Learning from others: international comparisons of death and dying.
Death comes to us all, but attitudes towards death vary greatly. Take Dylan Thomas (“Do not go gentle into that good night; rage, rage at the dying of the light”) and Elisabeth Kubler-Ross (“Dying is nothing to fear. It can be the most wonderful experience of your life.”), as examples. 
 
The Commonwealth Fund's latest International Health Policy Survey (Osborn et al. 2014) also shows that how we prepare for ill health or death varies considerably around the world. In France, for instance, only 12% of seniors living outside of healthcare institutions say that they have had a discussion with family, a close friend or a health professional about the healthcare treatment they want if they become very ill and cannot make decisions for themselves. That compares with 78% in the US, 72% in Germany and 66% in Canada. Across all 11 countries included in the survey, the proportion of seniors who said that they had a written plan describing treatment that they want at the end of life was lower. It ranged from 4-5% in Norway, Sweden and France to 46–58% in Canada, the US and Germany. 
 
Interestingly, there is much less variation in the settings in which older adults die. A 2013 article (Broad et al. 2013) compiled the latest published rates of place of death for 45 populations, including data for 10 of the 11 countries included in the Commonwealth Fund survey. Among these countries, the authors found that deaths in hospital or residential aged care facilities varied from 65% in New Zealand to 80% in Australia. 
 
In both cases, as always, caution is required in interpreting international comparisons. Nevertheless, they do provide a prompt for a number of important policy conversations – comparisons being a type of mirror through which we have the potential to better understand ourselves. 
 
Authors in this issue of Healthcare Policy/Politiques de Sante use these and many other techniques to illuminate important policy, research and practice questions facing the health sector today. These range from how to capture patient perspectives on primary and community care outcomes to drivers of spending on prescription medications. Also in this issue are contributions on how best to share and apply new knowledge, including an online repository of documents addressing healthcare renewal and the research–policy divide for oral health inequality. 
 
Whatever your role in health policy, I hope that the thoughtful commentary and new research published in this issue of Healthcare Policy/Politiques de Sante offers interesting new insights and perspectives for you.