Thursday, May 14, 2009

Regional variations, u.s. health system - The U.S.: A Nation of Nations

I’d like to bring to readers’ attention a blog, www.buz In his May 1 blog, “How is the U.S. Doing?”, Dr. Cooper, a professor of medicine and principal of the Leonard Davis Institute of Health Care Economics at the University of Pennsylvania, makes the point that the U.S. is a “nation of nations” with tremendous regional differences in health outcomes.

Cooper says the rate of preventable mortality in the Confederate States, where blacks account for 20% of the population, is 127/100,000, compared to 95/100,000 for the rest of the U.S. where blacks make up 10% of the population, a 33.7% difference in preventable mortality. Black mortality in the Confederacy is 55% higher than in the rest of the U.S., and white mortality is 15% higher.

Cooper concludes: “ So we should be too quick to malign the U.S. health care system for spending too much and having poor outcomes. We are a nation of nations and must be understood in each of those nations. Real health care reform will have to be built around regional realities and around the realities of wealth and poverty.”
Reform must also be built around the realities of immigration (one of five Americans is a recent immigrant or a close relative of one) and of ethnic origin, as exemplified by these statistics from the Abstract of the United States 2000-2004.

• White, 68 % of population, longevity, 81.0 years
• Black, 12% of population, longevity, 73.6 years
• Hispanic, 14% of population, longevity, 74.0 years
• Asian, 4% of population, longevity, 75.2 years

The U.S. is, in short, a vast continental nation, made up of different regions, with stark differences in culture, ethnic mix, and health outcomes.

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