上周三出炉的一份报告说，相比其他高收入国家的居民，平均来看美国人死得更早，患病和发生事故的比例更高，即使是那些更富裕、有保险、受过高等教育的美国人也是一样。

　　Americans die younger and have more illnesses and accidents on average than people in other high-income countries─even wealthier, insured, college-educated Americans, a report said Wednesday.

　　The study by the federally sponsored National Research Council and Institute of Medicine found the U.S. near the bottom of 17 affluent countries for life expectancy, with high rates of obesity and diabetes, heart disease, chronic lung disease and arthritis, as well as infant mortality, injuries, homicides, teen pregnancy, drug deaths and sexually transmitted diseases.

　　&aposThe [U.S.] health disadvantage is pervasive─it affects all age groups up to age 75 and is observed for multiple diseases, biological and behavioral risk factors, and injuries,&apos said the report&aposs authors, who are public-health and medicine academics recruited by the government panels.

　　The shorter life expectancy for Americans largely was attributed to high mortality for men under age 50, from car crashes, accidents and violence. But the report also said U.S. women&aposs gains in life expectancy had been lagging behind other well-off countries.

　　The authors offered a range of possible explanations for Americans&apos worse health and mortality, including social inequality. They also described criticisms including limited availability of contraception for teenagers, community designs that discourage physical activity such as walking, air pollution and access to firearms, as well as individual behaviors such as high calorie consumption., to suggest that even affluent Americans were worse off compared with their peers in other countries

　　The U.S. health-care system wasn&apost spared criticism, with authors describing it as fragmented, lacking sufficient primary-care physicians and posing financial barriers to millions of Americans who lack insurance or are unable to afford out-of-pocket medical costs.

　　But the chairman of the panel of authors, Steven Woolf, a professor of family medicine at Virginia Commonwealth University, said the report showed that health outcomes were determined &aposby much more than health care.&apos

　　&aposOur health as Americans is only partly aided by having a very good health-care system,&apos he said. &aposMuch of our health disadvantage comes from factors outside of the clinical system and outside of what doctors and hospitals can do.&apos

　　The Obama administration has aimed to improve Americans&apos health by expanding insurance coverage through the 2010 Affordable Care Act, while Republicans have pushed for giving the private sector a greater role in managing health care through changes to such programs as Medicare.

　　Public health has received relatively little attention from lawmakers, despite campaigns by high-profile figures such as first lady Michelle Obama on childhood obesity and New York City Mayor Michael Bloomberg on smoking, gun control and the sale of high-calorie beverages.

　　&aposThe political environment on health is so wrapped up right now around implementation of health rorm that we need to have the space to have this larger conversation and for people to understand that having health insurance is necessary but not sufficient to close this gap,&apos said Jf Levi, head of the Trust for America&aposs Health, a public health advocacy group. He wasn&apost involved in the study.

　　The new report noted that average life expectancy for American men, at 75.6 years, was the lowest among the 17 countries and almost four years shorter than for Switzerland, the best-performing nation.

　　American women&aposs average life expectancy, 80.8 years, was second-lowest among the countries and five years shorter than Japan&aposs, which had the highest expectancy.

　　上周三出炉的一份报告说，相比其他高收入国家的居民，平均来看美国人死得更早，患病和发生事故的比例更高，即使是那些更富裕、有保险、受过高等教育的美国人也是一样。

　　这项由联邦政府资助的美国国家研究委员会(National Research Council)和美国医学研究院(Institute of Medicine)进行的研究发现，在预期寿命方面，美国在17个富裕国家中接近垫底，美国肥胖症、糖尿病、心脏病、慢性肺病和关节炎患者的比例很高，婴幼儿死亡、受伤、凶杀、青少年怀孕、吸毒致死和性传播疾病的比例也很高。

　　相关阅读该报告的作者说，美国人健康状况不佳的现象很普遍，影响75岁以前的各个年龄段，存在多种疾病、生物和行为风险因素及损伤。作者是上述政府机构招募的公共卫生和医学学术人士。

　　美国人预期寿命较短，很大程度上这是因为50岁以下男性死亡率较高，死因包括车祸、意外事故和暴力。但该报告也说，美国女性预期寿命的上升幅度一直不及其他富裕国家。

　　作者对美国人健康状况恶化和死亡率上升提出了各种可能的解释，包括社会不公。他们还提出了一些批评，包括青少年避孕措施有限，社区的设计不利于步行等身体活动，空气污染和枪支滥用，以及摄入高热量食物等个人行为，表明即使是富裕的美国人也比其他国家的同龄人健康状况要差。

　　美国的医疗体系也难逃诟病。作者称美国医疗体系碎片化、缺乏足够的基础医疗医生、给数百万缺乏保险或无力承担医疗费用个人缴纳部分的美国人设置了资金障碍。

　　但该研究负责人、弗吉尼亚联邦大学(Virginia Commonwealth University)家庭医学教授史蒂文•沃尔夫(Steven Woolf)说，该报告表明健康问题的决定因素不仅在于医疗体系。

　　他说，我们美国人的健康状况只是部分得益于拥有一个很好的医疗体系。不利于我们健康的因素有很多来自于医疗体系之外，是医生和医院无能为力的。

　　奥巴马政府一直力争借助2010年的《平价医疗法案》(Affordable Care Act)扩大保险覆盖面，进而改善美国人的健康状况，而共和党议员则一直呼吁通过调整美国联邦医疗保险(Medicare)等计划，使私营部门在管理医疗体系方面发挥更大的作用。

　　尽管多位知名人物发起了一系列运动，比如第一夫人米歇尔•奥巴马(Michelle Obama)发起的抵制儿童肥胖运动和纽约市长迈克尔•布隆伯格(Michael Bloomberg)发起的禁烟、控枪和抵制销售高热量饮料的运动，但公共健康问题相对来说几乎没有得到国会议员的注意。

　　公共健康维权组织美国健康信托(Trust for America&aposs Health)负责人杰夫•列维(Jf Levi)说，健康问题的政治环境目前紧紧围绕医疗改革的实施，我们需要有进行更广泛讨论的空间，需要让人们明白拥有医疗保险是必要的，但不足以弥补差距。他没有参与上文提到的研究。

　　新的报告指出，美国男性平均预期寿命为75.6岁，是17个富裕国家中最短的，比男性预期寿命最长的瑞士少近四年。

　　美国女性平均预期寿命为80.8岁，在17个富裕国家中排在倒数第二，比女性预期寿命最长的日本少五年。

美国人预期寿命不及其他富裕国家 中文对照翻译

　　上周三出炉的一份报告说，相比其他高收入国家的居民，平均来看美国人死得更早，患病和发生事故的比例更高，即使是那些更富裕、有保险、受过高等教育的美国人也是一样。

　　Americans die younger and have more illnesses and accidents on average than people in other high-income countries─even wealthier, insured, college-educated Americans, a report said Wednesday.

　　The study by the federally sponsored National Research Council and Institute of Medicine found the U.S. near the bottom of 17 affluent countries for life expectancy, with high rates of obesity and diabetes, heart disease, chronic lung disease and arthritis, as well as infant mortality, injuries, homicides, teen pregnancy, drug deaths and sexually transmitted diseases.

　　&aposThe [U.S.] health disadvantage is pervasive─it affects all age groups up to age 75 and is observed for multiple diseases, biological and behavioral risk factors, and injuries,&apos said the report&aposs authors, who are public-health and medicine academics recruited by the government panels.

　　The shorter life expectancy for Americans largely was attributed to high mortality for men under age 50, from car crashes, accidents and violence. But the report also said U.S. women&aposs gains in life expectancy had been lagging behind other well-off countries.

　　The authors offered a range of possible explanations for Americans&apos worse health and mortality, including social inequality. They also described criticisms including limited availability of contraception for teenagers, community designs that discourage physical activity such as walking, air pollution and access to firearms, as well as individual behaviors such as high calorie consumption., to suggest that even affluent Americans were worse off compared with their peers in other countries

　　The U.S. health-care system wasn&apost spared criticism, with authors describing it as fragmented, lacking sufficient primary-care physicians and posing financial barriers to millions of Americans who lack insurance or are unable to afford out-of-pocket medical costs.

　　But the chairman of the panel of authors, Steven Woolf, a professor of family medicine at Virginia Commonwealth University, said the report showed that health outcomes were determined &aposby much more than health care.&apos

　　&aposOur health as Americans is only partly aided by having a very good health-care system,&apos he said. &aposMuch of our health disadvantage comes from factors outside of the clinical system and outside of what doctors and hospitals can do.&apos

　　The Obama administration has aimed to improve Americans&apos health by expanding insurance coverage through the 2010 Affordable Care Act, while Republicans have pushed for giving the private sector a greater role in managing health care through changes to such programs as Medicare.

　　Public health has received relatively little attention from lawmakers, despite campaigns by high-profile figures such as first lady Michelle Obama on childhood obesity and New York City Mayor Michael Bloomberg on smoking, gun control and the sale of high-calorie beverages.

　　&aposThe political environment on health is so wrapped up right now around implementation of health rorm that we need to have the space to have this larger conversation and for people to understand that having health insurance is necessary but not sufficient to close this gap,&apos said Jf Levi, head of the Trust for America&aposs Health, a public health advocacy group. He wasn&apost involved in the study.

　　The new report noted that average life expectancy for American men, at 75.6 years, was the lowest among the 17 countries and almost four years shorter than for Switzerland, the best-performing nation.

　　American women&aposs average life expectancy, 80.8 years, was second-lowest among the countries and five years shorter than Japan&aposs, which had the highest expectancy.

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