American life expectancy is lower than that of Cuba, Lebanon, and Czechia.
Should it have been a surprise that federal health authorities, late last year, revealed that life expectancy in America had decreased for two years consecutively? Conversely, as vaccines took hold, life expectancy started to rebound across the globe following the pandemic, but not in the U.S.
Currently, the average life expectancy in the US is about 77 years — nine years better than in 1950. Despite the increase, G7 experts have pointed out that the U.S. is not keeping up with the rate of growth of other countries.
And last week, more concerning news surfaced. In the U.S., maternal mortality reached a peak in 2021, and there were increasing mortality rates for children and adolescents. This information was shared by the Journal of the American Medical Association.
“This is the first time in my career that I’ve ever seen [an increase in pediatric mortality] – it’s always been declining in the United States for as long as I can remember,” says the JAMA paper’s lead author Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “Now, it’s increasing at a magnitude that has not occurred at least for half a century.”
American life expectancy is lower than in other developed nations in every demographic.
Ten years ago, one group warned us of this happening. Woolf and the other researchers embarked on a 400-page study, “Shorter Lives, Poorer Health.” The name is self-explanatory.
A research panel commissioned by the National Academy of Sciences with support from the National Institutes of Health compared U.S. health outcomes and mortality to other developed countries. Their findings highlighted a significant disparity in comparison with America’s peers.
Let’s take a look at the eye-opening research findings and why the researchers insist that we have yet to reach a point of no return.
Beyond bad habits
“American children are less likely to live to age 5 than children in other high-income countries,” the authors write on the second page. It goes on: “Even Americans with healthy behaviors, for example, those who are not obese or do not smoke, appear to have higher disease rates than their peers in other countries.”
Researchers have observed that Americans tend to face more health issues when compared to counterparts living in other affluent nations such as the U.K., Switzerland, and Japan. This has been attributed to what is known as the “U.S health disadvantage”.
“We went into this with an open mind as to why it is that the U.S. had a shorter life expectancy than people in other countries,” says Woolf, who chaired the committee that produced the report. After looking across different age and racial and economic and geographic groups, he says, “what we found was that this problem existed in almost every category we looked at.”
“That was a decision – not to emphasize the differences in our population, because there is data that actually shows that even the top proportion of the U.S. population does worse than the top proportion of other populations,” she explains. “We were trying to just say – look, this is an American problem.”
Why?
Researchers were assigned the task of studying why Americans tend to suffer from more diseases and die earlier than those in other countries. The primary goal was to investigate the root causes behind this discrepancy.
“We were very systematic and thorough about how we thought about this,” says Woolf. The panel looked at American life and death in terms of the public health and medical care system, individual behaviors like diet and tobacco use, social factors like poverty and inequality, the physical environment, and public policies and values.
“In every one of those five buckets, we found problems that distinguish the United States from other countries.”
And yes, Americans still consume more calories than necessary. Plus, the lack of healthcare access is another issue. There are other factors contributing to this issue such as higher child poverty, racial segregation, social isolation, and how cities are designed which makes it difficult to access healthy food.
“Everybody has a pet thing they worry about and say, ‘it’s oral health’ or ‘it’s suicides’ – everyone has something that they’re legitimately interested in and want to see more attention to,” says John Haaga, who was the director of the Division of Behavioral and Social Research at the National Institute on Aging at NIH, before he retired.
“The great value of an exercise like this one was to step back and say, ‘OK, all of these things are going on, but which of them best account for these long-term population-level trends that we’re seeing?’ “
The real difference between the U.S. and other countries when it comes to life expectancy can be attributed to early death from various causes such as teenage pregnancy, drug overdoses, HIV, car accidents, etc. This has been elaborated on in the “Shorter Lives, Poorer Health” report.
“Two years difference in life expectancy probably comes from the fact that firearms are so available in the United States,” Crimmins says.
“There’s the opioid epidemic, which is clearly ours – that was our drug companies and other countries didn’t have that because those drugs were more controlled. Some of the difference comes from the fact that we are more likely to drive more miles. We have more cars,” and ultimately, more fatal crashes.”
There’s one strong result
According to the “Shorter Lives, Poorer Health” report, there are a few areas in which Americans are succeeding in terms of longevity and overall health.
“The United States has higher survival after age 75 than do peer countries, and it has higher rates of cancer screening and survival, better control of blood pressure and cholesterol levels, lower stroke mortality, lower rates of current smoking, and higher average household income.”
Despite those successes, it is not enough to reverse the overall life expectancy rate (77) because not enough people are making it that far.
“I really think that most Americans know that Americans are more overweight and obese and that we have higher rates of disease and live shorter lives than other countries,” said Dr. Ravi Sawhney, who helped conceive of and launch the “Shorter Lives, Poorer Health” study at NIH before he left the agency.
“It’s just the NIH and the CDC that don’t want to take the responsibility for that failure or to do anything about it.”
‘We can’t touch everything’
At a press conference earlier this month, Secretary Xavier Becerra of the Department of Health and Human Services responded to NPR’s inquiry on countermeasures they are taking to tackle declining life expectancy. He discussed the impact of COVID-19, vaccine reluctance, mental wellness problems as well as gun violence.
“There’s so many things that we’re doing,” Becerra said. “We can’t touch everything. We can’t touch state laws that allow an individual to buy an assault weapon and then kill so many people. We can only come in afterwards.”
Take small steps, consistently
The “Shorter Lives, Poorer Health” study makes it clear that the U.S. is not faring well in terms of health care, as Americans are suffering and dying at rates that should be avoidable. It’s not about being better or worse than other nations, it’s about ensuring citizens get the care they need.
Despite the magnitude of the problems, it is important to recognize that other countries have been able to successfully solve health-related issues. Dr. Sawhney suggests that US citizens should take solace in this and be motivated to identify solutions for their own country as well.
He believes that the nationwide improvements needed might not be as problematic as some policymakers and health officials seem to think.
“You look at these healthier countries, they’re free countries – England, France, Italy – they’re not banning delicious foods. They’re not chaining people to treadmills,” he says.
“Americans love to travel to Europe, to Australia, to Canada to enjoy their foods and their lifestyles, and so the idea that we might say, ‘Hey, maybe we could bring some of those lifestyles back’ – I don’t think people are going to go up in arms that we’re taking away their freedoms.”
Woolf argues that attempting to borrow policy ideas from other countries is an obvious move. “If a martian came down to earth and saw this situation, it would be very intuitive that you [would] look at other countries that have been able to solve this problem and apply the lessons learned,” he says.
In historical research he’s been doing, “I found that there are dozens and dozens of countries on almost every continent of the world that have outperformed the United States for 50 years,” he says. “It’s worth taking a look at what they’ve done and Americanizing it – you don’t have to take it right off the shelf.”
He believes universal, efficient health care, health and safety regulations and access to education are crucial to a better tomorrow. Furthermore, he emphasizes the need for more investments in young children’s futures. These policies are “paying off for them,” he says, and could for Americans, too.
A similar story appeared on NPR