Kaiser Daily Health Policy Report, August 13, 2007
Life expectancy in the U.S. has reached its highest point ever, but it is exceeded by the rates in 41 other countries, the AP/Arizona Daily Star reports. The U.S. has been slipping for decades in international rankings of life expectancies as other countries are improving health care, nutrition and lifestyles, according to the AP/Daily Star. Countries that rank above the U.S. include Japan, most of Europe, Jordan and the Cayman Islands. A U.S. resident born in 2004 has a life expectancy of 77.9 years, placing the U.S. in 42nd place, down from 11th place two decades ago.
Researchers say the lower U.S. ranking is attributed to the high uninsured rate among the population, in addition to rising obesity rates and racial disparities in life expectancy. Black U.S. residents have a shorter life span, at 73.3 years, than whites. The U.S. also has a high infant mortality rate compared with other industrialized nations, with 40 countries having lower infant mortality rates than the U.S. in 2004.
The country with the longest life expectancy is Andorra at 83.5 years. Swaziland is last at 34.1 years, attributed to sub-Saharan Africa’s high rate of HIV and AIDS, as well as famine and civil strife.
Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington, said, “Something’s wrong here when one of the richest countries in the world, the one that spends the most on health care, is not able to keep up with other countries.” According to Murray, improving access to health insurance could increase life expectancy, but he predicted that the U.S. ranking would not improve as long as the health care debate is limited to insurance. Murray said policymakers must direct their efforts to reducing cancer, heart disease and lung disease. Murray supports additional efforts to reduce tobacco use, control blood pressure, reduce cholesterol and regulate blood sugar.
Sam Harper, an epidemiologist at McGill University, said, “It’s not as simple as saying we don’t have national health insurance. It’s not that easy.” Paul Terry, an assistant professor of epidemiology at Emory University, said, “The U.S. has the resources that allow people to get fat and lazy,” adding, “We have the luxury of choosing a bad lifestyle as opposed to having one imposed on us by hard times” (AP/Arizona Daily Star, 8/12).
A “growing body of evidence” indicates that the U.S. is not a “leader in providing good medical care” but a “laggard,” a New York Times editorial states. According to the editorial, a comparison of the U.S. and other industrialized nations in several important areas of health care finds that:
- “All other major industrialized nations provide universal health coverage” — most with “comprehensive benefit packages with no cost sharing by the patients” — but the U.S. “to its shame” has 45 million uninsured residents and millions of residents with inadequate coverage;
- U.S. residents receive “prompter attention” than those in most other nations, but “even Americans with above-average incomes find it more difficult than their counterparts abroad to get care on nights or weekends without going to an emergency room”;
- The U.S. “ranks dead last on almost all measures of equity,” with the “greatest disparity in the quality of care given to richer and poorer citizens”;
- The U.S. ranks “near the bottom in healthy life expectancy at age 60” and 15th among 19 nations in deaths that would not have resulted “if treated with timely and effective care”;
- The U.S. ranks “first in providing the ‘right care’ for a given condition” and high for preventive care but performs “poorly in coordinating the care of chronically ill patients, in protecting the safety of patients and in meeting their needs and preferences”;
- The U.S. in a recent comparison of five nations “had the best survival rate for breast cancer, second best for cervical cancer and childhood leukemia, worst for kidney transplants, and almost-worst for liver transplants and colorectal cancer”;
- U.S. residents “hold surprisingly negative views of their health care system,” and “American attitudes stand out as the most negative” in a recent comparison of five nations; and
- The U.S. health care system — despite “our vaunted prowess in computers, software and the Internet” — is “still operating in the dark ages of paper records and handwritten scrawls,” with many U.S. physicians “years behind doctors in other advanced nations in adopting electronic medical records or prescribing medications electronically.”
The editorial states, “With health care emerging as a major issue in the presidential campaign and in Congress, it will be important to get beyond empty boasts that this country has ‘the best health care system in the world’ and turn instead to fixing its very real defects,” adding, “The world’s most powerful economy should be able to provide a health care system that really is the best” (New York Times, 8/12).