A study published in the Journal of the American Medical Association examines avoidable mortality trends over a decade, highlighting significant disparities between the United States and its comparator countries. Avoidable mortality, which includes deaths that could have been prevented through timely public health interventions and access to high-quality medical care, increased in all U.S. states between 2009 and 2019. In contrast, most European Union (EU) and Organization for Economic Co-operation and Development (OECD) countries experienced declines in avoidable mortality, revealing stark differences in health outcomes and policy effectiveness across regions.
Between 2009 and 2019, the median avoidable mortality in the U.S. increased by 29.0 deaths per 100,000 people, with significant variation among states. New York recorded the smallest increase (4.9 per 100,000), while West Virginia saw the largest (99.6 per 100,000). Conversely, avoidable mortality in most EU and OECD countries declined by an average of 23.9 and 19.1 deaths per 100,000, respectively. Notable improvements were seen in Eastern European nations such as Lithuania, Latvia, Estonia, and Hungary, as well as in Ireland and South Korea.
The study disaggregates avoidable mortality into preventable and treatable mortality. In the U.S., the increase was primarily driven by preventable mortality (median increase of 24.3 per 100,000), while treatable mortality saw a smaller increase (7.5 per 100,000). The predominant contributors to preventable mortality were external causes such as traffic collisions, homicides, suicides, and drug- and alcohol-related deaths, which collectively accounted for a median increase of 15.0 per 100,000. Drug-related deaths alone contributed 71.1% of the increase in avoidable external-cause mortality.
In contrast, most comparator countries achieved reductions in avoidable mortality, mainly through declines in preventable mortality (median decrease of 10.6 per 100,000) and, to a lesser extent, treatable mortality (median decrease of 3.8 per 100,000). Declines in avoidable deaths from external causes were observed in nearly every country except for Canada, Turkey, the UK, Mexico, the Netherlands, Australia, and Iceland.
This study highlights critical public health challenges in the U.S., where avoidable mortality has increased over time, in contrast to many comparator countries that have made significant improvements. The widening disparities among U.S. states further indicate systemic health inequities. The findings underscore the need for targeted policy interventions to reduce preventable deaths, improve healthcare access, and enhance overall health outcomes.
