Australia offers lessons for increasing American life expectancy

Despite being home to some of the most dangerous animals in the world, Australia has led the English-speaking world in life expectancy over the past thirty years. Among other high-income English-speaking countries, the Irish saw the biggest increase in life expectancy, while Americans ranked last since the early 1990s, according to a team of social scientists led by a Penn State researcher.

The team has published their findings in the news BMJ opened.

“One lesson we Americans can learn about life expectancy by looking at comparable countries is where the line of best performance lies,” said Jessica Ho, associate professor of sociology and demography at Penn State and senior author of the paper. “Yes, we are doing poorly, but this research shows what we can aim for. We know that this increase in life expectancy is actually achievable because other major countries have already done this.”

The 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 between 1990 and 2019. They analyzed the data by gender , age and age. 18 individual and comprehensive categories of causes of death, including cancer, drug and alcohol related deaths, firearms and motor vehicle collisions.

They also examined life expectancy within each country to identify geographic disparities in life expectancy by region.

The researchers found that Australians had the longest life expectancy at birth during the study period, with women living almost four years longer and men living five years longer than their American counterparts. The Irish showed the largest increase in life expectancy, with men’s lifespans increasing by about eight years and women’s by more than 6.5 years. Americans had the shortest life expectancy at birth: women lived to an average of almost 81.5 years in 2019 and men lived to an average of almost 76.5 years.

According to the researchers, the United States also showed some of the largest geographic disparities in life expectancy compared to the other countries. Women and men in California and Hawaii had some of the highest life expectancies at birth: women averaged 83 to 83.9 years and men averaged 77.5 to 78.4 years. States in the American Southeast had some of the lowest life expectancies at birth of all subnational regions surveyed, with women averaging 72.6 to 79.9 years and men averaging 69.3 to 74.4 years.

“One of the main reasons why the American lifespan is so much shorter than in other high-income countries is that our younger people are dying more often from largely preventable causes such as drug overdoses, car accidents and homicide,” Ho said. is also an associate of Penn State’s Social Science Research Institute.

In middle age (the age range from 45 to 64), some of these causes persist, such as the high death rates from drug and alcohol-related deaths, Ho explained, adding that Americans are also seeing higher death rates from cardiovascular disease.

“Some of the latter may be related to a sedentary lifestyle, high rates of obesity, unhealthy diet, stress and a history of smoking,” she said. “It is likely that these patterns of unhealthy behavior are putting Americans at a disadvantage in terms of their health and vitality.”

Australia offers the US a model to improve life expectancy, Ho added. Like the US, Australia is large in land area and has a similar history of personal car ownership. The two countries have some cultural similarities, including historically greater use of firearms. However, Australia has implemented a number of policies in recent decades, including gun law reforms, that have propelled the country to the top of the life expectancy rankings.

“What the study shows is that a comparable country like Australia is far outperforming the US and has been able to control young adult mortality,” Ho said. “The country has very low rates of gun deaths and homicides, lower drug and alcohol use, and better performance on chronic diseases, the latter of which points to lifestyle factors, health behaviors, and healthcare performance.”

Ho said policies such as investing in public transportation infrastructure, adding more roundabouts and fewer large cars on the road could reduce traffic fatalities in the United States. Increased support for programs designed to reduce drug addiction and reduce barriers to overdose treatment and prevention could help reduce drug-related deaths, she said. And 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 mortality from cardiovascular disease, she added.

“Australia is a model for how Americans can do better and achieve not only higher life expectancy, but also lower geographic inequality in life expectancy,” Ho said.

Rachel Wilkie, a doctoral candidate at the University of Southern California, also contributed to this research.