Why Americans die younger than those in other rich nations


Life expectancy in the US fell again for the second year in a row in 2016, meaning Americans’ lives are about three years shorter than those of people in 34 similarly wealthy countries, according to the latest data. 

Not so long ago, the reverse was true: Americans lived to be 73.9 in 1979, while people in the other countries in world’s highest wealth bracket, Organization for Economic Co-operation and Development (OECD), lived to be 72.3 on average.  

The flip, recent research suggests, can be traced to the trajectories of changes to healthcare policies in these rich nations.  

As other countries expand their social welfare programs to create more equal access, the US offers fewer benefits than any other economically-similar nation and the income inequality gap continues to grow. 

Life expectancy continued to increase for most of the decade, until drug overdose deaths began driving it back down last year, a trend that continued in 2016

Life expectancy continued to increase for most of the decade, until drug overdose deaths began driving it back down last year, a trend that continued in 2016

Life expectancy continued to increase for most of the decade, until drug overdose deaths began driving it back down last year, a trend that continued in 2016

Earlier this month, the Centers for Disease Control and Prevention (CDC) simultaneously released data on 2016 drug overdose deaths and life expectancy, and for good reason: overdose deaths emerged as the clear force driving Amercan lifespans down. 

But a look at the broader body of data indicates that drugs – and specifically the opioid epidemic – are far from the only force at work against American public health. 

The origin of our low life expectancy can be traced back in time from death, to old age, to death rates at a relatively young age.  

The US has the second highest gross domestic product (GDP) in the world following the European Union. 

Yet, according to a Commonwealth Fund study published in November, Americans not only have poorer health in old age than those in 10 other wealthy countries, but they neglect to seek medical attention for fear they can’t afford it. 

More than a third of Americans over 65 have more than one chronic health condition. 

In the same age group, 20 percent spend more than $2,000 on out of pocket health care expenditures annually, yet a quarter of seniors said they feel insecure in their ability to pay for even basic life necessities like food and shelter.

‘In the US, we are hearing loud and clear that many of our seniors, especially those who are sickest, need more support if they are going to get the health care they need and live healthy lives,’ said Commonwealth Fund president Dr David Blumenthal in a press release. 

Some analysts have suggested that the newly enacted tax reform will increase the federal budget deficit. 

When that happens, another law dictates that funding has to be siphoned away from other federal programs, like Medicare, which provides health insurance to 15 percent of Americans, most of whom are over 65. 

But American life expectancy takes major hits long before each generation hits Medicare age, according to a 2014 Harvard study.  

Its review of data from OECD countries found that American life expectancy lagged behind 17 other nations, and that deaths under the age of 50 were responsible for between 40 and 67 percent of that gap. 

‘The US life expectancy disadvantage originates at early age and extends across the life-course,’ the study authors wrote. 

Many of the young deaths in American are traceable to one of two epidemics – opioids and obesity – says Dr Marianne Fahs, a professor at the City University of New York Graduate School of Public Health and Heath Policy. 

She says that the opioid crisis mostly kills those between 20 and 50 years old, and that obesity is driving the surge of diabetes in this country, as well as raising risks for many inflammation-related diseases.  

The Harvard study found that women were particularly at risk of dying young during pregnancy, childbirth and the immediate aftermath. These types of deaths were more common in the US than nearly any other wealthy country in 2014.

The US remains the only OECD country that does not require employers to give women paid maternity leave, suggesting some women may have to return to work sooner in here than in other similar countries. 

What’s more, about two thirds of the Americans insured through Medicaid are women, and nearly 40 percent of low-income women of childbearing age rely on the program, according to research from the Kaiser Family Foundation. 

The tax bill also included a component that does away with the Affordable Care Act provision requiring those that don’t get insurance through employers to purchase it – often through Medicaid. 

Analysts have suggested that this could leave many women low-income women – who have disproportionately high early death rates – without access to health care.   

‘Do we as a nation want to live with such income inequality that ends up creating stress and racism and disease?’ asks Dr Fahs.  

‘Stress has been shown to affect life expectancy, and is associated with both racism and extreme poverty. We [in the US] are seeing that kind of disparity more than in other OECD countries,’ she says. 

 



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