Guns, drugs and motor vehicle crashes account for half of the life-expectancy gap between men in the United States and other high-income countries, according to a study published Tuesday in the Journal of the American Medical Association.
For years, it's been known that U.S. life expectancy trails that of people in other high-income countries, despite the fact that we spend more on health care per person than anyone else in the world. American men die at 76 years of age and American women at 81, about 2.2 years earlier than their counterparts in a dozen other high-income countries, according to 2012 data. Efforts to understand why have often focused on chronic disease, obesity, smoking or access to health care -- traditional health issues that might trim years off Americans' lives compared with others.
But Andrew Fenelon, a researcher with the National Center for Health Statistics, decided to look at the role that factors other than chronic diseases could play in the disparity, reasoning that a person whose life is cut short in their 30s from a drug overdose or a gunshot wound would have a bigger effect on average life expectancy than someone who dies in their early 70s of a heart attack.
Fenelon examined what would happen if men around the world simply stopped dying of the three largest non-disease causes of death -- drug overdoses, gun violence and motor vehicle accidents. If those causes of death play a small role in the life expectancy gap, the disparity should stay pretty much the same without them. But Fenelon found that life expectancy would rise more in the United States than in other countries -- by a full year -- erasing about half of the disadvantage that American men face.
"The really surprising thing isn’t that the U.S. has higher death rates from these causes, but how substantial the contribution is," Fenelon said. "I expected it to make a contribution, maybe 10 percent of the gap. But half the gap for men is sort of astounding."
The largest portion of the difference was due to gun violence, which accounted for more than five months of the shorter life expectancy, followed by drug poisonings (including drug overdoses) and motor vehicle deaths.
Those causes of death accounted for a smaller amount of the difference in life expectancy for women -- about five months of the 2.2-year gap was explained by guns, drugs or motor vehicles. About 2 ½ months of the gap came from drug overdoses, with smaller contributions from motor vehicle crashes and gun deaths.
The study suggests that increasing life expectancy might not be just about addressing traditional health spending but about forming policies that reduce injuries. Fenelon now plans to drill deeper into the data to try to detect the socioeconomic differences between Americans who die in each of these ways.