Thoughts, essays, and writings on Liberty. Written by the heirs of Patrick Henry.

March 24, 2010

Life Expectancy — Due To Lack Of Healthcare Or Gluttony and Smoking?

by Brad Warbiany

A new study suggests that simply due to the results of blood pressure, obesity, blood glucose levels and smoking, American life expectancy is artificially low by 4.9 and 4.1 years for men and women, respectively (h/t Reason):

A new study led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington estimates that smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the U.S. by 4.9 years in men and 4.1 years in women. It is the first study to look at the effects of those four preventable risk factors on life expectancy in the whole nation.

Below is the number of years that would be gained in life expectancy in the U.S. if each individual risk factor was reduced to its optimal level:

  • Blood pressure: 1.5 years (men), 1.6 years (women)
  • Obesity (measured by body mass index): 1.3 years (men), 1.3 years (women)
  • Blood glucose: 0.5 years (men), 0.3 years (women)
  • Smoking: 2.5 years (men), 1.8 years (women)

This study in particular was largely looking at different subgroups within the US (ethnicities, geographies, etc) to determine relative differences in life expectancy due to those factors.

But I’d like to see a wider question answered. America typically ranks lower on life expectancy rankings than most European countries with generous welfare states and single-payer or heavily-socialized health care systems. This fact was largely heralded all during the debate over the health care bill. America is also considered to be gluttonous, unhealthy, lazy*, and fat compared to Europe; anecdotally, on my one trip to France, the only fat people I met spoke perfect English.

So I’d like to see a serious academic look at what drives the life-expectancy differences between America and Europe. I’ve heard in the past that non-healthcare death rates (automotive accidents and homicides) are significantly higher here, but is it also the case that we’re eating and smoking ourselves to death at a rate much higher than Europe?

And if so, does anyone think — as I do — that the healthcare bill will do little or nothing to affect this life expectancy gap?

* I personally think the “lazy” aspect is a misnomer with regards to this debate. While it affects obesity to be sure, one difference between here and Europe is that we don’t take 5-week vacations every summer and work 35-hour weeks. The stress and fast pace of the American workplace probably doesn’t help blood pressure very much.

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  • Let’s Be Free

    It’s funny how the life expectancy gap was dropped when it came down to debating brass tacks on the bill. In any event, a lot more liberty and a little earlier death ain’t necessarily a bad thing. I’m willing to live with the consequnces of my choices whether they be positive or negative.

  • Justin Bowen

    I gave a short speech on this subject for a communications class last year. During my research, I came across a number of studies and reports that led me to conclude that life expectancy statistics (of the sort that come from the CDC, CIA World Factbook, and the WHO) are quite possibly the worst possible way to gauge the quality of different health care systems.

    Problems with using [the commonly-cited] LE statistics to gauge the quality of health care systems:

    – They don’t exclude factors that are exogenous to health care (murders, auto fatalities, suicides, deaths from diseases that can’t be prevented and/or for which there are no known treatments, etc.);

    – They don’t exclude (or at least make allowances for) deaths from medical conditions that are entirely the result of personal behavioral choices (obesity-related, smoking-related, drinking-related, and other behavior-related health conditions);

    – The cause of death listed on death certificates is not reflective of the different factors that might have led to the death (a person who is healthy prior to getting into an auto accident and then develops chronic health conditions that eventually result in that person’s death is not likely to have his cause of death be listed as a car accident, even though that is the ultimate cause of death);

    – Deaths from factors that appear to be exogenous to health care might, in fact, be a result of the the health care system (how many auto fatalities are the result of poor distribution of emergency services (on the flip side, how many are the result of poor highway and road planning));

    – They don’t account for the cultural differences that lead to different rates of deaths for different causes (the US’s higher teen pregnancy rate, which leads to all kinds of bad consequences; the increased reliance upon automobiles instead of public transportation, which leads to all kinds of bad consequences; the US’s historically-higher [than European nations'] smoking rate (which has reversed over the decades), which didn’t really begin to manifest itself until the latter half of the 20th century (most people before the latter half of the 20th century didn’t live long enough for many cancers and other health conditions to become a problem (Alzheimer’s is becoming a more serious problem now for the same reason)); Americans’ increased exposure to plastics, pesticides, steroids (via meats), pharmaceutical drugs; the effects of racism and sexism);

    – They don’t account for the problems generated by the huge influx of immigrants from third-world countries (who bring with them all kinds of problems that lead to earlier deaths for themselves and their children).

    There are all kinds of problems – in addition to those listed above – with using LE statistics to gauge the quality of health care systems. Unfortunately, people keep simply keep repeating the same Michael Moore talking points because they know full-well that most people probably don’t have the slightest clue (or don’t care) about how statistics can be manipulated to fit an agenda.

    While researching, I did come across a couple studies (one of which was this one: http://www.bmj.com/cgi/content/full/327/7424/1129) that do take a stab at calculating life expectancies without the factors that are exogenous to health care included in the calculations so that a more accurate picture of the quality of different health care systems could be seen. What they found was that the life expectancy rankings of some countries changed dramatically while others only changed slightly. While these LE statistics are far better than the general ones that are used, they’re still very problematic (and the authors of the studies admit that) because of the many problems associated with determining why people died.

    All-in-all, I don’t expect these kinds of studies to have any impact on anything. Few people care and fewer people who have the means to make things happen want to see the government removed from the health care system.

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