American Life Expectancy Continues to Fall Behind Other Countries

Author: Commonwealth Fund
Published: 2010/10/07 - Updated: 2025/02/23
Publication Details: Peer-Reviewed, Findings
Topic: Americas - Publications List

Page Content: Synopsis - Introduction - Main - Insights, Updates

Synopsis: Analysis of US life expectancy trends highlights disparities across states, emphasizing need for targeted healthcare reforms to improve longevity and health equity.

Why it matters: This report examines the persistent lag in U.S. life expectancy compared to other developed nations, revealing that despite increased healthcare spending, Americans have not experienced proportional gains in longevity. The study analyzes factors such as obesity, smoking, traffic fatalities, and homicide, determining that these are not the primary causes for America's relative decline. Instead, the findings suggest systemic issues within the U.S. healthcare system, including unregulated fee-for-service payments and a reliance on specialty care, may contribute to the nation's stagnating life expectancy. This information is particularly relevant for policymakers, healthcare professionals, seniors, and individuals with disabilities, as it underscores the need for comprehensive healthcare reforms to address underlying inefficiencies and improve health outcomes for all populations - Disabled World (DW).

Introduction

The United States continues to lag behind other nations when it comes to gains in life expectancy, and commonly cited causes for our poor performance - obesity, smoking, traffic fatalities, and homicide - are not to blame, according to a Commonwealth Fund-supported study published today as a Health Affairs Web First. The study, by Peter Muennig and Sherry Glied at Columbia University, 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 United Kingdom).

Main Item

While the U.S. has achieved gains in 15-year survival rates decade by decade between 1975 and 2005, the researchers discovered that other countries have experienced even greater gains, leading the U.S. to slip in country ranking, even as per capita health care spending in the U.S. increased at more than twice the rate of the comparison countries.

Fifteen-year survival rates for men and women ages 45 and 65 in the US have fallen relative to the other 12 countries over the past 30 years.

Forty-five year old U.S. white women fared the worst by 2005 their 15-year survival rates were lower than that of all the other countries.

Moreover, the survival rates of this group in 2005 had not even surpassed the 1975 15-year survival rates for Swiss, Swedish, Dutch or Japanese women.

The U.S. ranking for 15-year life expectancy for 45-year-old men also declined, falling from 3rd in 1975 to 12th in 2005, according to the study, "What Changes in Survival Rates Tell Us About U.S. Health Care."

When the researchers compared risk factors among the 13 countries, they found very little difference in smoking habits between the U.S. and the comparison countries in fact, the U.S. had faster declines in smoking between 1975 and 2005 than almost all of the other countries.

In terms of obesity, the researchers found that, while people in the U.S. are more likely to be obese, this was also the case in 1975, when the U.S. was not so far behind in life expectancy. In fact, even as the comparison countries pulled ahead of the US in terms of survival, the percentage of obese men and women actually grew faster in most of those countries between 1975 and 2005.

Finally, examining homicide and traffic fatalities, the researchers found that they have accounted for a stable share of U.S. deaths over time, and would not account for the significant change in 15-year life expectancy the study identified.

The researchers say that the failure of the U.S. to make greater gains in survival rates with its greater spending on health care may be attributable to flaws in the overall health care system. They point to the role of unregulated fee-for-service payments and our reliance on specialty care as possible drivers of high spending without commensurate gains in life expectancy.

"It was shocking to see the U.S. falling behind other countries even as costs soared ahead of them," said lead author Peter Muennig, assistant professor at Columbia University's Mailman School of Public Health.

"But what really surprised us was that all of the usual suspects smoking, obesity, traffic accidents, and homicides are not the culprits. The U.S. doesn't stand out as doing any worse in these areas than any of the other countries we studied, leading us to believe that failings in the U.S. health care system, such as costly specialized and fragmented care, are likely playing a large role in this relatively poor performance on improvements in life expectancy."

"This study provides stark evidence that the U.S. health care system has been failing Americans for years," said 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 good news is that the Affordable Care Act will take significant steps to improve our health care system and the health of Americans by expanding health insurance, improving primary care, and holding health care organizations accountable for their patients' overall health and ensuring the coordination of primary care and specialty care to eliminate errors, waste of patients' time, and wasteful duplication of tests and services."

Insights, Analysis, and Developments

In light of the data presented, it becomes evident that addressing the disparities in life expectancy across U.S. requires a multifaceted approach. Factors such as socioeconomic status, access to quality healthcare, and public health initiatives play pivotal roles in influencing longevity. Policymakers and health advocates must prioritize targeted interventions that consider these variables to bridge the gap and promote equitable health outcomes nationwide. For aging populations and disabled individuals, these insights are more than numbers - they're a roadmap for demanding accountability and tailored solutions where gaps persist

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Commonwealth Fund and published on 2010/10/07, this content may have been edited for style, clarity, or brevity. For further details or clarifications, Commonwealth Fund can be contacted at commonwealthfund.org NOTE: Disabled World does not provide any warranties or endorsements related to this article.