PSC Working Paper Series

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Working Paper

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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.


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.


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



Date Posted: 27 July 2009

This document has been peer reviewed.