One of the great victories of the 20th century is that humanity became much smarter about health. We figured out refrigeration, immunization, and that smoking isn't actually good for you, and we began living longer.
In 2006, the average life expectancy at birth was 75 years for American men and 80 years for women, compared with just 48 years for men and 51 years for women in 1900.
But new research shows that while life span has been on a positive overall trajectory for mankind, it's been on a not-so-positive trajectory for the U.S. in particular: Americans' life expectancies might be increasing, but those of other nations are increasing much faster, particularly among women. From 1980 to 2007, for example, the life spans of 50-year-old women in the U.S. had increased by about 2.5 years. But in Japan and Italy, it had increased by 6.4 years and 5.2 years, respectively.
And now, researchers are scrambling to understand why it is that American women are dying sooner than than those in other first-world countries.
Using data from the Human Mortality Database, a research project by the University of California at Berkeley and the Max Planck Institute for Demographic Research in Germany that calculates death rates, a panel of experts convened by the National Research Council examined the changes in life expectancy across a variety of countries. They published their research in a report published by the National Academies Press in 2011 (and flagged by the study's director, Laudan Aron at the Urban Institute this week.)
Their findings throw cold water on the good news that Americans' lives have been getting longer. Life expectancy at birth, they found, "is rising in absolute terms but falling relative to other countries."*
Here's the chart for men, with the U.S. shown as red dots that are gradually slipping in rank among their peers:
It's an even more dramatic story for women:
Then the authors went even deeper, looking at the probability of someone from a given country living to age 50. American men, they found, have historically ranked low among all countries when it comes to their likelihood of making it to old age. But what they found for women was even worse news: "Over the past 10 years, only the United States has failed to make significant improvements in the probability of survival up to age 50 for women," they wrote.
You can see American women (the red dots) trailing further and further from the pack each year:
"In 1980, the United States was ranked 11th on this measure; by 1990 it had fallen to 13th and by 2006 had dropped to 21st," they wrote.
The findings dovetail with other recent research that shows that in half of U.S. counties, life expectancy is getting worse: Today's women are not living as long as their mothers once did, as Grace Wyler described in The Atlantic last year.
Some public-health researchers think more and better healthcare is the answer. Longevity in the Netherlands also stagnated in the 1980s, for example, but skyrocketed from 2002 to 2008 after the country began dumping money into the healthcare system.
Others think the cause is poverty, and underpinning that, inadequate education. Less-educated women are less likely to have jobs, and therefore they may not only struggle to afford doctors' visits and healthier lifestyles, but also may lack the strong social networks and sense of purpose that have shown to reduce mortality. At the Metrotrends Urban Institute blog, Aron writes, "Our preliminary analyses suggest that increases in mortality are especially pronounced among white women of reproductive age, not a group we generally think of as being disadvantaged." A 2012 Health Affairs study found that this drop in longevity has been especially dramatic for white high-school dropouts, who are now expected to die five years younger than the previous generation.
Past research has shown that Americans without high-school diplomas are at greater risk for nearly every kind of health issue, and while racial differences in life span persist even among college graduates, better-educated people of every race tend to live longer.
The debate over whether and how poverty causes poor health is endless, but the speed at which the U.S. is losing ground in women's health is worrisome. Sure, less-educated women have less money for healthy food and gym memberships, but those behaviors might be symptoms of larger failings in low-wage jobs, the healthcare system, and public policy.
*The countries included in the analysis were Australia, Austria, Belgium, Canada, Denmark, Finland, France, Iceland, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, the United Kingdom, the United States, and West Germany.