PROVIDENCE — In a startling contrast with most other high-income nations, avoidable deaths rose across the United States for more than a decade, according to a new study from researchers at Brown and Harvard universities.
Between 2009 and 2021, avoidable mortality — deaths ranging from motor vehicle crashes to those that could have been prevented by vaccines, medicine, or medical treatments — worsened in the US on average by 32.5 avoidable deaths per 100,000 people, according to the study, published Monday in JAMA Internal Medicine.
“It’s a bit shocking,” lead study author Irene Papanicolas, a professor of health services, policy and practice at Brown’s School of Public Health, said in a statement. “What we found is that while avoidable mortality varies by state, all U.S. states are getting worse.”
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The rate decreased in European Union countries by 25.2 avoidable deaths per 100,000 people and dropped in Organization for Economic Cooperation and Development by 22.8 avoidable deaths per 100,000 people, Brown University officials said in a press release.
OECD, which has 38 member countries, is an intergovernmental organization that advises governments on policy to promote well-being.
Papanicolas said the findings suggest persistent and ingrained issues within the American health care system and in public policy are driving factors behind worsening health outcomes.
“We’ve known for some time that life expectancy has been getting worse in the U.S., but now we can see that the country is on a different trajectory from other high-income countries,” Papanicolas said. “Other countries are getting better at reducing avoidable deaths through prevention and treatment, but in the U.S., these deaths are growing.”
According to Brown officials, researchers compared mortality data for people under the age of 75 from all 50 states with data from 40 high-income countries in the EU and in the OECD.
With the exception of the COVID-19 pandemic between 2019 and 2021, the rate in the US worsened compared to those in the EU and OECD, officials said. The research also revealed deaths from a variety of different causes — with the exception of cancer in some states — are increasing in every American state.
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“There’s been a lot of discussion about preventable deaths in the U.S. such as drug-related deaths or suicides, which do account for a big proportion of this trend,” Papanicolas said. “However, we found that deaths from nearly all major categories are increasing.”
Brown officials said researchers also determined there was no “clear association between health expenditures and avoidable mortality in the US, meaning that states that spend more on health care don’t necessarily fare better.”
“On the other hand, in the high-income countries evaluated in the study — including Canada, Japan, Spain and Turkey — there was a correlation between higher spending on health care and better outcomes in terms of avoidable mortality,” the university officials said.
Papanicolas noted that given the US spends more on health care per capita than any other country researchers studied, those findings are especially troublesome.
“The results point to systemic factors that the U.S. and all its states are dealing with,” she said.
The study builds on previous research conducted by the same group of researchers at the two higher education institutions. Papanicolas said the cohort now plans to probe what the US can do to improve health outcomes.
Christopher Gavin can be reached at christopher.gavin@globe.com.
