【雙語閱讀】美國人預(yù)期壽命不及其他富裕國家.

　　Americans Die Younger Than Peers

　　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.

　　【中文對(duì)照翻譯】

　　上周三出爐的一份報(bào)告說，相比其他高收入國家的居民，平均來看美國人死得更早，患病和發(fā)生事故的比例更高，即使是那些更富裕、有保險(xiǎn)、受過高等教育的美國人也是一樣。

　　這項(xiàng)由聯(lián)邦政府資助的美國國家研究委員會(huì)(National Research Council)和美國醫(yī)學(xué)研究院(Institute of Medicine)進(jìn)行的研究發(fā)現(xiàn)，在預(yù)期壽命方面，美國在17個(gè)富裕國家中接近墊底，美國肥胖癥、糖尿病、心臟病、慢性肺病和關(guān)節(jié)炎患者的比例很高，嬰幼兒死亡、受傷、兇殺、青少年懷孕、吸毒致死和性傳播疾病的比例也很高。

　　相關(guān)閱讀該報(bào)告的作者說，美國人健康狀況不佳的現(xiàn)象很普遍，影響75歲以前的各個(gè)年齡段，存在多種疾病、生物和行為風(fēng)險(xiǎn)因素及損傷。作者是上述政府機(jī)構(gòu)招募的公共衛(wèi)生和醫(yī)學(xué)學(xué)術(shù)人士。

　　美國人預(yù)期壽命較短，很大程度上這是因?yàn)?0歲以下男性死亡率較高，死因包括車禍、意外事故和暴力。但該報(bào)告也說，美國女性預(yù)期壽命的上升幅度一直不及其他富裕國家。

　　作者對(duì)美國人健康狀況惡化和死亡率上升提出了各種可能的解釋，包括社會(huì)不公。他們還提出了一些批評(píng)，包括青少年避孕措施有限，社區(qū)的設(shè)計(jì)不利于步行等身體活動(dòng)，空氣污染和槍支濫用，以及攝入高熱量食物等個(gè)人行為，表明即使是富裕的美國人也比其他國家的同齡人健康狀況要差。

　　美國的醫(yī)療體系也難逃詬病。作者稱美國醫(yī)療體系碎片化、缺乏足夠的基礎(chǔ)醫(yī)療醫(yī)生、給數(shù)百萬缺乏保險(xiǎn)或無力承擔(dān)醫(yī)療費(fèi)用個(gè)人繳納部分的美國人設(shè)置了資金障礙。

　　但該研究負(fù)責(zé)人、弗吉尼亞聯(lián)邦大學(xué)(Virginia Commonwealth University)家庭醫(yī)學(xué)教授史蒂文?沃爾夫(Steven Woolf)說，該報(bào)告表明健康問題的決定因素不僅在于醫(yī)療體系。

　　他說，我們美國人的健康狀況只是部分得益于擁有一個(gè)很好的醫(yī)療體系。不利于我們健康的因素有很多來自于醫(yī)療體系之外，是醫(yī)生和醫(yī)院無能為力的。

　　奧巴馬政府一直力爭借助2010年的《平價(jià)醫(yī)療法案》(Affordable Care Act)擴(kuò)大保險(xiǎn)覆蓋面，進(jìn)而改善美國人的健康狀況，而共和黨議員則一直呼吁通過調(diào)整美國聯(lián)邦醫(yī)療保險(xiǎn)(Medicare)等計(jì)劃，使私營部門在管理醫(yī)療體系方面發(fā)揮更大的作用。

　　盡管多位知名人物發(fā)起了一系列運(yùn)動(dòng)，比如第一夫人米歇爾?奧巴馬(Michelle Obama)發(fā)起的抵制兒童肥胖運(yùn)動(dòng)和紐約市長邁克爾?布隆伯格(Michael Bloomberg)發(fā)起的禁煙、控槍和抵制銷售高熱量飲料的運(yùn)動(dòng)，但公共健康問題相對(duì)來說幾乎沒有得到國會(huì)議員的注意。

　　公共健康維權(quán)組織美國健康信托(Trust for America&aposs Health)負(fù)責(zé)人杰夫?列維(Jf Levi)說，健康問題的政治環(huán)境目前緊緊圍繞醫(yī)療改革的實(shí)施，我們需要有進(jìn)行更廣泛討論的空間，需要讓人們明白擁有醫(yī)療保險(xiǎn)是必要的，但不足以彌補(bǔ)差距。他沒有參與上文提到的研究。

　　新的報(bào)告指出，美國男性平均預(yù)期壽命為75.6歲，是17個(gè)富裕國家中最短的，比男性預(yù)期壽命最長的瑞士少近四年。

　　美國女性平均預(yù)期壽命為80.8歲，在17個(gè)富裕國家中排在倒數(shù)第二，比女性預(yù)期壽命最長的日本少五年。

　　Americans Die Younger Than Peers

　　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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