5 Takeaways on Disparities in U.S. Health System

December 28, 2023

The U.S. is among the global leaders in health care but has fallen behind its peers when it comes to life expectancy and other key measures.

Released annually, the National Healthcare Quality and Disparities Report offers a portrait of American health care, with a focus on social determinants of health and other key markers for disparities.

The U.S. is a global leader in science and innovation, featuring a diverse set of specialists, insurers, providers, and other groups that are responsible for bringing those advances to the people, the report notes.

“The various health care systems often emerged at different points in our nation’s history, under varied contexts and for different purposes,” the report notes. “Thus, they were not always designed to function as a single, coherent system. But it is essential that they work together to ensure that the benefits of science and innovation reach all Americans.”

Here are five key takeaways from the report:

• Life expectancy:  U.S. life expectancy (76.1 years) is falling behind other peer countries, including Japan (84.5 years), Switzerland (84.0 years), and Australia (83.4 years).
  • COVID-19, drug overdoses, and heart disease have been leading contributors to the nation’s drop in life expectancy.
• Rural health:  Nearly 72 percent of primary care health professional shortage areas were in rural and micropolitan (small town) counties. There have been 174 rural hospital closures between 2005 and 2020.
• Severe COVID-19:  American Indian/Alaska Natives, Native Hawaiian/Pacific Islanders, Hispanic, and Black people were more likely to die from COVID-19 than other groups, signaling the need for "tailored disease mitigation strategies to address different groups’ specific concerns."
• Key factors:  Education, access to care through insurance, economic stability, and social and community context are key drivers for health across the U.S.
  • “In fact, such determinants often have a stronger influence on health and use of health care services than care provided by health care systems,” the report notes.
• Opioids:  The the percentage of patients filling four or more outpatient opioid prescriptions significantly declined from 2013 (4.6%) to 2020 (2.6%).
  • Drug overdoses due to synthetic opioids increased from 0.9 to 21.8 deaths per 100,000 from 2011 to 2021.
  • About 22 percent of people with an opioid use disorder received medications to treat their disorder during 2021.

The report and an executive summary are available online.