US Life Expectancy Slips to 49th in World: Too Much Modern Healthcare?

Examination of all possible causes for America’s worsening life expectancy eliminates everything but modern health care as the cause.

One of the most shameful statistics of the United States is its ever-slipping mortality rate. Once a shining example of life quality and length, the US has slipped to 49^th in life expectancy. A recent study examined potential reasons for it, and found that most explanations simply don’t measure up.

Smoking, obesity, traffic fatalities, and murders are often cited as potential reasons for Americans’ poor showing in mortality rates, but the facts simply don’t support them.

The Study

The study, entitled “What Changes in Survival Rates Tell Us About US Health Care”, published on Web First, was produced by Peter A. Muennig and Sherry A. Glied, both from the Health Policy and Management department of the Mailman School of Public Health in Columbia University. They compared 15-year survival of middle age and older people in the US with 12 other modern nations: Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, Netherlands, Sweden, Switzerland, and the United Kingdom.

They opted to compare life expectancy of adults, rather than from birth, because:

We chose to study adult survival, rather than measures at birth, because variations in family planning policy and coding at birth may affect life expectancy at birth. Most of the important chronic diseases that can be successfully prevented or treated with health interventions—such as cardiovascular disease, stroke, and diabetes—arise in midlife, and deaths due to these diseases cluster in the second half of life.⁽¹⁾

15-year survival rates were measured, rather than life expectancy, to avoid the statistical bias of exceptionally long lives of a small number of people, and because it allows direct comparisons between cohorts. As much as possible, data were supplied by the same sources: the Organisation for Economic Co-operation and Development (OECD) and the World Health Organization (WHO).

Differing Explanations for the Relative Shortening of US Lifespans Compared with Other Nations

The researchers reviewed several standard explanations for why the US mortality rate compares badly with other nations—and debunks each one.

Population Diversity

Often, the melting pot character of America is cited, with the implication that people from other areas of the world lead shorter lives, thus reducing the overall lifespan of Americans. The study found that this claim is completely without merit:

Contrary to the diversity hypothesis, including the experience of diverse groups in the US data improves the comparative performance of the United States, since the superior survival gains of other Americans relative to non-Hispanic whites boosts the overall performance of the United States relative to that of other countries.

In other words, the United States’ mortality rates would be even worse if it weren’t for people from diverse heritages.

Behaviorial Risk: Smoking

The presumption of higher smoking rates in the US is often cited as a confounding factor that can explain shorter lifespans. As the authors demonstrate, though, this claim cannot be supported.

They examined the smoking-related disease, lung cancer. They found that mortality from lung cancer has increased in the US relative to some groups in other countries, and decreased relative to others. For example, it has declined in 65-year-olds in the US compared to the same age group in Belgium and France, but has increased compared to 65-year-olds in Australia and Austria. As the authors stated, “Lung cancer mortality rates varied greatly by country, age, and sex…and no clear relationship emerged.

Behaviorial Risk: Obesity

American obesity is infamous, and it seems logical to blame it for the worsening mortality rate. The average weight of Americans is much greater than in any other country in the world. However, as the authors noted, “For obesity to explain the decline in US life expectancy or the increase in health spending relative to the twelve comparison countries, Americans would have to be becoming obese at a faster rate than people in the comparison nations over time.”

The study found, instead, that the increase in American obesity was at a slower rate than in all but three of the comparison countries.

Though unlikely, the authors also looked at the possibility that absolute levels of obesity, rather than increases in the rate of obesity cause higher mortality rates. This, though, did not prove to be the case, either.

Behaviorial Risk: Traffic Accidents & Homicides

While it’s certainly true that Americans die at far greater rates from traffic accidents and murders, the rates of these kinds of deaths have not been increasing. It is, therefore, highly unlikely that they can be blamed for Americans’ increasing mortality.

Medical Insurance

Ultimately, health care seems to be the culprit in Americans’ increasingly shorter lifespans. The authors investigated the impact of health insurance on mortality rates, and found that there is very little. They stated that insurance “coverage has large effects on use of health care but only small effects on mortality, which are concentrated in low-income groups.”

They go on to note that only a very small difference in life expectancy can be found as a result of access to medical insurance. It should also be pointed out that these studies are looking for such a connection, so their inability to find one should be taken as highly significant.

Healthcare Spending

The one clear connection between the US population’s decrease in mortality has been an increase in spending on health care. The authors surmise three different possible explanations, but ignore the single most likely.

The first possible reason the authors noted is that, with greater spending, more people become uninsured. While this has certainly been the case, the authors’ own documentation demonstrates that this isn’t logical. As noted in the previous section, “Medical Insurance”, no connection between life expectancy and medical coverage could be found.

The second possible reason explored is that “health spending may be choking off public funding on more important life-saving programs.” Interestingly, they do not pursue this consideration.

The third possible reason is that:

Finally, unregulated fee-for-service reimbursement and an emphasis on specialty care may contribute to high US health spending, while leading to unneeded procedures and fragmentation of care. Unneeded procedures may be associated with secondary complications. Fragmentation of care leads to poor communication between providers, sometimes conflicting instructions for patients, and higher rates of medical errors.

What can we say? Though the authors try to soften the implications of this statement by saying that the extent of these factors is uncertain, they leave little room for any other interpretation of Americans’ declining life expectancy relative to the rest of the world.

Modern medicine is the problem. Modern medicine’s massive use of poisonous drugs, excessive and unnecessary surgeries, harmful diagnostics, “preventative” treatments, and vaccinations are evoking a dreadful toll on lifespan and quality of life.

Is it any wonder that, whenever there have been doctor strikes, the death rate declines?

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