America's Health Rankings

*Introduction to Determinants*
Personal Behaviors
Prevalence of Smoking
Motor Vehicle Deaths
Prevalence of Obesity
High School Graduation
Community Environment
Violent Crime
Occupational Fatalities
Infectious Disease
Children in Poverty
Public & Health Policies
Lack of Health Insurance
Per Capita Public Health Spending
Immunization Coverage
Health Services
Adequacy of Prenatal Care

*Introduction to Outcomes*
Poor Mental Health Days
Poor Physical Health Days
Infant Mortality
Cardiovascular Deaths
Cancer Deaths
Premature Death

The United States has the potential to substantially improve its population�s health in the future. The Commonwealth Fund, on their first national scorecard, indicated, �The United States would have to improve its performance on key indicators by 50 percent or more to reach benchmark rates.�[1]

No comparable index to this study compares the United States to other nations, but individual measures do show what other countries have already achieved and indicate the potential for the United States. For example, infant mortality rates in 35 countries are less than or equal to the rate in the United States (Table 10). The goal for the United States, as established by Healthy People 2010, is 4.5 deaths per 1,000 live births, an aggressive target that requires substantial improvement from current rates in the next four years.

Country	Rate
Iceland	2
Singapore	2
Finland	3
Japan	3
Monaco	3
Norway	3
San Marino	3
Sweden	3
Belgium	4
Cyprus	4
Czech Republic	4
Denmark	4
France	4
Germany	4
Greece	4
Italy	4
Netherlands	4
Portugal	4
Slovenia	4
Spain	4
Switzerland	4
Australia	5
Austria	5
Canada	5
Ireland	5
Israel	5
Luxembourg	5
Malta	5
New Zealand	5
Republic of Korea	5
United Kingdom	5
Andorra	6
Croatia	6
Cuba	6
Estonia	6
United States of America	6

Another broader measure used to compare health in countries is Healthy Life Expectancy. This is the basic indicator of population health used by the World Health Organization and published each year in The World Health Report. This indicator measures the equivalent number of years in full health that a newborn child can expect to live based on current death rates and current rates of illness and disability. Improvement in healthy life expectancy is also the first goal of Healthy People 2010 for the United States. Today, 27 countries have healthy life expectancies for males and females that exceed the United States (Table 11). The highest, Japan, substantially exceeds the United States where a newborn baby girl can expect to have seven additional years and a newborn baby boy can expect to have five additional years in which to enjoy a healthy, active life.

Table 11 - Healthy Life Expectancy at Birth, 2002^[3]

Country	Female	Male
Japan	78	72
San Marino	76	71
Spain	75	70
Switzerland	75	71
Monaco	75	71
Sweden	75	72
France	75	69
Italy	75	71
Andorra	75	70
Australia	74	71
Canada	74	70
Germany	74	70
Luxembourg	74	69
Iceland	74	72
Norway	74	70
Austria	74	69
Finland	74	69
Belgium	73	69
Greece	73	69
Malta	73	70
Netherlands	73	70
Israel	72	70
Slovenia	72	67
New Zealand	72	69
United Kingdom	72	69
Portugal	72	67
Ireland	72	68
Singapore	71	69
United States of America	71	67
Denmark	71	69
Czech Republic	71	66
Republic of Korea	71	65
Cuba	70	67
Cyprus	68	67
Kuwait	67	67

While the United States does have some of the most advance technical medical care available, the use of electronic medical records by physicians is estimated at 17 percent. Of nineteen studies, the top three countries averaged 80 percent use of electronic medical records by physicians¹.

[1] Schoen, Cathy et. al. U.S. Health System Performance: A National Scorecard, Health Affairs, Sept 20, 2006, http://content.healthaffairs.org/cgi/content/abstract/hlthaff.25.w457

[2] World Health Organization, Core Health Indicators, http://www3.who.int/whosis/core/core_select.cfm

[3] World Health Organization, The World Health Report, 2006