Not so in the United States. “Notable among poor-performing countries is the USA,” the researchers wrote, “whose life expectancy at birth is already lower than most other high-income countries, and is projected to fall further behind, such that its 2030 life expectancy at birth might be similar to the Czech Republic for men, and Croatia and Mexico for women.”
Americans will gain only a couple of years of life expectancy between 2010 and 2030, the study predicted, keeping life spans in the early 80s for women and late 70s for men. The study projects a life expectancy of 83.3 for women in the United States and 79.5 for men in 2030, up from 81.2 for women and 76.5 for men in 2010.
The reasons for the United States' lag are well known. It has the highest infant and maternal mortality rates of any of the countries in the study, and the highest obesity rate. It is the only one without universal health insurance coverage and has the “largest share of unmet health-care needs due to financial costs,” the researchers wrote.
Tellingly, the United States was the first high-income country to see a halt to the pattern of increasing height in adulthood, a reliable indicator of improving public health, according to Majid Ezzati, a professor of public health at Imperial College London, who led the research team.
Some Americans get a “bad start to life in nutrition and education” and suffer “high rates of homicide,” Ezzati said. “And then lack of universal insurance. Some people probably get diagnosed too little and too late.
“If you have good insurance and you live on the East Coast and the West Coast, you probably get the best health care in the world,” he added. “It’s not the technical quality of it, which is superb. It's the spread of it.” In many parts of the country, top health care simply isn't available.
In December, the U.S. government reported that life expectancy had declined in 2015 for the first time since 1993 as death rates for eight of the 10 leading causes of death, including heart disease, rose.
In 2015, research by Princeton University economists Anne Case and Angus Deaton brought worldwide attention to the unexpected jump in mortality rates among white middle-aged Americans. That trend was blamed on what are sometimes called diseases of despair: overdoses, alcoholism and suicide.
Demographer Sam Preston, a sociologist at the University of Pennsylvania who has conducted numerous studies on this subject, cited the prescription opioid epidemic, homicides, obesity and the lingering effects of smoking — the latter now declining among many groups in the United States — as primary causes for the poor showing.
“It's very worrisome,” said Preston, who was not involved in the new research. “The U.S. is at the bottom of the barrel among [Organization for Economic Cooperation and Development] countries, and its relative position is worsening, not improving.”
The results released Tuesday echo some earlier analyses, including a report from the United Nations. Ezzati's group approached the task in a somewhat different way, running the numbers through 21 statistical models, combining the results and attaching probabilities to the conclusions.
Like other researchers, they found that women's advantage in life expectancy over men will continue to narrow, the result of more injuries, lung cancer and cardiovascular disease among women. In most places, gains in life span will come more from postponing death among older people, rather than eliminating killers of the young and middle-aged, such as infections. The analysis does not link specific causes of death to various countries' life expectancies.
Nations such as China, Russia and India were not included, because they did not have adequate historical data, Ezzati said.
In contrast to the United States, South Korea “has a remarkable investment in early childhood nutrition,” has been taking advantage of medical advances and technology across its population and has some of the world's lowest obesity and hypertension rates, Ezzati said. The researchers said there is a 57 percent chance that the nation's women will live an average of more than 90 years by 2030 and a better than 95 percent chance that its men will survive beyond 80 (along with men in Australia and Switzerland).
“They seem to be getting a lot of things right at the same time, and getting them right for almost everyone,” he said.