The United States is falling sharply behind in worldwide rankings of life expectancy, and shortcomings in the U.S. health care system may be to blame, scientists say.
Researchers studying the issue concluded that obesity, smoking, traffic accidents and homicide can’t account for the drop—“leading us to believe that failings in the U.S. health care system, such as costly specialized and fragmented care, are likely playing a large role,” said Peter Muennig of Columbia University, lead author of the study.
In the research, which appears in the Oct. 7 online issue of the journal Health Affairs, Muennig and co-author Sherry Glied of Columbia cite the growing lack of health insurance among Americans as a possible culprit.
The study looked at health spending, behavioral risk factors like obesity and smoking, and survival rates for men and women ages 45 and 65 in the U.S. and 12 other industrialized nations.
While the U.S. has achieved gains in 15-year survival rates decade by decade from 1975 to 2005, the researchers found that other countries enjoyed even greater gains. So the U.S. slipped in the ranking, even as per capita health care spending rose at more than twice the rate of the other countries.
Around 1950, the United States ranked 5th for life expectancy at birth for women and 10th for men among developed countries, according to research cited by Muennig and Glied. The most recent figures, from the CIA World Factbook, rank the United States 22nd among those same countries.
Muennig and Glied found similar trends in the 13 countries that they studied, though they only examined 15-year survival rates for people at age 45 and 65.
When they compared risk factors, they found very little difference in smoking habits between the U.S. and the comparison countries—in fact, U.S. smoking rates declined more quickly than most other countries.
And while people are more likely to be obese in the U.S. than elsewhere, this was also the case in 1975, when the U.S. was less far behind in life expectancy, the investigators noted. Moreover, they said, the percentage of obese people actually grew faster in most of the other countries between 1975 and 2005.
Homicide and traffic deaths, meanwhile, have accounted for a stable share of U.S. deaths over time, and can’t explain the drop in life-expectancy ranking, the scientists said.
The most likely remaining explanation is flaws in the health care system, said Muennig and Glied, pointing to the role of unregulated fee-for-service payments and high reliance on specialty care amid skyrocketing costs.
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