During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes.
According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages—cancer and cardiovascular disease—available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable.
Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which—unlike randomized controlled trials—are subject to many biases.
Sign in to access your saved publications, downloads, and email
preferences.
Former MyNAP users: You'll need to reset your password on your first
login to MyAcademies. Click "Forgot password" below to receive a reset
link via email. Having trouble?
Visit our FAQ page
to contact support.
Members of the National Academy of Sciences, National Academy of
Engineering, or National Academy of Medicine should log in through their
respective Academy portals.
Register
Register
Download as a Guest
Download as a Guest
While logged on as a guest, you can download any of our free PDFs on
nationalacademies.org
. You will remain logged in until you close your browser.
Thank You
Thank You
Thank you for creating a MyAcademies account!
Enjoy free access to thousands of National Academies' publications, a
10% discount off every purchase, and build your personal library.
Forgot Password
Forgot Password
Enter the email address for your MyAcademies (formerly MyNAP) account to
receive password reset instructions.
Reset Requested
Reset Requested
We sent password reset instructions to
your email
. Follow the link in that email to create a new password. Didn't receive
it? Check your spam folder or
contact us
for assistance.
We sent a verification link to your email. Please check your inbox (and
spam folder) and follow the link to verify your email address. If you
did not receive the email, you can request a new verification link below