BOX 1-3How Many Years Behind Is the United States?

One focus of this report is the U.S. health disadvantage among younger adults. One summary measure of mortality in this age group is the probability that a 15-year-old will die before reaching age 50 (given current age-specific mortality rates). Demographers refer to this measure as 35q15, or the probability of dying in the 35 years following one’s 15th birthday. For females in the 16 peer countries, 35q15 was around 2 percent in 2007 but was approximately twice as high—4 percent—in the United States. This means that the probability of a 15-year-old U.S. female dying within 35 years was double the average for 16 peer high-income countries.

In all high-income countries, including the United States, 35q15 has been declining for more than half a century. But the relative position of the United States has deteriorated since the late 1950s, when it was near the average of its peers. These countries, on average, had reduced their 35q15 for females to the U.S. 2007 level of 4 percent almost 40 years earlier. In this sense, one can say that, in 2007, the United States was 40 years behind the average of its peers (and 50 years behind the leading peer country).

This concept of “years behind” provides a useful indicator of how well a given country is keeping pace with other countries. Figure 1-3a, from Verguet and Jamison (2011), plots years behind the leader for both the United States and the average of its peers for the period 1958–2007. It shows that the United States has fallen further behind the leader, while its peer countries began to “catch up” with the leader (albeit at an uneven pace) beginning in the mid-1970s. The net result of these uneven trends has been a steady decline of the U.S. position from near average to far below average.

Figure 1-3b also plots “years behind the leader” for both the United States and the average of its peers, but in this case it shows female mortality rates, by 5-year age groups, for a single year, 2007. These results confirm a U.S. mortality gap for females across the life span. It is most pronounced between the ages of 15 and 50 and diminishes somewhat for women above age 60.

FIGURE 1-3a. Number of years behind the leading peer country for the probability of dying between ages 15 and 50 among females, 1958–2007.

FIGURE 1-3a

Number of years behind the leading peer country for the probability of dying between ages 15 and 50 among females, 1958–2007. NOTES: The figure plots 35q15, or the probability that a 15-year-old female will die before age 50. The y-axis measures (more...)

FIGURE 1-3b. Number of years behind the leading peer country for female mortality by 5-year age group, 2007.

FIGURE 1-3b

Number of years behind the leading peer country for female mortality by 5-year age group, 2007. NOTE: The figure shows how many years earlier female mortality in the 17 peer countries had been achieved by the country with the lowest age-specific mortality (more...)

From: 1, Shorter Lives

Cover of U.S. Health in International Perspective
U.S. Health in International Perspective: Shorter Lives, Poorer Health.
National Research Council (US); Institute of Medicine (US); Woolf SH, Aron L, editors.
Washington (DC): National Academies Press (US); 2013.
Copyright © 2013, National Academy of Sciences.

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