It’s no mystery why our people in the U.S. don’t live as long as elsewhere in the industrialized world.
For U.S. males, life expectancy at birth increased by about 5.5 years (from 69.9 to 75.5) from 1980 to 2006. That’s good, but it still lags the average life-expectancy gains of 21 other countries. For U.S. women, life expectancy at birth increased by about three years (from 77.5 to 80.7) from 1980 to 2006, which also ranks lower than other developed nations.
Why aren’t Americans living the longest given the amount spent on health care? According to the report, about half of the gap between U.S. life expectancy and countries with higher life expectancy is because of heart-disease rates in the United States. Moreover, among U.S. women, smoking appears to account for lower life expectancy relative to other countries.
Obesity may account for one-fifth to one-third of the shortfall in U.S. life expectancy as compared with other countries, the report states.
Three to five decades ago, smoking was much more widespread in the U.S. than in Europe or Japan, and the health consequences are still playing out in today’s mortality rates, the report says. Smoking appears to be responsible for a good deal of the differences in life expectancy, especially for women. The habit also has significantly reduced life expectancy in Denmark and the Netherlands, two other countries with lower life expectancy trends than comparable high-income countries.
Because there appears to be a lag of two to three decades between smoking and its peak effects on mortality, one can predict how smoking will affect life expectancy over the next 20 to 30 years. On this basis, life expectancy for men in the U.S. is likely to improve relatively rapidly in coming decades because of reductions in smoking in the last 20 years, the report says. For U.S. women, whose smoking behavior peaked later than men’s, declines in mortality are apt to remain slow for the next decade. Similarly, life expectancy in Japan is expected to improve less rapidly than it otherwise would, because of more-recent high smoking rates.
Obesity’s contribution to lagging life expectancies in the U.S. also appears to be significant, the report says. While there is still uncertainty in the literature about the magnitude of the relationship between obesity and mortality, it may account for a fifth to a third of the shortfall in longevity in the U.S. compared to other nations, the report says. And if the obesity trend in the U.S. continues, it may offset the longevity improvements expected from reductions in smoking. However, recent data suggest that the prevalence of obesity in the U.S. has leveled off, and some studies indicate that the mortality risk associated with obesity has declined.
Lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, the report says, though this is a less significant factor for those over age 65 because of Medicare access.
Medicynical Note: The health care industrial complex has excelled at making money not improving longevity and public health. Somehow this needs to change.