USA Population Life Spans: Why Americans Die So Much – Opinion

U.S. life spans, which have fallen behind those in Europe, are telling us something important about American society. 

By Derek Thompson | The Atlantic  

AMERICA HAS A DEATH PROBLEM. 

NO, I’m not just talking about the past year and a half, during which COVID-19 deaths per capita in the United States outpaced those in similarly rich countries, such as Canada, Japan, and France.

I’m NOT just talking about the past decade, during which drug overdoses skyrocketed in the U.S., creating a social epidemic of what are often called “deaths of despair”.     

I’M TALKING ABOUT THE PAST 30 YEARS. Before the 1990s, average life expectancy in the U.S. was not much different than it was in Germany, the United Kingdom, or France. But since the 1990s, American life spans started significantly falling behind those in similarly wealthy European countries.

According to a new working paper released by the National Bureau of Economic Research, Americans now die earlier than their European counterparts, no matter what age you’re looking at. Compared with Europeans, American babies are more likely to die before they turn 5, American teens are more likely to die before they turn 20, and American adults are more likely to die before they turn 65.

AT EVERY AGE, LIVING IN THE UNITED STATES CARRIES A HIGHER RISK OF MORTALITY. This is America’s unsung death penalty, and it adds up. Average life expectancy surged above 80 years old in just about every Western European country in the 2010s, including Portugal, Spain, France, Italy, Germany, the U.K., Denmark, and Switzerland. By contrast, in the U.S., the average life span has never exceeded 79 — AND NOW IT HAS JUST TAKEN A HISTORIC TUMBLE. 

Why is the U.S. so much worse than other developed countries at performing the most basic function of civilization: KEEPING PEOPLE ALIVE? 

Hannes Schwandt, a Northwestern University professor who co-wrote the paper, told me: “It’s important that we collect this data, so that people can ask the right questions, but the data alone does not tell us what the cause of this longevity gap is. Europe has better life outcomes than the United States across the board, for white and Black people, in high-poverty areas and low-poverty areas,”

Finding a straightforward explanation is hard, because there are so many differences between life in the U.S. and Europe. Americans are more likely to kill one another with guns, in large part because Americans have more guns than residents of other countries do. Americans die more from car accidents, not because our fatality rate per mile driven is unusually high but because we simply drive so much more than people in other countries. Americans also have higher rates of death from infectious disease and pregnancy complications. BUT WHAT HAS THAT GOT TO DO WITH GUNS, OR COMMUTING? 

By collecting data on American life spans by ethnicity and by income at the county level — and by comparing them with those of European countries, locality by locality — Schwandt and the other researchers made three important findings.

FIRST, Europe’s mortality rates are shockingly similar between rich and poor communities. Residents of the poorest parts of France live about as long as people in the rich areas around Paris do. “Health improvements among infants, children, and youth have been disseminated within European countries in a way that includes even the poorest areas,” the paper’s authors write.

But in the U.S., which has the highest poverty and inequality of just about any country in the Organization for Economic Cooperation and Development, where you live is much more likely to determine when you’ll die. Infants in the U.S. are considerably more likely to die in the poorest counties than in the richest counties, and this is true for both Black and white babies. Black teenagers in the poorest U.S. areas are roughly twice as likely to die before they turn 20, compared with those in the richest U.S. counties. In Europe, by contrast, the mortality rate for teenagers in the richest and poorest areas is exactly the same — 12 deaths per 100,000. IN AMERICA, THE PROBLEM IS NOT JUST THAT POVERTY IS HIGHER; IT’S THAT THE EFFECT OF POVERTY ON LONGEVITY IS ALSO GREATER.   

SECOND, even rich Europeans are outliving rich Americans. “There is an American view that egalitarian societies have more equality, but it’s all one big mediocre middle, whereas the best outcomes in the U.S. are the best outcomes in the world,” Schwandt said. But this just doesn’t seem to be the case for longevity. White Americans living in the richest 5 percent of counties still die earlier than Europeans in similarly low-poverty areas; life spans for Black Americans were shorter still. The study did not examine other American racial groups. “It says something negative about the overall health system of the United States that even after we grouped counties by poverty and looked at the richest 10th percentile, and even the richest fifth percentile, we still saw this longevity gap between Americans and Europeans,” he added. In fact, Europeans in extremely impoverished areas seem to live longer than Black or white Americans in the richest 10 percent of counties.  

THIRD, Americans have a lot to learn about a surprising success story in U.S. longevity. In the three decades before COVID-19, average life spans for Black Americans surged, in rich and poor areas and across all ages. As a result, the Black-white life-expectancy gap decreased by almost half, from seven years to 3.6 years. “This is a really important story that we ought to move to the forefront of public debate,” Schwandt said. “What happened here? And how do we continue this improvement and learn from it?” 

ONE EXPLANATION BEGINS WITH SCIENCE AND TECHNOLOGY. Researchers found that nothing played bigger roles in reducing mortality than improvements in treating cardiovascular disease and cancer. New drugs and therapies for high cholesterol, high blood pressure, and various treatable cancers are adding years or decades to the lives of millions of Americans of all ethnicities.

Policy also plays a starring role. Schwandt credits the Medicaid expansion in the 1990s, which covered pregnant women and children and likely improved Black Americans’ access to medical treatments. He cites the expansion of the earned-income tax credit and other financial assistance, which have gradually reduced poverty. He also points to reductions in air pollution. “Black Americans have been more likely than white Americans to live in more-polluted areas,” he said. But air pollution has declined more than 70 percent since the 1970s, according to the EPA, and most of that decline happened during the 30-year period of this mortality research.

Other factors that have reduced the Black-white life-expectancy gap include the increase in deaths of despair, which disproportionately kill white Americans, and — up until 2018 — a decline in homicides, which disproportionately kill Black Americans. The recent rise in homicides, along with the disproportionate number of non-white Americans who have died of COVID-19, will likely reduce Black life spans.

We are a long way from a complete understanding of the American mortality penalty. But these three facts — the superior outcomes of European countries with lower poverty and universal insurance, the equality of European life spans between rich and poor areas, and the decline of the Black-white longevity gap in America coinciding with greater insurance protection and anti-poverty spending — all point to the same conclusion: Our lives and our life spans are more interconnected than you might think. 

For decades, U.S. politicians on the right have resisted calls for income redistribution and universal insurance under the theory that inequality was a fair price to pay for freedom. BUT NOW WE KNOW THAT THE PRICE OF INEQUALITY IS PAID IN EARLY DEATH — FOR AMERICANS OF ALL RACES, AGES, AND INCOME LEVELS. With or without a pandemic, when it comes to keeping Americans alive, we really are all in this together.  

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  • Clyde Duncan  On 09/19/2021 at 6:57 pm

    What Is Causing The Longevity Inequality?

    Steve Vernon | FORBES

    YOU HAVE HEARD ABOUT WEALTH AND INCOME INEQUALITIES IN THE U.S. Now add to that the “Longevity Inequality”.

    In recent years, a substantial body of evidence has emerged, showing there is a growing inequality in expected U.S. lifespans that have been attributed to the differences in wealth, income, and education between various demographic groups.

    For example, one study, led by respected Harvard economist Raj Chetty, found that the richest 1% of the U.S. population lived, on average, 15 years longer than the poorest 1%.

    Another study reports that in 2008, U.S. white men with 16 years or more of education lived, on average, 14 years longer than U.S. black men with less than 12 years of education.

    The comparable gap for women in the same groups was 10 years. THESE GAPS HAVE ONLY BEEN GROWING LARGER SINCE 2008.

    When studying the potential causes of these inequalities, it is instructive to understand how we’ve dramatically increased lifespans in the past 100 years. Let’s take a look.

    ONE OF HUMANKIND’S GREATEST ACHIEVEMENTS

    Comparing average life expectancy from the beginning to the end of the 20th century, the U.S. added about 30 years to the average expected lifespan of its citizens. For example, according to statistics published by the U.S. Centers for Disease Control and Prevention, people born in 1900 could expect to live 47.3 years on average.

    Fast-forward to 2000: People born in that year can expect to live 76.8 years on average. UNDOUBTEDLY, THIS IS ONE OF HUMANKIND’S GREATEST ACHIEVEMENTS.

    This significant accomplishment is the result of advantages that accrued widely to most of the population, regardless of their circumstances, including:

    Efficient waste disposal

    Availability of clean water

    Vaccinations against deadly, infectious diseases

    Abundant food supplies, which helped reduce food insecurity

    Widespread use of electricity and refrigeration, which help keep food safe

    Reduction in deaths due to violence and war

    Expansion in public school systems, leading to a more educated citizenry

    Improvements in transportation, including cars, highways, and public transportation, and improvements in communication, including telephones, television, and the Internet

    It is important to realize that the environment people lived in automatically provided these advantages — people didn’t need to make many choices to reap these advantages that improved their health and longevity. As you’ll see, however, that’s not necessarily the case if we want to continue improving life expectancies today.

    POTENTIAL CAUSES OF LIFESPAN INEQUALITIES

    In the 21st century, it’s becoming apparent that future improvements in expected lifespans will rely on the ability of individuals to make choices that help them navigate a complex environment with features that are both supportive and unsupportive of increased longevity.

    And often, people with lower education and financial means are more vulnerable to the features of the environment that aren’t supportive of increased longevity.

    For example, the first study mentioned above found that THE POOREST AMERICANS WERE MORE LIKELY TO SMOKE, DRINK, and BE OVERWEIGHT COMPARED TO THEIR WEALTHIER COUNTERPARTS.

    SPECIFICALLY, HERE ARE THE POTENTIAL FACTORS IN OUR CURRENT ENVIRONMENT THAT AREN’T SUPPORTIVE OF INCREASED LONGEVITY:

    UNEQUAL ACCESS TO HEALTH CARE AND HEALTH INSURANCE

    PERSUASIVE AND WIDESPREAD ADVERTISING OF UNHEALTHY, PROCESSED FOODS and BEVERAGES WITH HIGH AMOUNTS OF SUGAR AND SODIUM

    UNEQUAL ACCESS TO HEALTHY FOOD

    INCREASED VULNERABILITY TO VIOLENCE AND CRIME AMONG INDIVIDUALS OF LOWER ECONOMIC STATUS

    REDUCED EXERCISE AND MOVEMENT, IRONICALLY PARTIALLY ATTRIBUTED TO MORE EFFICIENT TRANSPORTATION SYSTEMS

    In 2016, the Stanford Center on Longevity published its landmark “Sightlines” study, which summarized compelling scientific evidence that living long and living well is most realistic for those who adopt healthy behaviors, are financially secure, and are socially engaged.

    The study investigated how well Americans did and are doing in each of these three areas over historical time and identified 26 factors that are associated with health, financial security, and social engagement.

    STANFORD

    THE SIGHTLINES PROJECT – Stanford Center on Longevity

    The Sightlines study specifically measured how Americans of all ages are doing with respect to healthy behaviors, financial security, and social engagement. It examined differences due to race, education, and income. The study found that:

    Non-whites are more likely to live in poverty or near poverty, have less access to health insurance and health care, are less likely to participate in retirement savings plans, and realize lower educational achievement.

    Financial insecurity is associated with increased susceptibility to illness and shorter lifespans.

    Similar to the first study mentioned above, the Sightlines study found that obesity levels and the prevalence of smoking are both higher in people who have lower levels of education and in ethnic minorities.

    The COVID-19 pandemic has highlighted these challenges, since the hardest-hit groups have been the ones more likely to have below-average income and wealth, and are more likely to be NON-WHITE.

    In 2021, the Stanford Center on Longevity will update its 2016 report and drill down further on the practices recommended for all Americans to live long, healthy, financially secure lives.

    It is becoming apparent that to continue increasing lifespans for all groups of Americans, we’ll need to tackle the negative influences of poverty and the unequal access to health care and healthy foods that some citizens have, and we’ll need to investigate interventions that can encourage healthier choices.

    We have our work cut out for us!

  • wally n  On 09/19/2021 at 7:44 pm

    COMMUNISM is the answer????? small steps???? small steps???
    slip sliding away……

  • Clyde Duncan  On 09/20/2021 at 12:21 am

    Ramnarine wrote:

    They live fast and die young!!

  • wic  On 09/25/2021 at 12:33 am

    Life in the US is generally more stressful than Europe where many people can make long journeys to and from home to work. From the information shared above, it also seems as if more education is a key factor in determining longevity. Eating less (you should see how some people gobble down large amounts of food at the All You Can Eat places in many states)
    To avoid stressing one’s organs and becoming over-weight as they get older; visiting a doctor for an annual checkup before one is at death’s door should also identify a potential problem and with the foregoing help to extend life. All over the world, higher the levels of education result in better jobs, income, quality of life and a longer one barring accident or mutant gene inherited. At age 81, I would suggest also that regular exercise and vitamin supplements also help. The moral of the story is: Stay in School to make it.

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