Mortality in the United States – Dying Prematurely

by Jeffrey J. Downey, Esq.

The United States has the lowest life expectancy among large, wealthy, industrialized countries, despite the fact that it far outspends other countries on healthcare.  The CDC estimates that life expectancy at birth in the U.S. decreased to 76.1 years in 2021, down 2.7 years from 78.8 years in 2019 and down 0.9 years from 2020. The average life expectancy at birth among comparable countries was 82.4 years in 2021.  On a per person basis, the U.S. spends about twice what other countries spend on healthcare.

Even more disturbing is the trend that young Americans, ages 15 to 24 are twice as likely to die as their peers in France, Germany and Japan.  According to a recent report,  Dying young in the United States, co-authored by Colorado University Boulder Sociology Professor Richard Rogers and published by the nonprofit, Population Reference Bureau, more young people are dying and are not likely to see the age of 25. The report said younger adults are prematurely dying from “unintentional injuries,” whereas adults tend to die too early from diseases. However, Rogers said, “‘accidental’ is a bit of a misnomer. “It assumes it is all purely by chance, but in many cases, these deaths can be prevented.”

Premature death is considered dying before the age of 75 and in the United States, 900,000 people die prematurely.  Per the Centers for Disease Control and Prevention, “Americans die prematurely from the five leading causes of death – yet 20 percent to 40 percent of the deaths from each cause could be prevented. The five leading causes of death in the United States are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. Together they accounted for 63 percent of all U.S. deaths in 2010, with rates for each cause varying greatly from state to state

“When it comes to long term care in nursing homes and assisted living facilities, unintentional injuries like falls and other adverse outcomes are often preventable with proper care,” explains nursing home attorney Jeffrey Downey.  The failure to properly manage chronic health issues like diabetes, alcohol abuse and obesity also contribute to lower life expectancies.

There is much we can learn from other industrialized countries in improving our long-term care. While many countries have similar nursing home populations (4-5%), in the U.S. the distinction between skilled and intermediate care has largely been eliminated in the law based on reimbursement criteria. In Norway, which has medical care orientation, nursing homes endeavor to treat patients without transferring them to hospitals, with the exception of surgery. Supportive housing in the Netherlands is another way that the country decreases its reliance on traditional nursing home models.  Incentives have been created to expand home and community-based care options and reduce or even reverse the rate of growth in nursing home beds. Australia, for example, has instituted standardized pre-admission assessment procedures to control nursing home admissions and has expanded the range of nursing-related services (e.g., dementia care) in traditional housing models.

In all LTC service systems, institutions generally provide two levels of care. Typically, there will be a 24-hour nursing case at the highest level, in what is the traditional nursing home model. The Netherlands differs from all the other countries in the study by having formally divided its nursing home sector into somatic (general) and psychogeriatric homes. The average size of nursing homes has a wide range. The Netherlands has the largest size with 150 beds, and Norway with its 40 beds has the smallest. The other countries have an average between these figures.

As diverse as the history and growth of the LTC service systems are for these five countries, there are some common policy themes. Two major themes are shifts in levels of intensity and improvements in quality. Policies to shift away from the highest level of institutional LTC are common to all the countries. In some countries, the shift is to lower levels of institutional care. In others, the shift is to home and community care. Nursing Home Care in 5 Nations, ASPE, Publication

In the United States our long-term care system is the weak link in our health care chain, exposing our seniors to unnecessary risks, explains Downey. There is much we can learn from other community-based models that seek to keep elders in the community longer, with a better quality of life.  Given the huge amount of money the US spends on health care each year, our elders should be given a higher priority in the system.

If you have a question about a nursing home or assisted living facility, call the Law Office of Jeffrey J. Downey for a free consultation.


Contact Information:

The Law Office of Jeffrey J. Downey, P.C. (Licensed in Virginia, Maryland, New York, and Washington DC

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McLean, VA 22102

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Phone: 703-564-7357