U.S.
lags behind other countries in life expectancy
By STEPHEN OHLEMACHER
Associated Press Writer
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, Macau, 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."
__
On
The Net:
Census
Bureau: http://www.census.gov/ipc/www/idb/
National
Center for Health Statistics: http://www.cdc.gov/nchs/fastats/lifexpec.htm
