Why Is Our Life Expectancy Shorter Than in Other Developed Countries?

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Why Is Our Life Expectancy Shorter Than in Other Developed Countries?

The gap is growing.

July 16, 2013  |  

 Let’s talk life expectancy.

The stats first. They tell a clear story: Americans now live shorter lives than men and women in most of the rest of the developed world. And that gap is growing.

Back in 1990, shouts a new study published last week in the prestigious Journal of the American Medical Association, the United States ranked just 20th on life expectancy among the world’s 34 industrial nations. The United States now ranks 27th — despite spending much more on health care than any other nation.

Americans, notes an editorial the journal ran to accompany the study, are losing ground globally “by every” health measure.

Why such poor performance? Media reports on last week’s new State of U.S. Healthstudy hit all the usual suspects: poor diet, poor access to affordable health care, poor personal health habits, and just plain poverty.

In the Wall Street Journal, for instance, a chief wellness officer in Ohio opined that if Americans exercised more and ate and smoked less, the United States would surely start moving up in the global health rankings.

But many epidemiologists — scientists who study health outcomes — have their doubts. They point out that the United States ranked as one of the world’s healthiest nations in the 1950s, a time when Americans smoked heavily, ate a diet that would horrify any 21st-century nutritionist, and hardly ever exercised.

Poor Americans, then as now, had chronic problems accessing health care. But poverty, epidemiologists note, can’t explain why fully insured middle-income Americans today have significantly worse health outcomes than middle-income people in other rich nations.

The University of Washington’s Dr. Stephen Bezruchka has been tracking these outcomes since the 1990s. The new research published in the Journal of the American Medical Association, Bezruchka told Too Much last week, should worry Americans at all income levels.

“Even if we are rich, college-educated, white-skinned, and practice all the right health behaviors,” he notes, “similar people in other rich nations will live longer.”

A dozen years ago, Bezruchka published in Newsweek the first mass-mediacommentary, at least in the United States, to challenge the conventional take on poor U.S. global health rankings.

To really understand America’s poor health standing globally, epidemiologists like Bezruchka posit, we need to look at “the social determinants of health,” those social and economic realities that define our daily lives.

None of these determinants matter more, these researchers contend, than the level of a society’s economic inequality, the divide between the affluent and everyone else. Over 170 studies worldwide have so far linked income inequality to health outcomes. The more unequal a society, the studies show, the more unhealthy most everyone in it — and not the poor alone.

Just how does inequality translate into unhealthy outcomes? Growing numbers of researchers place the blame on stress. The more inequality in a society, the more stress on a daily level. Chronic stress, over time, wears down our immune systems and leaves us more vulnerable to disease.

This same stress drives people to seek relief in unhealthy habits. They may do drugs or smoke — or eat more “comfort foods” packed with sugar and fat.

Inequality has an equally potent impact on policy decisions around health.

“A substantial proportion of our adult health,” as Stephen Bezruchka explained last week, gets programmed in the early years of a child’s life. Given this reality, guaranteeing every child the best possible supports in the early years ought to be priority number one for any society committed to better health for all.

But unequal nations do precious little of this guaranteeing. The nations with thehighest ranking for child well-being turn out to be the nations with the most equal distributions of income.

Can the United States change course on health? Will Americans in the future be able to look forward to living lives as long as people in other developed nations?

Japan may offer the most encouraging precedent. In the middle of the 20th century, Japan ranked as a deeply unequal and unhealthy nation. But since the 1950s Japan has become a much more equal society, one of the world’s most equal, and, on life expectancy, Japan now ranks number one globally.

The United States, over the same span of time, has gone in the exact opposite direction. We have become the world’s most unequal major nation, with health outcomes among the developed world’s worst.

So how do we start a turnaround? Most Americans, Stephen Bezruchka notes, already understand the concept of “vital signs.”

“We can sense these vital signs tell us something significant about our individual health,” he notes, “every time we step on a scale at the doctor’s office or feel a blood pressure cuff tighten.”

But societies have “vital signs,” too, with none more important to health than our level of inequality. We need to start recognizing these broader “vital signs.” If we do, Bezruchka believes, we can make a difference.

“Dying so much younger than we should,” he sums up, “can be changed.”

Sam Pizzigati is the editor of the online weekly Too Much, and an associate fellow at the Institute for Policy Studies.

 http://www.alternet.org/why-do-americans-live-lives-so-short?paging=off

U.S. lags behind other wealthy nations in health and life expectancy

By Agence France-Presse
Wednesday, July 10, 2013 13:22 EDT

Topics: united states

 

The United States spends more per capita on health care than any place in the world but lags behind other wealthy nations in health and life expectancy, according to research published on Wednesday.

Japan still leads the world in terms of living the longest, with average life expectancy at 82.6 years in 2010, up from 79.1 years in 1990.

Americans are living longer too — an average of 78.2 years compared to 75.2 two decades ago — but were outpaced by other developed nations as the US ranking for life expectancy slid from 20th to 27th in the world.

Americans are also living with more health problems, ranging from chronic back pain to depression, said the study in the Journal of the American Medical Association.

Disease and disability account for nearly half the health burden in the United States, and poor diet, smoking, high blood pressure and physical inactivity are leading risk factors, it said.

“Individuals in the United States are living longer but are not necessarily in good health,” said the study, called “The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors.”

The research is based on data from 34 countries and includes estimates for death and disability from 291 diseases, conditions and injuries.

The United States spends twice as much as France on its average health care per person — nearly $8,000 per capita in 2009, for 17.4 percent of US GDP — according to the Organization for Economic Co-operation and Development.

But France ranks much higher than the United States for life expectancy — ninth in the world with an average age for both sexes combined of 80.9.

 

“The United States spends more than the rest of the world on health care and leads the world in the quality and quantity of its health research, but that doesn’t add up to better health outcomes,” said Christopher Murray, director of the Institute for Health Metrics and Eval‎uation (IHME) and one of the lead authors on the study.

“The country has done a good job of preventing premature deaths from stroke, but when it comes to lung cancer, preterm birth complications, and a range of other causes, the country isn’t keeping pace with high-income countries in Europe, Asia, and elsewhere.”

A separate study by IHME, an independent research organization at the University of Washington, in the journal Population Health Metrics, found that Americans are exercising more than they did at the start of the century but obesity is still rising.

“As physical activity increased between 2001 and 2009, so did the percentage of the population considered obese,” the group said in a statement.

Among US men, obesity preval‎ence was 26.1 percent in 2001 and 32.8 percent in 2009, a rise of 6.7 percentage points.

For US women, obesity preval‎ence was 28.7 percent in 2001 and 35.1 percent in 2009, a change of 6.4 percentage points.

“It’s quite disappointing that the US is falling behind in outcomes for diseases, such as cardiovascular disease, and especially those diseases with preventable causes,” said cardiologist Robert Rosenson, director of cardiometabolic disorders at The Mount Sinai Medical Center.

“We need to make a major effort to make better lifestyle choices daily based on diet,” he added. “The costs due to poor eating and disabling health conditions are overtaxing our society.”

http://www.rawstory.com/rs/2013/07/10/u-s-lags-behind-other-wealthy-nations-in-health-and-life-expectancy/