New Study: U.S. Life Expectancy Continues to Fall Behind Other Countries
Despite spending the most on health care, the United States continues to lag behind other nations when it comes to gains in life expectancy—and commonly cited causes for the nation’s poor performance are not to blame, a new Commonwealth Fund–supported study finds.
The Health Affairs Web First article, written by Peter Muennig and Sherry Glied of Columbia University, examines 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 advanced nations. The findings reported show that while the U.S. has achieved gains in 15-year survival rates decade by decade between 1975 and 2005, other countries have experienced greater gains, even as per capita health care spending in the U.S. increased at more than twice the rate of the comparison countries. 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. Meanwhile, the U.S. ranking for 15-year life expectancy for 45-year-old men fell from third in 1975 to 12th in 2005.
In comparing risk factors among the 13 countries, the researchers 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 the other countries. And 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.
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 overreliance on specialty care.
"This study provides stark evidence that the U.S. health care system has been failing Americans for years," said Commonwealth Fund president Karen Davis. "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."
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