Forty years ago Americans could expect to live slightly longer than Europeans. This has since reversed. Despite similar levels of economic development, Americans now live about a year and a half less, on average, than their Western European counterparts — and also less than people in most other developed nations. How did Americans fall behind?
A study in the July 2011 issue of Social Science & Medicine is the first to calculate the fiscal consequences of the growing life-expectancy gap over the next few decades. The study also pinpoints the crucial age at which U.S. life expectancy starts to deteriorate.
Specifically, researchers from the University of Southern California and colleagues at RAND Corp. and Harvard School of Public Health find that health in middle-age — around the age of 50 — is overwhelmingly the main contributor to disparities in life expectancy between Americans and Europeans.
In the first half of the past century, average life expectancy increased by saving more babies, explains Dana Goldman, director of the Schaeffer Center for Health Policy and Economics at USC. “But now it is reduction in mortality among the elderly — rather than the young — that propels increases in life expectancy.”
“The question,” Goldman says, “is whether ‘being American’ is an independent mortality risk factor.”
Accounting for levels of socioeconomic diversity in the United States and predicted future demographic estimates, the researchers found much of the life-expectancy gap would disappear if the United States lowered prevalence of middle-aged obesity and obesity-related chronic diseases such as diabetes and hypertension to European levels.
The researchers also consider the health consequences of smoking on future life-expectancy trends. While the prevalence of smoking is likely to continue decreasing in the future, the results of this study correspond to a National Research Council study.
The research offers compelling evidence that poor health behaviors among middle-aged Americans — and not inefficiency in the U.S. health care system — are primarily responsible for earlier death. Indeed, prior research has shown that the U.S. does a good job keeping people alive once they are sick, ranking highly in life expectancy among people with chronic or terminal illness.
The researchers looked at a group of Western European countries, including Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden.