Life Expectancy in U.S. Lags Behind Global Rates

Posted on Aug 25, 2011 in Health & Wellness

By Kristina Fiore

Life expectancy at birth for American men was 75.6 years and 80.8 for women in 2007 — 36th and 33rd in the world — with wide variation from county to county, researchers said.

County-level life expectancies for men ranged from 15 years ahead of an international average of top-performing nations to more than 50 years behind, Christopher Murray, MD, of the University of Washington in Seattle, and colleagues reported in Population Health Metrics.

The range for women was 16 years ahead to more than 50 years behind.

“The U.S. picture, with its remarkable combination of poor health outcomes despite the highest levels of health spending per capita, is even more stark and disturbing when examined at the local level,” Murray and colleagues wrote.

There are wide geographic and racial disparities in the U.S., but data had not been updated since 1999, the researchers said.

So they looked at data from the National Center for Health Statistics from 2000 to 2007 to analyze deaths by age, sex, county, and race.

At the county level, life expectancy in 2007 ranged from 65.9 years to 81.1 years for men and 73.5 to 86 years for women. The lowest life expectancies were in counties in Appalachia, the deep South, and across northern Texas, the researchers said.

Life expectancy rates also were lower in counties in the western U.S. with large Native American populations.

The highest county-level expectancies were in the northern plains and along the Pacific coast, they said.

When compared against an average of 10 nations with the best life expectancy (the “international frontier”), U.S. numbers were lower by 3.2 years — 13 years behind for men and 16 years behind for women, Murray and colleagues wrote.

When compared at the county level, life expectancies in 2000 ranged from nine years ahead of the international frontier to over 50 years behind for men and from one year ahead to 45 years behind for women.

By 2007, those figures were somewhat improved, ranging from 15 years ahead to over 50 years behind for men and 16 years ahead to over 50 years behind for women. These figures still lagged behind other countries overall.

“This means that some [U.S.] counties have a life expectancy today that nations with the best health outcomes had in 1957,” Murray said.

When focusing on African Americans, life expectancy in 2007 ranged from seven years ahead to over 50 behind the international frontier for men, and from eight years ahead to over 50 years behind for women.

Overall, more than 85% of U.S. counties have fallen further behind the international life expectancy frontier, the researchers said.

“Despite the fact that the U.S. spends more per capita than any other nation on health, eight out of every 10 counties are not keeping pace in terms of health outcomes. That’s a staggering statistic,” Murray said.

Robert Field, PhD, of Drexel University in Philadelphia, told MedPage Today and ABC News via email that the lag in life expectancy is likely attributable to “decades of increases in chronic diseases.”

He said improvements in life expectancy may stall if rates of obesity, and other lifestyle and environmental factors, continue to worsen.

“The diseases that these factors cause can take decades to develop, so we won’t see improvements in life expectancy for a while,” Field said. “However, the sooner we start, the sooner we will see the payoffs.”

The researchers noted that the study was limited because applying models to populations under 7,000 people was associated with increased error.

Still, they said several contributing factors are worth further investigation, including the environment, modifiable lifestyle behaviors, and performance of the U.S. healthcare system.

In particular, they said, it is worth assessing how much of the problem with life expectancy is attributable to risk factors such as smoking, hypertension, diabetes, obesity, cholesterol, diet, and alcohol.

They also called for further assessment of disparities in the U.S., not only by county, but also by racial and ethnic groups as well as by socioeconomic status.

Life Expectancy Of US Women Dropping

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