anderson et al., 2006).
Anderson, G. F., Frogner, B. K., Johns, R. A., & Reinhardt, U. E. (2006). Health care spending and use of information technology in OECD countries. Health Affairs, 25(3), 819-831.
Centers for Disease Control and Prevention (CDC. (1999). Healthier mothers and babies. MMWR. Morbidity and mortality weekly report, 48(38), 849.
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Eichler, H. G., Kong, S. X., Gerth, W. C., Mavros, P., & Jonsson, B. (2004). Use of costeffectiveness analysis in healthcare resource allocation decisionmaking: how are costeffectiveness thresholds expected to emerge?. The value in health, 7(5), 518-528.
Human Development Report. Retrieved from: http://hdr.undp.org/en/composite/HDI
Jahana, S., & United Nations Development Programme, (2016). Human development report 2016: Human development for everyone.
MacDorman, M. F., & Mathews, T. J. (2008). Recent trends in infant mortality in the United States.
MacDorman, M. F., Mathews, T. J., Mohangoo, A. D., & Zeitlin, J. (2014). International comparisons of infant mortality and related factors: the United States and Europe, 2010.
National Center for Health Statistics (U.S.). (2014). Health, United States, 2013: With special feature on prescription drugs. Hyattsville, Md: Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
National Research Council, & Committee on Population. (2011). Explaining divergent levels of longevity in high-income countries. National Academies Press. Available from: https://www.ncbi.nlm.nih.gov/books/NBK62373/Rettner, R. (2014). The US ranks behind 25 other countries in infant mortality. Publishers in Live Science.
Woolf, S. H., & Aron, L. Y. (2013). The US health disadvantage relative to other high-income countries: findings from a National Research Council/Institute of Medicine report. Jama, 309(8), 771-772.
World Health Organizations Ranking of the Worlds Health Systems. (n.d.). Retrieved February 12, 2018, from http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/
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