Reevaluating 'Preventable' Deaths: Uncovering Systemic Barriers to Healthcare Access

Every year in the United States, tens of thousands of deaths are classified as "preventable," implying that these deaths could have been avoided with proper interventions or timely medical care. Conditions such as cancers, asthma attacks, or infections that go untreated may all be counted under this label, which is often used in public health reports, policy discussions, and media coverage.

However, this terminology can be misleading and oversimplifies the complex reality behind health outcomes. Researchers have highlighted that the definition of preventable death is frequently imprecise and influenced by subjective judgment. Clinical reviews tend to focus on individual mistakes or decisions, neglecting broader systemic issues like hospital understaffing, regional disparities, and socioeconomic barriers that significantly shape health outcomes.

As a public health historian, I study how structural factors—from Medicaid policies to regional health investments—affect access and mortality. While the language of preventability aims to highlight system failures, it often shifts the focus onto individual responsibility, obscuring the role of social and economic determinants.

The common understanding of a preventable death is that it could have been avoided with adequate medical care or behavioral changes. But in reality, factors such as lack of health insurance, geographical barriers, and cost-related obstacles play a critical role in whether individuals receive the necessary care.

For example, the expansion of Medicaid under the Affordable Care Act has been linked to reductions in premature death, better chronic disease management, and improved cancer outcomes. Conversely, states that opted out of expansion—mainly in the South—leave many low-income adults without accessible, affordable healthcare, leading to higher mortality rates.

Other aspects like dental health further exemplify systemic underinvestment. Medicare does not cover dental, and Medicaid dental coverage varies by state, resulting in limited access especially in rural areas. Rural hospitals face chronic underfunding and closures, reducing emergency and routine care availability and exacerbating health disparities.

Data reveals that during certain periods, preventable death rates are considerably higher in regions like the South and among marginalized racial groups, reflecting underlying policy and socioeconomic inequalities rather than individual choices. These patterns underscore that many deaths deemed preventable are the foreseeable outcomes of policies, resource allocation, and systemic inequalities.

The language used to describe these deaths influences public perception and policy. Labeling them as "preventable" can suggest personal failure, disregarding the structural barriers that prevent access to care. Public health experts advocate for more precise language and explanations that acknowledge these systemic issues, fostering policies rooted in equity and justice.

Understanding the actual context of these deaths is crucial. It illuminates how structural decisions—such as Medicaid policy, healthcare infrastructure, and resource distribution—shape health outcomes. Addressing these root causes requires structural reforms and clearer public communication about how systemic factors influence individual health and mortality.

Source: https://medicalxpress.com/news/2025-09-deaths-obscure-barriers-health-access.html