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New life-expectancy study hints at socioeconomic disparities

Dominika Osmolska Psy.D.'s picture

Despite the fact that the United States spends more per capita than any other nation on health care, its citizens continue to slip further behind in life expectancy. Christopher Murray, MD, of the University of Washington in Seattle, and colleagues reported in Population Health Metrics that the US life expectancy for women is 33rd while that for men is 36th. That’s right. About three dozen developed nations outperform the US in longevity. That’s a lot of countries.

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What this translates to is that life expectancy, on average, is 75.6 years for men, and 80.8 years for women. While the numbers look reasonable, even impressive on first glance, keep in mind that these are rough averages. The study demonstrated deep region-specific disparities. Some counties in certain regions of the country rate so poorly in life expectancy that their rank falls in line with some of the poorer developing nations. The lowest life expectancies were discovered to be in counties in Appalachia, the deep South, and across northern Texas, the researchers said. They dipped as low as 65.9 years for men and 73.5 for women.

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.

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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.

Granted, average US figures nestle in close proximity to Germany, Finland and Ireland, perfectly respectable countries with a high standard of living. However, the United States is able to achieve that average because some areas of the country are extremely long-lived, on par with places like Japan. The quiet subtext of the study underscores the deep socioeconomic disparities in existence here. These disparities are simply not seen in more egalitarian countries like Finland or Norway. The figures are all the more troubling when per-capita health care expenditures are taken into consideration. If the US spends more per capita on health care than any other country, where is the money going, when it is clearly not serving so many people?

Robert Field, PhD, of Drexel University in Philadelphia says 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.

His comment hints at the problem of the sedentary, car-dependent lifestyle led by so many Americans, This problem is exacerbated when combined with endemic poverty and nonexistent community development funds.