New York Times  [Printer-friendly version]
August 11, 2007

U.S. LIFE SPAN SHORTER

By The Associated Press

WASHINGTON (AP) -- Americans are living longer than ever, but not as
long as people in 41 other countries.

For decades, the United States has been slipping in international
rankings of life expectancy, as other countries improve health care,
nutrition and lifestyles.

Countries that surpass the U.S. include Japan and most of Europe, as
well as Jordan, Guam and the Cayman Islands.

"Something's wrong here when one of the richest countries in the
world, the one that spends the most on health care, is not able to
keep up with other countries," said Dr. Christopher Murray, head of
the Institute for Health Metrics and Evaluation at the University of
Washington.

A baby born in the United States in 2004 will live an average of 77.9
years. That life expectancy ranks 42nd, down from 11th two decades
earlier, according to international numbers provided by the Census
Bureau and domestic numbers from the National Center for Health
Statistics.

Andorra, a tiny country in the Pyrenees mountains between France and
Spain, had the longest life expectancy, at 83.5 years, according to
the Census Bureau. It was followed by Japan, Maucau, San Marino and
Singapore.

The shortest life expectancies were clustered in Sub-Saharan Africa, a
region that has been hit hard by an epidemic of HIV and AIDS, as well
as famine and civil strife. Swaziland has the shortest, at 34.1 years,
followed by Zambia, Angola, Liberia and Zimbabwe.

Researchers said several factors have contributed to the United States
falling behind other industrialized nations. A major one is that 45
million Americans lack health insurance, while Canada and many
European countries have universal health care, they say.

But "it's not as simple as saying we don't have national health
insurance," said Sam Harper, an epidemiologist at McGill University in
Montreal. "It's not that easy."

Among the other factors:

-- Adults in the United States have one of the highest obesity rates
in the world. Nearly a third of U.S. adults 20 years and older are
obese, while about two-thirds are overweight, according to the
National Center for Health Statistics.

"The U.S. has the resources that allow people to get fat and lazy,"
said Paul Terry, an assistant professor of epidemiology at Emory
University in Atlanta. "We have the luxury of choosing a bad lifestyle
as opposed to having one imposed on us by hard times."

-- Racial disparities. Black Americans have an average life expectancy
of 73.3 years, five years shorter than white Americans.

Black American males have a life expectancy of 69.8 years, slightly
longer than the averages for Iran and Syria and slightly shorter than
in Nicaragua and Morocco.

-- A relatively high percentage of babies born in the U.S. die before
their first birthday, compared with other industrialized nations.

Forty countries, including Cuba, Taiwan and most of Europe had lower
infant mortality rates than the U.S. in 2004. The U.S. rate was 6.8
deaths for every 1,000 live births. It was 13.7 for Black Americans,
the same as Saudi Arabia.

"It really reflects the social conditions in which African American
women grow up and have children," said Dr. Marie C. McCormick,
professor of maternal and child health at the Harvard School of Public
Health. "We haven't done anything to eliminate those disparities."

Another reason for the U.S. drop in the ranking is that the Census
Bureau now tracks life expectancy for a lot more countries -- 222 in
2004 -- than it did in the 1980s. However, that does not explain why
so many countries entered the rankings with longer life expectancies
than the United States.

Murray, from the University of Washington, said improved access to
health insurance could increase life expectancy. But, he predicted,
the U.S. won't move up in the world rankings as long as the health
care debate is limited to insurance.

Policymakers also should focus on ways to reduce cancer, heart disease
and lung disease, said Murray. He advocates stepped-up efforts to
reduce tobacco use, control blood pressure, reduce cholesterol and
regulate blood sugar.

"Even if we focused only on those four things, we would go along way
toward improving health care in the United States," Murray said.

"The starting point is the recognition that the U.S. does not have the
best health care system. There are still an awful lot of people who
think it does."