Lowered U.S. Life Expectancy, Part 2 – Culture

Recently a report — U.S. Health in International Perspective: Shorter Lives, Poorer Health — looked at factors that contribute to poor health and lower life expectancy in the United States as compared to similar industrialized nations. I already mentioned the role that violence plays in reducing American males’ life expectancy, but an even bigger culprit may be American culture.

The Associated Press quoted Dr. Steven H. Woolf, who chaired the panel that produced the report as saying,

We have a culture in our country that, among many Americans, cherishes personal autonomy and wants to limit intrusion of government and other entities on our personal lives and also wants to encourage free enterprise and the success of business and industry. Some of those forces may act against the ability to achieve optimal health outcomes.

It is interesting to look at how, for example, the United States and Great Britain have each chosen to deal with a specific method of suicide — overdosing on acetaminophen. According to a study in the British Medical Journal,

In the United States paracetamol [acetaminophen] is associated with more than 100,000 calls a year to poison control centres, as well as 56,000 visits to emergency departments, 26,000 hospitalisations, and 450 deaths.

The United Kingdom has a similar problem with acetaminophen overdoses and deaths, so in 1998 it passed restrictions on the sale of acetaminophen. In the Uk,acetaminophen can only be purchased in packages of 32 tablets in pharmacies and is limited to just 16-tablet packages when sold elsewhere. Moreover, the tablets must be individually blister packed to increase the time and effort required to gain access to a large number of pills.

Meanwhile, here in the United States I can walk down to the neighborhood Walgreens and for $12 pick up a 500 count bottle of 500mg acetaminophen.

Not only is the idea of restricting access to acetaminophen not even on the table in the United States, but even the suggestion of such restrictions would likely be met with derision as limiting personal autonomy unnecessarily.

Lowered U.S. Life Expectancy, Part 1 – Violence

We know that those of us living in the United States have shorter life expectancy than those living in similar industrialized countries, such as in Europe. We also know that Americans are far more likely to be the victims of homicide than those who live in countries like ours, but how much does that increased risk of homicide impact life expectancy? How much longer would we be likely to live if we didn’t live in such a violent country?

The Associated Press looked at this question in its coverage of a recent report about health discrepancies between the United States and other industrialized nations. The report, U.S. Health in International Perspective: Shorter Lives, Poorer Health is available to read for free online.

First, lets look at just how big those life expectancy discrepancies are. The report looks at life expectancy of men and women in 17 similar countries in 2007. For women, the U.S. life expectancy rate in 2007 was 80.78 years. Japan led the world in life expectancy for women that year at 85.98 years. So U.S. women had a life expectancy 5.2 years lower than Japan.

For men, the U.S. life expectancy rate in 2007 was 75.64 years. Switzerland led the world in life expectancy for men in 2007 with an average of 79.33 years. So American men born in 2007 could expect to die 3.69 years sooner on average than men born in the same year in Switzerland.

The report estimates that homicide and suicide together account for up 25 percent of that disparity for U.S. men. So, compared to Switzerland, American men born in 2007 will on average die a little over 11 months earlier because of the combination of an extremely high homicide rate and relatively high suicide rate.