![]() One could write an entire book on what this chart shows us. 1 Why is life expectancy shorter in the US? With the pandemic of 2020 – which already caused more than 225,000 deaths due to COVID-19 and 300,000 excess deaths – it is unfortunately already certain that the decline of life expectancy in the US will continue this year. While life expectancy for people around the world continued to increase, the life expectancy of Americans has declined since 2014. But this extremely positive trend has come to an end. The US has achieved very substantial progress in health outcomes over the last 140 years: in 1880 the life expectancy of Americans was 39 years, since then it has doubled. In the US health spending per capita is up to four times higher, yet life expectancy is lower than in all of these countries. The unequal development over recent decades led to an inequality between the US and other rich countries. The consequence of these two exceptional developments is that the US followed the much-flatter trajectory that the chart shows. increased much more rapidly, particularly since the mid-1980s. At the same time, health spending in the U.S. In the 1970s the US didn’t stand out at all, it does so now because life expectancy increased much more slowly than in other countries. ![]() The arrows start in 1970 and connect the annual data points for both metrics, showing the change over time. The chart here doesn’t just show the latest data points, but how life expectancy and health spending have changed during the last five decades. The US clearly stands out as the chart shows: Americans spend far more on health than any other country in the world, yet the life expectancy of the American population is shorter than in other rich countries that spend far less. Life expectancy and health expenditure over time, the US is an outlier In addition to this, deeper poverty and less access to healthcare mean Americans at lower incomes die at a younger age than poor people in other rich countries. The short summary of what I will discuss below is that Americans suffer higher death rates from smoking, obesity, homicides, opioid overdoses, suicides, road accidents, and infant deaths. Why do Americans have a lower life expectancy than people in other rich countries, despite paying so much more for health care?
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