Low Life Expectancy in the United States: Is the Health Care System at Fault?

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PSC Working Paper Series
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Age
BMI
Body mass index
Breast cancer
Cancer
Cancer mortality
Cause of death
Causes of death
Data
Death rate
Demographic methods
Demography
Developed countries
Developing Countries
Disease
Health care system
International Agency for Research on Cancer
Life expectancy
Morbidity
Mortality
Personal health care
Prostate cancer
Prostate Specific Antigen Screening
PSA screening test
Race
Risk
Sex
Statistics
Survival rates
Treatment
Trends
United States
United States National Center for Health Statistics
World Health Organization
Demography, Population, and Ecology
Diseases
Medicine and Health
Quantitative, Qualitative, Comparative, and Historical Methodologies
Sociology
Statistics and Probability
Survival Analysis
Vital and Health Statistics
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Abstract

Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.

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2009-07-01
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Preston, Samuel H. and Jessica Ho. 2009. "Low Life Expectancy in the United States: Is the Health Care System at Fault?." PSC Working Paper Series PSC 09-03.
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