Despite spending more on health care than any other country in the world, the United States is seeing a troubling trend: a steady rise in deaths that could have been avoided. A new study published in JAMA Internal Medicine by researchers at Brown University and Harvard University highlights just how far the U.S. is falling behind its international peers when it comes to public health outcomes.
The study focuses on a metric known as avoidable mortality, which includes deaths under age 75 that could have been prevented with timely and effective health care or public health measures. These include everything from deaths caused by treatable conditions like sepsis and appendicitis, to preventable tragedies like traffic accidents and vaccine-preventable diseases.
From 2009 and 2019, the average U.S. rate of avoidable deaths increased by 33 people per 100,000 people. In stark contrast, countries in the European Union saw an average decrease of 24 avoidable deaths per 100,000 people. Members of the Organization for Economic Cooperation and Development (OECD), which includes Canada, Japan, and Germany, saw a similar decline of 19 people per 100,000.
“Other countries are getting better at reducing avoidable deaths through prevention and treatment, but in the U.S., these deaths are growing,” said Dr. Irene Papanicolas, lead author of the study and a professor at Brown’s School of Public Health. “It’s a bit shocking.”
Researchers examined mortality data from all 50 U.S. states and compared them with 40 high-income nations. While the numbers varied from state to state, the trend was consistent: every U.S. state saw an increase in avoidable mortality. In New York, the rate rose by nearly 5 deaths per 100,000 people, while in West Virginia, it jumped by nearly 100.
What’s perhaps most unsettling is that the rise in avoidable deaths spans across nearly all causes, not just the highly discussed drug overdoses and suicides. Deaths from treatable diseases and conditions that should be detected early, like cervical cancer or heart disease, are also on the rise. Only cancer-related deaths saw a modest decline in some states.
The study also looked at health care spending and found no clear link between how much a state spends and how well it performs in preventing avoidable deaths. This contrasts sharply with other high-income countries, where increased health spending often translates to better health outcomes.
This disconnect raises serious questions about the U.S. healthcare system—particularly the role of fragmented policies at the state level. While other nations often take a centralized approach to health policy through investment in social determinants of health, the U.S. has taken a more divided path, with state governments making key decisions on issues like Medicaid expansion, abortion access, and gun control.
“Understanding the differences across states and countries could help clarify whether the U.S.’s poor performance is driven by nationwide issues or policy failures at the state level,” said Papanicolas.
The researchers hope their findings will serve as a call to action for U.S. policymakers. If the country wants to reverse its trajectory and start saving more lives, it must look not only at how much it spends — but how it spends it, and whether its health policies truly support equitable, accessible care. As future scientists, engineers, and innovators, it’s a sobering reminder that technology and funding alone can’t fix broken systems. It takes thoughtful policy, coordinated public health efforts, and a commitment to learning from what’s working, both here and abroad.
