Why Americans – and the Nurses and Doctors Who Care For Them – Are Dying In Increasing Numbers
Posted Oct 13 2012 10:01pm
Posted on | October 11, 2012 |
For the first time in our nation’s history, annual deaths of Americans exceeded 2.5 million off of a baseline population of 314 million.(1) Before anyone shrieks with alarm, let me add that the rate of deaths per 100,000 people actually dropped to an all-time low. Why the discrepancy? Because the increase of 45,000 deaths over the prior year was totally attributable to our aging demographics.(1,2)
The reality is that older people die at greater rates than their younger counterparts. In fact, infant mortality in the US has hit a new low at 6.05 deaths per 100,000. But our general life expectancy hasn’t budged in the past year – about 79 years for men and 84 years for women. Heart disease and cancer all still the top killers, but flu and pneumonia as a cause of death are rising since these are more common in the elderly.(2)
What for the future? Well, first it’s worth mentioning that, unlike many other countries, on the supply side, our replacement births are more than adequate. Last year there were some 4 million births in the US versus 2.5 million deaths. In addition, our changing demographics including growing percentages of Latinos and immigrant populations in general favor higher birth rates.(1,2)
Will we live longer, more productive lives in the future? The new Gallup Healthways Well-Being Index survey which studied a random sample of 591,821 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, suggests we have a ways to go. 20% still smoke; 46% didn’t achieve moderate exercise in the week surveyed; and 38% still have days when they don’t eat healthy. Translation? 25% obesity, 22% high blood pressure, 20% high cholesterol, 13% depression, 10% asthma, 7% diabetes, 4% cancer, and 2% heart attacks.(3)
The study uses two different composite scores: one for physical health and another for behavioral health. The Physical Health Index included “18 items, which measure the number of sick days in the past month, disease burden, health problems that get in the way of normal activities, obesity, feeling well-rested, daily energy, daily colds, daily flu, and daily headaches”. The Healthy Behavior Index “includes four items: smoking, eating healthy, weekly consumption of fruits and vegetables, and weekly exercise frequency.”(3)
On physical health, the population scored an 81, but on behavioral health dropped to a 63. How does this compare to the health professionals taking care of the people. On the physical health score, 1,984 doctors and 7,166 nurses scored 86 and 80 respectively, compared to the general population’s 81. On the behavioral health score, doctors and nurses scored 70 and 66 respectively compared to the general populations 63.(2,3)
Why the difference between doctors and nurses? Two factors stand out: 1) 15% of nurses smoke compared to 4% of physicians. 2) Chronic disease burden is higher in nurses than in doctors – obesity (25% vs. 13%), high blood pressure (22% vs. 16%), depression (14% vs. 7%).
What are the take-aways here? 1) On the aging and chronic disease burden side, further progress will occur as we expand insured populations under the Accountable Care Act. 2) Increasingly, as we move toward personalized and preventive health care, we will need to be certain that the health professionals who support health planning and health coaching are themselves models of health and well being. This will likely require more enlightened training programs, and less stressful and more humane work settings.