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On Life Expectancy in America

This letter in today’s Washington Post gives some perspective on life expectancy in the U.S.:

The Sept. 23 front-page article “For French, U.S. Health Debate Hard to Imagine” cited the longer life expectancy of the French compared with Americans as an indicator of superior health-care quality.

Broad population metrics, such as life expectancy, are affected by behavior. Our lower life expectancy is not attributable to poor U.S. health care. It stems from the higher U.S. rate of homicides and the death rate from transportation accidents.

In their book “The Business of Health,” Robert Ohsfeldt and John Schneider explain that the U.S. homicide rate of 7.3 per 100,000 population is eight times the rate in France. The U.S. death rate from transportation accidents is also higher than in other countries. When life expectancy data are adjusted for differences in homicide and transportation death rates, U.S. life expectancy is slightly higher than for all other countries.

U.S. health-care expenditures per capita are much higher than in France, but that spending results in access to high-quality care and the latest medical advances. In terms of quality indicators, such as five-year age-adjusted survival rates for almost all cancers, the United States has significantly higher survival rates than France.