Despite being home to some of the world’s most dangerous animals, Australia has been the English-speaking nation with the highest life expectancy for the past three decades. As for other high-income English-speaking countries, the Irish saw the biggest increases in life expectancy, while Americans have been in last place since the early 1990s, according to a team of social scientists led by a Penn State researcher.
The team published their findings today (August 13) in the journal BMJ Open.
“One lesson we Americans can learn about life expectancy by looking at comparable countries is where the frontier of best performance lies,” said Jessica Ho, an assistant professor of sociology and demography at Penn State and senior author on the paper. “Yes, we’re doing poorly, but this study shows what we can aspire to. We know these improvements in life expectancy are actually achievable because other large countries have already done it.”
Researchers compared life expectancy in the United States, Canada, Ireland, the United Kingdom, Australia and New Zealand using data from the Human Mortality Database and the World Health Organization Mortality Database from 1990 to 2019. They analyzed the data by sex, age, and 18 individual and complete cause-of-death categories, including cancers, drug- and alcohol-related deaths, firearms, and motor vehicle collisions.
They also examined life expectancy within each country to identify geographic inequalities in life expectancy by region.
Researchers found that Australians had the longest life expectancy at birth over the study period, with women living nearly 4 years longer and men 5 years longer than their American counterparts. Irish people showed the largest increases in life expectancy, with men’s life expectancy increasing by about 8 years and women’s by more than 6.5 years. Americans had the shortest life expectancy at birth, with women living an average of nearly 81.5 years and men an average of nearly 76.5 years in 2019.
According to the researchers, the United States also showed some of the largest geographic disparities in life expectancy compared to any other country. Women and men in California and Hawaii had some of the highest life expectancies at birth, averaging 83 to 83.9 years for women and 77.5 to 78.4 years for men. States in the American Southeast had some of the lowest life expectancies at birth of all subnational regions studied, averaging 72.6 to 79.9 years for women and 69.3 to 74.4 years for men.
“One of the main factors explaining why American longevity is so much lower than in other high-income countries is that our young people die at higher rates from largely preventable causes of death, such as drug overdoses, car accidents and homicide,” said Ho, who is also an associate at Penn State’s Social Science Research Institute.
In middle age (ages 45 to 64), some of these causes continue, such as high rates of drug- and alcohol-related mortality, Ho explained, adding that Americans are also seeing higher rates of mortality from cardiovascular disease.
“Some of the latter may be related to sedentary lifestyle, high rates of obesity, unhealthy diet, stress and smoking history,” he said. “These unhealthy behavior patterns are likely putting Americans at a disadvantage in terms of health and vitality.”
Australia offers the United States a model for improving its life expectancy, Ho added. Like the United States, Australia is large in terms of land area and has a comparable history of personal vehicle ownership. The two countries have some cultural similarities, including greater historical use of firearms. However, Australia implemented a number of policies in recent decades, including gun law reforms that helped catapult it to the top of the life expectancy rankings.
“What the study shows is that a country like Australia far outpaces the United States and has managed to control young adult mortality,” Ho said. “It has really low levels of gun deaths and homicides, lower levels of drug and alcohol use, and better performance on chronic diseases, pointing to factors related to lifestyle, health behaviors and health care performance.”
Ho said policies such as investing in public transportation infrastructure, adding more roundabouts and having fewer large cars on the road could reduce traffic deaths in the United States. Increased support for programs designed to reduce drug dependence and reduce barriers to drug overdose treatment and prevention could help reduce drug-related mortality, he said. And having a strong combination of public health efforts, access to health care and community interventions to encourage healthier lifestyles and the use of preventive medicine could reduce cardiovascular disease mortality, he added.
“Australia is a model for how Americans can do better and achieve not only longer life expectancy but also less geographic inequality in life expectancy,” Ho said.
Rachel Wilkie, a doctoral student at the University of Southern California, also contributed to this research. The National Institute on Aging at the National Institutes of Health supported this work.