Avoidable deaths increased in the U.S. as they dropped elsewhere 

In the United States, the number of deaths that didn’t have to happen has risen over time.

From 2009 to 2019, the average rate of avoidable deaths rose by 33 per 100,000 people across the country, researchers report March 24 in JAMA Internal Medicine. Meanwhile, other countries trended down: Members of the European Union experienced an average decrease of 24 per 100,000 over the same time period. And countries that are part of the Organization of Economic Cooperation and Development — which come from North America, South America, Europe and Asia — reported an average decrease of 19 per 100,000.

The rise in avoidable deaths in the United States has occurred despite the fact that the country spends more on health care than any other high-income nation, the researchers write.

Avoidable mortality is a metric for how well health systems are working. It adds up the annual number of deaths among those under 75 years old that, with timely health care, wouldn’t have happened. The average number of avoidable deaths across all U.S. states in 2019 was roughly 280 per 100,000 people.

The umbrella of avoidable mortality includes both preventable and treatable deaths. Preventable deaths — such as those from vaccine-preventable diseases and traffic collisions — are those that may be avoidable through public health prevention measures. Treatable mortality refers to deaths from conditions such as sepsis or appendicitis that may be avoidable with appropriate medical care. Some deaths, including those from heart disease, cervical cancer and tuberculosis, fall into both categories, with a proportion attributed to each.

The research team also assessed the average rate of avoidable deaths for individual U.S. states, which spanned from an increase of 5 per 100,000 people in New York to a jump of 100 per 100,000 people in West Virginia. The study wasn’t designed to account for the specific factors fueling the overall increase in the United States or the differences between states. But the researchers write that state-level public health policies — such as Medicaid expansion, abortion restrictions and gun control measures — have diverged over time.