When a Rich Country Can’t Keep Its People Alive
Here’s a fun fact to ruin your morning coffee: if you live in the United States and you’re under 75, you’re more likely to die from something that could’ve been prevented than if you lived in almost any other wealthy country. Not exactly the kind of “American exceptionalism” anyone wants to brag about—but here we are.
According to Irene Papanicolas, PhD—who’s not some crank on the internet but an actual professor at Brown University—the U.S. is falling flat on its face when it comes to avoidable deaths. That means people are dying not because of fate or chance, but because the healthcare system, public policy, and basic human decency have all taken a backseat to profit margins and political finger-pointing.
And it gets worse.
What Counts as an “Avoidable Death” Anyway?
Let’s keep it simple: avoidable mortality means someone under 75 dies from something that shouldn’t have killed them. In the land of billion-dollar hospital wings and $700 EpiPens, you’d think we’d be doing better. But no.
There are two flavors of this mess:
- Preventable mortality: Things we could’ve stopped with smart public health moves—like vaccines, harm reduction, or not treating mental health care like a luxury spa treatment.
- Treatable mortality: Deaths that could’ve been avoided if people had access to effective medical care—on time and without bankrupting them.
But instead of getting better, the numbers are getting worse. From 2009 to 2019, avoidable deaths went up in every single U.S. state. Meanwhile, the European Union and other rich countries (OECD nations) managed to reduce theirs. That’s right—while other nations were saving more lives, America was busy proving that “freedom” apparently means the freedom to die young from things that were totally fixable.
A Deep, Widening Hole of Shame
Let’s talk numbers. From 2009 to 2019, the U.S. added 32.5 more avoidable deaths per 100,000 people. Europe cut theirs by nearly 24. The rest of the developed world followed suit.
That’s not just a minor dip or bump. That’s a screaming signal flare over a broken system.
And no, it’s not the same everywhere. New York had just 4.9 avoidable deaths per 100,000. But West Virginia? Nearly 100. You could write a whole book on what that says about state-level healthcare access, poverty, drug use, and—you guessed it—politics.
From 2019 to 2021, things got even uglier. Blame COVID, blame bad policy, blame a country that thinks healthcare is a reward for having a job, not a basic right. But whatever you blame, the results are the same—more Americans dying for absolutely no good reason.
The Usual Suspects: Drugs, Alcohol, Guns—and Neglect
So what’s killing people? Let’s not sugarcoat it.
A giant chunk of these avoidable deaths—71%, to be exact—were driven by drug overdoses, suicides, and alcohol-related causes. That’s what experts call “external causes.” That’s what the rest of us call a crisis.
And while we’re busy ignoring the root problems—mental health, addiction support, poverty, loneliness—other countries are actually doing something. They tax alcohol. They regulate guns. They offer real social support. Shocking how not abandoning people actually helps them stay alive.
Now, you might be thinking, “Okay, but at least we have great hospitals.” Cute. Because treatable mortality—stuff that good medical care should handle—is also on the rise. Circulatory system deaths (heart disease, strokes, etc.) are climbing here, while they’re dropping elsewhere.
Let that sink in. We’re spending more on healthcare than any country on Earth, and we’re still watching people die from things other countries are managing better—with less money.
Spoiler: More Money Doesn’t Equal Better Care
Now for the real kicker.
The researchers—using data from the CDC and WHO—looked for a link between how much a country spends on healthcare and how many avoidable deaths it has. In the U.S., they found… nothing. No connection. Nada.
Meanwhile, countries like Canada, Japan, and Spain—who spend less but spend smarter—do see better outcomes. They put money into systems that actually work, not into paperwork, profit-padding, or overpriced pills.
You want a real “American crisis”? It’s not just that our healthcare costs are through the roof—it’s that the care itself is broken and doesn’t deliver. Unless, of course, you’re a pharmaceutical CEO. Then things are going great.
What Needs to Happen (But Probably Won’t)
Dr. Papanicolas makes it plain: if we want fewer avoidable deaths, we need to fix public health first. That means funding mental health care, treating addiction like a health issue instead of a crime, and getting serious about gun violence and social safety nets.
On the medical side, it’s time to figure out why circulatory system deaths are still rising and start actually treating conditions like high blood pressure and diabetes—before they kill.
But here’s the part where I’m supposed to say “We can do it.” Except we won’t. Not until we admit the system isn’t just flawed—it’s designed to fail the very people it claims to protect.
We like to act shocked when we hear about America’s terrible health outcomes. But these aren’t side effects. They’re features. They’re what you get when you treat health care like a casino game—where the house always wins and the sick always lose.
Final Word: Dying Young in a Rich Country Shouldn’t Be This Easy
The data is clear. The path forward is obvious. And yet, here we are—watching the richest country in the world let its people die from causes that are, by every measure, fixable.
This isn’t about policy complexity. It’s about political will. And until we start caring more about human lives than stock prices, nothing will change.
As for the experts? They’ve spoken. Loudly.
But the real question is—who’s listening?
