More than 40 million people in the United States say they cannot afford adequate heath care and go without drugs, eyeglasses or dental treatment, according to a federal report released on Monday.

©REUTERS/Jessica Rinaldi

A customer at a pharmacy counter in a file photo.

The latest look at the state of U.S. health care also shows that while death rates from cancer and heart disease have dropped in recent years, just as many Americans are dying in car crashes.

"There has been important progress made in many areas of health such as increased life expectancy and decreases in deaths from leading killers such as heart disease and cancer," Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, said in a statement.

"But this report shows that access to health care is still an issue where we need improvement."

The report, available on the Internet at www.cdc.gov/nchs/, has a special section on access to health care.

Health care has jumped to the forefront of the 2008 campaign for the White House with virtually every presidential candidate offering some plan to provide more Americans with health insurance.

"In 2005, more than 40 million adults did not receive 'needed services' because they could not afford them," the report said.

"Nearly 15 million adults did not obtain eyeglasses, 25 million did not get dental care, 19 million did not get needed prescribed medicine, and 15 million did not get needed medical care due to cost."

The report found about one third of all children living below the poverty level had not visited a dentist in 2005, compared with fewer than one-fifth of children from wealthier families.

"The United States spends more on health per capita than any other country, and health spending continues to increase," the report said.

"In 2005, national health care expenditures in the United States totaled $2 trillion, a 7 percent increase from 2004. Hospital spending, which accounts for 31 percent of national health expenditures, increased by 8 percent in 2005."

Private insurance plans paid for 36 percent of total personal health care expenditures in 2005, while the federal government paid 34 percent, state and local governments paid 11 percent, and patients paid for 15 percent out of pocket.

Prescription drugs accounted for 10 percent of national health expenditure in 2005.

There was some good news: life expectancy was up to 77.8 years for a baby born in 2004 -- three years more than in 1990. "Mortality from heart disease, stroke, and cancer has continued to decline in recent years," the report said.

But the death rate for motor vehicle-related injuries has remained stable since the early 1990s, with 15 deaths per 100,000 people per year, down from 18.5 per 100,000 in 1990.