So, the US lost to Germany, but still managed to advance out of the “Group of Death” in the World Cup by ending up above Portugal. Lots of cheering and patriotic pride. But right after the Facebook post of the photo of the American team and their fans celebrating were two other links that were rather sobering.
The first was the result of the latest Commonwealth Fund study showing that, once again, the US ranks dead last in health system performance among 11 advanced countries studied. We’ve been in that position since the Fund first started doing these analyses in 2004. Britain, Switzerland, and Sweden ranked first through third, respectively, on overall performance. The highest score for the US was a 3 in “effective care.” Interestingly, we ranked 5th in “timeliness of care,” while Britain, with its much-maligned (at least in the American press) National Health System, ranked 2nd in this measure of quality. For access, efficiency, healthy lives (e.g., life expectancy), and equity – the US is right at the bottom.
Within our own country, the news for those of us here in Wisconsin was worse. The Annie E. Casey Foundation released a report, “Race for Results: Building a Path to Opportunity for All Children,” on disparities in the US. Based on an analysis of 12 different factors including educational attainment, socioeconomic status, and home life, Wisconsin was ranked the worst state in the nation for black children, and the state with the greatest disparities. A few key data points:
- 77% of black children in Wisconsin (and 67% of Latino children) live in a household under 200% of the federal poverty level, compared with 29% of non-Latino whites
- Wisconsin scored lowest of all states (238) on its ability to prepare black children for educational and financial success; the average score was 345, while Hawaii had the highest score, 583. (WY, ID, VT, and MT, with very small African-American populations, did not have sufficient data for analysis.) At the same time, Wisconsin was ranked 10th overall in its preparation for white children.
Knowing that socioeconomic and environmental factors are key determinants of overall health, these findings help explain some of the known racial disparities in health in our state.
Our vision for Children’s Hospital of Wisconsin is that the children of Wisconsin will be the healthiest in the nation. Not only are we far from it, but even when we get there, is that enough? Our health system doesn’t seem to be performing even as well as our soccer team. According to the WHO ranking of all 191 nations, the US (at #37) is well behind Portugal (#12). So much for making it out of the Group of Death.