Americans are living longer than ever before, but compared with the healthiest nations in the world, their life expectancy is shorter and falling behind. Even Californians, who fare better than the national average, are living shorter lives than their peers around the world.
The average American man in 2007 could expect to live 75.6 years, and a woman 80.8 years, according to research released today by the Institute for Health Metrics and Evaluation at the University of Washington. But between 2000 and 2007, more than 80 percent of counties in the United States fell in standing against the "international frontier," the average of the 10 nations with the best life expectancy in the world.
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"The progress has been less than what those 10 countries have been able to achieve," said Dr. Christopher Murray, director of the institute and co-author of the study. "We're falling behind what's medically possible."
The United States ranked 37th in the world for life expectancy in 2007. Throughout the country, women fared worse than men, and blacks could expect to live the shortest lives. The study, published in the journal Population Health Metrics, attributes the gap between the U.S. and other nations to preventable risk factors – namely tobacco use, obesity and high blood pressure.
"We put less money and attention into both public health programs and primary care than some other health systems," Murray said. "As a nation or as a community, every reduction in tobacco consumption and reduction in blood pressure is going to contribute to and enhance life expectancy."
The findings track with trends in tobacco consumption and obesity. For example, since 1990, adult smoking rates in California have dropped among both men and women in all race and ethnic groups, except for black women [PDF], according to the California Department of Public Health. The prevalence of obesity is also higher among women and blacks.
Still, Californians live longer than the average American – 77.4 years for men and 82.2 years for women. Among states, California men have the seventh-highest life expectancy and women the fifth.
Researchers were not able to analyze other racial and ethnic groups because of low population levels in many counties, but Murray said an influx of Latinos – who tend to live longer despite lower levels of education and income and higher rates of obesity – appears to have improved overall life expectancy.
But with few exceptions, Californians' life expectancy is still shorter than that of the healthiest nations. For men in Yuba County and women in Lake County, life expectancy was at a level not seen on the international frontier since 1978.
Marin County had the longest life expectancy for men in the state at 80.8 years in 2007 – a figure the world's leading nations can expect to reach in 2020. Men in Orange, Placer, San Mateo and Santa Clara counties also live longer than the international frontier. For women, Marin and San Mateo counties outpaced the international frontier by four years, with a life expectancy of 84.5 years.
Yet large disparities exist between black and white residents. While a white woman in California could expect to live 82 years in 2007, a black woman could expect to live 77.3 years. The gap was even greater among men: Life expectancy for a white man was 77.2, compared to 71.1 for a black man.
Research shows blacks often receive lower-quality health care than do other racial or ethnic groups – a contributing factor to shorter life expectancy, Murray said. Many blacks also live in historically disadvantaged communities with poor health outcomes.
The benefits of improved health care can be seen on both a global and local level, Murray said.
Like the United States, Australia is home to a diverse population and is struggling with an obesity epidemic. But as the U.S. has fallen behind in life expectancy, Australia has made steady progress.
The difference, Murray said, is greater emphasis on primary care and public health programs.
In San Francisco, for example, the introduction of antiretroviral therapy for the HIV-positive population had a "pretty dramatic effect on improving survival," Murray said. Male life expectancy went from being more than 50 years behind the international frontier in 1987 to six years behind in 2007.