Reproductive-age women in the U.S. had the highest rate of preventable deaths compared with 10 other high-income countries, according to a report from the Commonwealth Fund.
Nearly 200 in 100,000 deaths among reproductive-age women in the U.S. were avoidable, reported Munira Gunja, MPH, a senior researcher for the Commonwealth Fund's International Program in Health Policy and Practice Innovations, and colleagues in the .
This was higher than the 146 in 100,000 deaths in the U.K., the 132 in 100,000 in Canada, and the 90 in 100,000 in Switzerland, the authors pointed out.
In addition, the overall maternal mortality rate in the U.S. was 23.8 per 100,000 -- more than three times the rate for all other countries included in the report. These rates were highest among U.S. Black women, at 55.3 per 100,000, as compared with 19 per 100,000 for white women, and 18 per 100,000 for Hispanic women.
Rosemary Morgan, PhD, MSc, an associate scientist at Johns Hopkins University in Baltimore, who studies gender inequities in health, told 乌鸦传媒 that these data are "shocking" and show how the U.S. healthcare system fails women, especially Black women.
"The fact that the U.S. ranks last across a number of indicators should be a wake-up call for everyone," said Morgan, who was not involved in the report. "These data reflect the historical neglect of women's health within the United States, which is a gender bias that continues to persist."
The U.S. and Canada reported the highest rates of women with multiple chronic conditions, with 20% of women in both countries having two or more conditions. In Switzerland, Germany, France, and Sweden, only one in 10 women reported having multiple chronic conditions.
As for mental health, 58% of women in the U.S. reported a need for mental health care compared with 53% of women in Canada and Australia, 47% in New Zealand, and 45% in Sweden and the U.K.
"U.S. women are sicker, more stressed, and die younger compared to women in other countries," Gunja said in a press release. The reason that U.S. women have worse outcomes, she added, is because so many of them lack access to necessary care.
Approximately 49% of women in the U.S. reported that they skipped or delayed necessary care because of cost, which was a greater proportion than any of the other nations. In the U.K., for example, which provides free care to its residents, only one in 10 women reported having a problem paying a medical bill.
Among U.S. women, 52% had at least one problem paying their medical bills in the last year, and over a quarter paid more than $2,000 in out-of-pocket healthcare costs. It was also less common for women in the U.S., Canada, and Sweden to have a regular doctor or place of care.
"The United States is the world's wealthiest democracy, yet its failure to provide universal healthcare leaves 10 million women without coverage," Gunja noted.
For this report, Gunja and colleagues used data from the Commonwealth Fund's 2020 International Health Policy Survey and the Organisation for Economic Co-operation and Development to compare healthcare access and outcomes for reproductive-age women ages 18 to 49 in 11 high-income countries.