If you’re under 50 in the United States, you are more likely to die than in neighboring Canada or similar high-income countries.

The health disadvantage occurs at all ages from birth to 75, but it is especially noticeable for those under age 50.

The reasons for this important life and death statistic are outlined in a study from the Institute of Medicine and the National Research Council.

The U.S. ranked near the bottom in almost every health indicator, reported The New York Times.

“That stunned us,” said Steven Woolf, chairman of the Department of Family Medicine at Virginia Commonwealth University.

The panel examined trend data beginning in the 1970s, but most of the statistics came from the late 1990s through 2008.

“For many years, Americans have been dying at younger ages than people in almost all high-income countries. This disadvantage has been getting worse for three decades, especially among women.

Some of the early deaths are caused by risky behavior and poor lifestyle choices.

Americans are more likely to die from car accidents, sexually transmitted disease, gun violence and drug overdoses. Americans are 20 times more likely to die from firearm homicides.

Comparisons were made with 16 peer nations, such as Australia, Canada, Japan and Germany.

This not a political issue; it is bigger than that. It appears to be a part of the American character.

For instance, Americans are less likely to use seat belts or use motorcycle helmets.

Education plays a role, too. For instance, high school dropouts are three times more likely to die from diabetes than people with some college education.

As the report concludes, “The United States is among the wealthiest nations in the world, but it is far from the healthiest.”

But even Americans with college educations appear to be in worse shape than peers in other high-income nations.

The tragedy is that these early deaths are mostly unnecessary.

To live longer, in many cases, Americans need to rebel against the popular culture that makes risky behavior acceptable.

Reasons for the health disparities were summarized in four areas:

Health systems: More uninsured people in the U.S., less primary care.

Unhealthy behaviors: Americans are more obese, abuse drugs and fail to use their seat belts. There are comparatively more traffic accidents involving alcohol and more use of firearms in acts of violence.

Social and economic conditions: America has high rates of poverty, income inequality and fewer safety net programs.

Environment: America is built for the car, which discourages physical activity.

The U.S. is at or near the bottom in these categories:

– Infant mortality.

– Injuries and homicides.

– Teen pregnancies and sexually transmitted disease.

– Spread of HIV and AIDS.

– Drug-related deaths.

– Obesity and diabetes.

– Heart disease.

– Chronic lung disease.

– Disability.

More uninsured coming?
Will uninsured numbers rise under Obamacare? Blogger Greg Scandlen suggests they will. His reasoning:

– Medicaid expansion is not likely to have much impact. First, the incentives are not impressive. And the “passive and unengaged” who don’t use Medicaid now won’t be any more likely to sign up.

– Healthy and young will not be motivated to sign up.

– Businesses will cut health insurance coverage. A number of these formerly insured employees won’t sign up.

Scandlen predicts 15 million will get new coverage, but they will be outnumbered by the 23 million who lose their employer coverage and don’t sign up for exchanges.

Net result: 8 million more uninsured than before Obamacare was enacted.

The solution? Take another look at it. There are reforms that could make the program more affordable and encourage more young people to sign up. Given all the hostility in Washington, however, that is not likely.

Avoiding the ER
Want to save on waste in the health care system? Simple: Find ways for people to avoid using emergency rooms when they don’t need them.

As Jane Brody wrote in The New York Times, the explosion of ER visits is not caused by the poor but by insured people who are unable to see their physician. Maybe the illness happens at night or on a weekend. Maybe the doctor is booked that day.

These unnecessary visits add up to $38 billion in wasteful spending every year.

In fact, almost six in 10 ER visits are not necessary, estimates the New England Healthcare Institute.

The growth of walk-in clinics is one answer to that. In some cases, hospitals have walk-in clinics right next to the ER.

The Economist reports that Walgreens and CVS are expanding their walk-in services. Walgreens will be managing chronic conditions. And CVS expects to have 1,500 clinics by 2017.

Overall, walk-in clinics have grown fourfold between 2007 and 2009.

Along with retail clinics, some businesses are setting up clinics at the work site.

The church factor
Want to improve your health? Go to church. Regular attendance boosts the immune system and decreases blood pressure, reports The New York Times.

Regular churchgoers have larger social networks, more social support — thus better health.

Church attendance also is likely to be paired with more healthy behaviors.