Life expectancy is perhaps the most important measure of health. It is readily comparable across countries and asks the most fundamental question concerning health: how long can the typical person expect to live?
Life expectancy increases due to healthcare improvements like the introduction of vaccines, the development of drug cocktails to treat AIDS or positive behavior changes like the reduction in smoking or drinking rates. During the 20th century, the average lifespan in the United States increased by more than 30 years as the rates of infectious diseases declined.
Which OECD countries have the longest life expectancies? Japan's life expectancy is nearly 83 years with European countries like Italy, Switzerland, Spain, Sweden, Israel and Australia only a year or two behind. Japan's relative advantage is related to not only genetics but also its universal health care system, generally better diet and low levels of inequality.
What about the United States? Well, that is unfortunately a very different story. The United States has a life expectancy of around 78 years, comparable to Cuba and near the bottom of the OECD countries. The few OECD countries that lag behind the United States (Czech Republic, Poland, Mexico, Slovak Republic, Estonia, Hungary and Turkey) all have vastly lower measures of wealth. In 2000, the World Health Organization rated the United States' health system as 37th in the world, below middle income countries such as Columbia, Costa Rica, and Chile.
Life expectancy in the United States isn't uniform but rather there is a huge amount of variability within the country. For example, African-American urban men live about 20 years less than Asian-American women. Geographically, residents in diverse states such as Hawaii, Minnesota, California and New York have average life expectancies more than five years longer than people in Mississippi, West Virginia and Alabama where the influence of racial and economic disparities are related to this state-to-state difference.
It is remarkable that American's pay 2-5 times more for healthcare than most OECD countries while having one of the shortest life expectancies. If you think of health expenditures as an investment with longevity being the return on this investment, then we can say that the United States receives a much lower return on its investment than other wealthy countries.
Sweden has a population of 9.4 million, GDP per capita of $47,934 (one of the highest in the OECD) and a life expectancy of 81.4 years. About 97% of medical costs are paid by the government with only 3% out of pocket.
Italy has a population of about 60 million, a GDP per capita of $34,059 (average for OECD countries) and a life expectancy of 81.5 years. In Italy, family doctors are paid by the National Health Service and surgeries and hospitalization provided by the public hospitals are free.
Australia has a population of around 23 million, a GDP per capita of over $55,000 (one of the wealthiest OECD countries) and a life expectancy of 81.5 years. Australia has universal healthcare coverage operated by the government.
Switzerland has a population of 7.9 million, a GDP per capita of nearly $70,000 Switzerland (one of the wealthiest countries in the OECD) and a life expectancy of 82.2 years. Swiss citizens must purchase health insurance from private insurance companies, which are required to accept every applicant.
Japan has a population of about 128 million, a GDP per capita of $42,820 (not in the top 10 for OECD countries) and a life expectancy of 82.7 years. In Japan, health insurance may be obtained through employers or from the national health insurance program. Japan has an obesity rate of 3.2%, about 10 times less than that of the United States.
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Note: The data source for life expectancy was Society at a Glance 2011 - OECD Social Indicators. Other sources may have slightly different estimates.
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