With major health reforms coming to the U.S. healthcare system in 2014, researchers are focused on the status of health in the nation and how these reforms might help or hurt health outcomes.  Proponents of the legislation, colloquially known as Obamacare, contend that healthcare will be more accessible with greater quality.

A recent study in JAMA examined the major health problems present in the U.S. and trends over time in these conditions in order to inform the future of health policy.  Researchers examined data covering the period between 1990 and 2010, looking at the burden of disease, injuries and risk factors.  These measures were then compared to 34 countries in the Organization for Economic Cooperation and Development (OECD).

Examining 291 diseases and injuries, 1,160 consequential conditions of these diseases or injuries, and 67 risk factors or risk clusters, the researchers calculated years of life lost as a result of premature death and disability-adjusted years of life due to the impact of health conditions on functioning.  Between 1990 and 2010, life expectancy increased from 75.2 years to 78.2 years.  Premature death was most common as a result of ischemic heart disease, road injury, chronic obstructive pulmonary disease, lung cancer, and stroke.  The leading risk factors were related to diet, weight, and physical activity, or use of tobacco.

In comparison to other OECD countries, the U.S. was considered mediocre.  Between 1990 and 2010, the U.S. fell on nearly every ranking in the study.  There is also an under-recognized national problem with disability due to bone and joint disease, mental disorders, and substance abuse.  The poor diet that is prevalent in the U.S. explains a large portion of the low health rankings.

Further research examined the U.S. in more detail, comparing various counties across the U.S.  Overall, between 2001 and 2009, there were rising obesity rates.  Recently, however, more Americans have been getting physically active.  Some counties in Texas, Kentucky, Georgia, and Florida have been showing the most improvement in rates of adequate physical activity.  Concho County in Texas has had the most improvement for men, with 58.2 percent getting adequate exercise in 2009 compared to 41.4 percent in 2001.  Kentucky’s Morgan County has had the most improvement for women, with 44 percent getting adequate exercise compared to 25.7 percent in 2001.

The Commonwealth Fund performed another analysis in 2011 that evaluated the U.S. against 42 performance indicators.  Out of 100, the U.S. scored 64.  Costs were rising, while access issues and disparities persisted.  Benchmarks were not met and the U.S. failed to show improvement over time.