U.S. Losing Ground in Life Expectancy Rankings

Oct. 8, 2010 -- The U.S. has failed to keep up with other wealthy nations when it comes to achieving gains in life expectancy rates, despite continuing to spend more on health care, according to a new study.

Researchers from the Commonwealth Fund, a private foundation focused on evaluating health care reform and health care policy, reviewed data on the U.S. and 12 other industrialized nations and looked at 15-year life expectancy rates for 45-year-old and 65-year-old men and women from 1975 to 2005. Their findings showed that:

• Both middle-age and senior groups lagged behind in survival rates compared with other nations, with 15-year survival rates for 45-year-old white women in the U.S. significantly lower than that of other countries.
• Fifteen-year survival rates for 45-year-old men in the U.S. also declined, dropping from third place in 1975 to 12^th.
• Health care spending in the U.S. increased at more than twice the rate of comparison countries.
• Compared with other industrialized nations, Americans are far more likely to die as a result of homicide or a traffic accident. However, the authors note this figure, while higher than other countries, has remained relatively unchanged in the U.S. and is unlikely to account for reduced gains in survival rates.
• Smoking and obesity were two of the biggest public health threats to American longevity. However, U.S. smoking rates were generally lower when compared with other industrialized countries. Although obesity rates in the U.S. remain high, the prevalence of obesity has increased more slowly compared with other wealthy nations. This suggests that smoking and obesity cannot completely explain the reductions in survival rates for middle-aged men and women, the authors say.

U.S. Health Care System

Other industrialized nations included in the analysis were: Canada, Australia, Italy, U.K., Austria, Belgium, France, Germany, Sweden, Switzerland, Netherlands, and Japan. The data used in the analysis were obtained from the World Health Organization, the CDC, International Mortality and Smoking Statistics, and the Organization for Economic Cooperation and Development.

The findings are published in the November issue Health Affairs.

"This study provides stark evidence that the U.S. health care system has been failing Americans for years," Commonwealth Fund president Karen Davis, says in a news release. "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."

The researchers say that the failure of the U.S. to make greater gains in survival rates despite its greater spending on health care may be attributable to flaws in the overall health care system, specifically the role of unregulated fee-for-service payments and an over-reliance on specialty care.