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Why more Americans perish as Aussies live longer

Affluence and a lack of health care in the US are proving deadly, a major survey has found.

A woman carrying shopping bags walks along George Street in central Sydney, March 31, 2010. (Daniel Munoz/Reuters)

SYDNEY, Australia — Universal, affordable health care may be expensive, but the world’s first comprehensive adult mortality study provides hard evidence of how well it works to preserve lives.

While the risk of dying young in Australia has fallen dramatically over the past 40 years, the United States has failed dismally to improve its record, according to the University of Washington study of premature deaths in 187 countries published in the Lancet

The study, which estimated the probability that an individual who has just turned 15 will die before reaching age 60, considered premature, showed that the U.S. — despite being one of the richest countries in the world — had fallen significantly behind other countries in reducing deaths. 

In 1990, the U.S. ranked 34th in the world in female mortality and 41st in male mortality, but by 2010 it had dropped in the rankings to 49th for women and 45th for men, putting it behind all of western Europe and some lower-income countries such as Albania.

Australia, meantime, was one of the best performers, having shot up from 36th spot for females and 44th for males in 1970 to enter the top 10 countries in adult death prevention for both genders.

Health experts say one of the main factors explaining the stark contrast between Australia and the U.S., is the fact that, unlike Australia, only people with money can afford proper health care in the U.S.

On top of that, smoking rates have declined much faster in Australia due to better public health campaigns, than in the U.S. and obesity levels have soared in America — Australia is catching up but that won’t show for another decade.

Health reform pioneer John Deeble, one of the original architects of Australia’s publicly funded Medicare system, said America’s primary care system is ‘‘very weak’’ compared with Australia and there is too much reliance on expensive specialists rather than general doctors.

‘‘The Americans do not have anything that is the equivalent of the Australian and British GP [general practitioner],’’ said Deeble, an emeritus fellow at the Australian National University.

‘‘Fifteen percent of the population doesn’t have any health insurance at all. They may have a bigger underclass [than Australia],’’ he said.

The Public Health Association of Australia president, Mike Daube, said the results were unsurprising.

‘‘Smoking has declined rapidly here and obesity has been increasing dramatically in the U.S. America has been an incredibly affluent country over that period so they’ve been quicker to be affected by the diseases of affluence [cardiovascular diseases],’’ Daube said.

‘‘The really big overarching difference here is that we not only have health care that is pretty much as good as you can find in the U.S. but it’s almost universally accessible.’’

‘‘In the U.S., they’ve had access essentially only if they’d had money.’’

The survey of 187 countries is the most comprehensive assessment to date of global adult mortality and showed a massive rise in global inequalities.