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Americans Have Shorter Life Expectancy at Birth Due to Unequal Access


I would like to draw your attention to a report issued by the Institute of Medicine (a part of the National Academies, which include the Academy of Medicine, of Engineering, and the National Research Council, all of which are considered non-governmental organizations although they were chartered by the US government.)  This report, issued in 2013, details the lower life expectancy at birth of Americans as compared to the European democracies, England, Australia, Canada, and Japan.

The US has long been behind these other advanced countries but the situation has gotten worse in the last 40 years.  For men, Switzerland leads at 79.33 years, and the US is last (seventeenth) at 75.64.  For women, Japan leads at 85.98 and the US is sixteenth at 80.78.  The most striking deficiencies, in terms of years of life lost before age 50, are unintentional injuries, perinatal conditions (especially for women), intentional injuries (especially for men), drug-related causes, cardiovascular causes (especially in women), and noncommunicable diseases other than heart disease.  The number of years of life lost before age fifty in the US is nearly twice that compared to the best of other countries.  Paradoxically, once an individual has reached age 75, he or she is more likely to survive than in other countries.

The advantage for elderly individuals is quite probably due to the fact that all Americans over 65 are covered by Medicare.  Conversely, there is a marked deficiency of health insurance coverage among younger Americans as compared to other countries– almost all of them have universal government-supplied health insurance.  Other causes of premature death relate to the high rate of children in poverty (one-fifth of Americans), higher rates of HIV and AIDS, higher rates of homicide and injuries, and automobile accidents.  However, Americans have lower rates of smoking and drink less than residents of other countries.

It is clear from these statistics that Americans are suffering explicitly through lack of health care insurance and access to health care.  There are also indications that Americans are exposed to more gunshot injuries as well as unintentional injuries.  Americans also have higher rates of drug abuse and consume more calories than people in other countries.   Some of these differences may be related to greater income inequality in the United States, due to lack of health insurance for the poor.

Another cause of shorter life expectancy is the fact that the US has the highest rate of teenaged pregnancy, and more than seven in every thousand Americans is imprisoned (a rate that has tripled in the last thirty years and is more than five times the average rate in other countries.)  The New York Times, in an opinion piece, blamed income inequality for the excess infant mortality rate, because white, college-educated, married women have rates of mortality equal to those in Europe, while disadvantaged women suffer dramatically greater mortality.

Whatever the cause, health care spending has not remedied it, because we spend almost twice as much as other developed countries do.  The NYT doesn’t blame the medical system for high mortality, because our medical care is considered the highest quality in the world when it is available.

Nonetheless, we can blame unequal access to medical care for much of the disparity in life expectancy.  This is as good an argument as any for a national health care system supported by taxes that covers all Americans and provides access to everyone, regardless of ability to pay, with no co-pays.

2 Comments leave one →
  1. Eric permalink
    2015-05-04 15:46

    Although I agree with the thrust of your blog, it is not precisely true that “all Americans over 65 are covered by Medicare.” The distinctions are not moot.

    What is true is that they automatically get Medicare Part B, which covers many but not all emergency hospital costs. Medicare Part A covers doctors’ visits, which Americans are NOT covered for unless they pay the monthly premium, which averages around $110/month. Part A, even if you have it, does not cover prescription drugs.

    While it’s a moot point for rich Americans, it’s not moot for those who cannot afford the $110/month. I believe the national average for a 65-year-old collecting Social Security is a bit more than $1200/month. Millions of Americans cannot afford the 10% chunk taken out of that for Medicare Part A (it’s a yearly choice you make when you sign up for your benefits). If you defer Part A because you need that $110/month, your cost for Medicare Part A goes up the following year.


    • Eric permalink
      2015-05-05 16:07

      These distinctions only further support your general thesis, but I felt they were important to delineate, since Americans over 65 still have to pay through the nose for medical care.


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