Why Americans Lag in Life Expectancy -- Even as Health Care Spending Soars

Surgery roomIt's often reported that the U.S. lags other nations when it comes to gains in life expectancy, but a new study from Columbia University finds that the reasons aren't the commonly cited obesity, smoking, traffic fatalities and homicide. Rather, the problem has been poor health care, or rather, a poor health care system.

Perhaps even worse, the Commonwealth Fund-supported study, which was published at Health Affairs, found the smaller gains in U.S. survival rates come even as health care spending increased at more than twice the rate of the comparison countries. "It was shocking to see the U.S. falling behind other countries even as costs soared ahead of them," says lead author Peter Muennig, assistant professor at Columbia University's Mailman School of Public Health.

The study, "What Changes In Survival Rates Tell Us About U.S. Health Care," looked at health spending, behavioral risk factors like obesity and smoking, and 15-year survival rates for men and women ages 45 and 65 in the U.S. and 12 other nations (Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland and the U.K).

From Fifth to 46th

Yes, the U.S. has improved 15-year survival rates since 1975, but other countries have racked up greater gains, leading the U.S. to slip in country ranking. In 1950, the U.S. was fifth among the leading industrialized nations with respect to female life expectancy at birth, but it ranked 46th in the last available measure. As of Sept. 23, 2010, the U.S. ranked 49th for both male and female life expectancy combined. Americans have 5.7 fewer years of "perfect health" than the typical Japanese.

Specifically, 45-year-old white American women fared the worst, with the lowest ranking among the 13 countries, not even surpassing the 1975 survival rates for Swiss, Swedish, Dutch or Japanese women. The ranking for 45-year-old men fell from 3rd in 1975 to 12th in 2005, according to the study.

"But what really surprised us was that all of the usual suspects -- smoking, obesity, traffic accidents, and homicides -- are not the culprits," Muennig adds.

When the researchers compared smoking habits among the 13 countries, they found very little difference. In fact, the U.S. had faster declines in smoking between 1975 and 2005 than almost all of the other countries. Similarly, the results didn't show that these factors contributed to the growing lag in survival rates.

Health Care Reform Should Help


The authors speculate that the U.S. health system itself, with its emphasis on fee-for-service treatments, specialty care and lack of care coordination, may explain both rising costs and deteriorating relative life expectancy.

They explain: "Many chronic diseases that can be prevented or treated with health interventions arise in midlife, and deaths from these diseases cluster in the second half of life. Significant reforms such as those in the Affordable Care Act will help improve the health care system and lower costs," the authors conclude.

"This study provides stark evidence that the U.S. health care system has been failing Americans for years," says Commonwealth Fund President Karen Davis. "It is unacceptable that the U.S. obtains so much less than should be expected from its unusually high spending on health care relative to other countries."

The Commonwealth Fund previously reported that the U.S. health care system ranked last compared to six other industrialized countries in different measures such as quality and efficiency despite having the highest costs: The U.S. spent $7,290 per capita on health care in 2007, compared to the $3,837 in the Netherlands, which ranked first.

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kawieboy

Big Mac's and donuts will kill you a lot faster than fish and seaweed. Doesn't take a genius to figure that one out.

October 18 2010 at 9:43 PM Report abuse rate up rate down Reply
Richard Tanner

You almost have to take control of your own health checks and do a lot of reading. Remember that the drugs we buy are the highest price for the same drugs in the world.Why does the government just tell the drug companies what we are going to pay like Canada does and so many other industral countries tell the drug companies what the drugs are really worth. And why do we get stuck for paying teh high cost,just because the companies are spending so much in TV advertizing? Richard

October 18 2010 at 11:49 AM Report abuse rate up rate down Reply
ha6ai

The Columbia - "Commonwealth Fund" is using intentionally misleading "statistics". "Life expectancies" measurements are based on when an infant is considered "live". Numerous European countries do not consider (as does the U.S) underweight infants to be "born alive". Canada, Germany, and Austria, a premature baby weighing less than 500g is not considered a living child. But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies, considered “unsalvageable” outside of the U.S. and therefore never alive, is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics. Some of the countries reporting infant mortality rates lower than the U.S. classify babies as "stillborn" if they survive less than 24 hours whether or not such babies breathe, move, or have a beating heart at birth. Forty percent of all infant deaths occur in the first 24 hours of life. SO THERE YOU HAVE IT: LIES, DAMN LIES, AND STATISTICS - LEFTY LIES.

October 07 2010 at 11:40 PM Report abuse -1 rate up rate down Reply
ha6ai

The Columbia - "Commonwealth Fund" is using intentionally misleading "statistics". "Life expectancies" measurements are based on when an infant is considered "live". Numerous European countries do not consider (as does the U.S) underweight infants to be "born alive". Canada, Germany, and Austria, a premature baby weighing less than 500g is not considered a living child. But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics. Some of the countries reporting infant mortality rates lower than the U.S. classify babies as “stillborn” if they survive less than 24 hours whether or not such babies breathe, move, or have a beating heart at birth. Forty percent of all infant deaths occur in the first 24 hours of life. SO THERE YOU HAVE IT: LIES, DAMN LIES, AND STATISTICS - LEFTY LIES.

October 07 2010 at 11:39 PM Report abuse -1 rate up rate down Reply
ha6ai

The Columbia - "Commenwealth Fund" is using intentionally misleading "statistics". "Life expectancies" measurements are based on when an infant is considered "live". Numerous European countries do not consider (as does the U.S) underweight infants to be "born alive". Canada, Germany, and Austria, a premature baby weighing

October 07 2010 at 11:38 PM Report abuse -1 rate up rate down Reply
ha6ai

The Columbia - "Commenwealt Fund" is using intentionally misleading "statistics". "Life expectancies" measurements are based on when an infant is considered "live". Numerous European countries do not consider (as does the U.S) underweight infants to be "born alive". Canada, Germany, and Austria, a premature baby weighing

October 07 2010 at 11:36 PM Report abuse -1 rate up rate down Reply
ha6ai

NONSENSE! THIS COMES FROM COLUMBIA - THE MOST EXTREME-LEFT INSTITUTION IN THE COUNTRY. I DON'T BELIEVE A WORD OF IT. PURE LEFTIST PROPAGANDA! OBAMACARE WILL DEGRADE MEDICAL CARE AND KILL AND DISABLE OLD PEOPLE! THESE LEFTISTS BELIEVE IN EUGENICS AND "QALY" (QUALITY ADJUSTED LIFE YEARS) TO DENY, DENY, DENY HEALTH CARE TO OLDER PEOPLE BECAUSE IT IS "TOO EXPENSIVE" TO PROVIDE AVAILABLE TREATMENTS SUCH AS SURGERIES OR CANCER TREATMENTS TO OLD PEOPLE - BECAUSE IT WILL COST TOO MUCH PER YEAR OF REMAINING LIFE!!! THESE ARE EVIL PEOPLE. OBAMACARE KILLS!

October 07 2010 at 11:06 PM Report abuse -1 rate up rate down Reply
1 reply to ha6ai's comment
mkovach517

Sounds like the folks at Columbia are running interference for Obamacare. No surprise there! Maybe, just maybe - we spend more because of all the tests we have to run to avoid lawsuits! We also work more hours than many of the other countries with longer life expectancies and our diet leaves much to be desired.

October 07 2010 at 9:11 PM Report abuse rate up rate down Reply
ingfp

Where's bawney? Wheres Al, Where's Chawlie?

October 07 2010 at 8:47 PM Report abuse rate up rate down Reply
ingfp

Afro....you only wish you had sex!

October 07 2010 at 8:45 PM Report abuse rate up rate down Reply