Despite the abundant evidence2 showing that health care outcomes in the US are much worse than in every other OECD country, I still hear arguments that this is because uninsured, Medicaid, minorities, or low-income people in the US bring down our health outcomes. This myth is repeated^3–5, and believed by a majority of Americans. ⁶ This JAMA study shows that this is not true. Even high-income white people get worse health outcomes than the average result in OECD countries. Time to change to a better health care system!

Key Points

Question  Are the health outcomes of White US citizens living in the 1% and 5% richest counties better than the health outcomes of average residents in other developed countries?

Findings  In this comparative effectiveness study of 6 health outcomes, White US citizens in the 1% and 5% highest-income counties obtained better health outcomes than average US citizens but had worse outcomes for infant and maternal mortality, colon cancer, childhood acute lymphocytic leukemia, and acute myocardial infarction compared with average citizens of other developed countries.

Meaning  For 6 health outcomes, the health outcomes of White US citizens living in the 1% and 5% richest counties are better than those of average US citizens but are not consistently better than those of average residents in many other developed countries, suggesting that in the US, even if everyone achieved the health outcomes of White US citizens living in the 1% and 5% richest counties, health indicators would still lag behind those in many other countries.

JAMA Intern Med. 2021;181(3):339-344. doi:10.1001/jamainternmed.2020.7484

Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries

Ezekiel J. Emanuel, MD, PhD; Emily Gudbranson, BA; Jessica Van Parys, PhD; et al.

December 28, 2020