Life Expectancy Gains Are Slowing, Especially in the U.S.

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babyThere’s a tendency among techno-optimists to point to charts that show an unequivocal increase in life expectancy in recent history. For example:


Modern medicine has undeniably extended the lives of people around the world, but, recently, a few data points have begun to muddle the clean lines of such charts when looking for a little more detail. Gains in life expectancy have begun to slow.

The United States, especially, lags behind. We have our growing income disparity to thank for pulling down the national average, according to a county-by-county analysis done by the University of Washington’s Institute for Health Metrics and published in the Lancet.

“There are counties in the U.S. where a woman or man can live close to the top life expectancy in the world, and we have counties in the U.S. where life expectancy is similar to what we see in Africa. That disparity is causing gains to slow down so that we’re not keeping up with our peers,” Ali Mokdad, of the Institute for Health Metrics and Evaluation, told Singularity Hub.

“Eighty percent of the counties in the U.S. have life expectancy lower than that of Cuba,” he added.

Comparing national averages doesn’t paint quite as dire a picture. Between 1990 and 2011, U.S. life expectancy at birth grew 5 percent from 75 years to 79. Between 1970 and 1990, infants also gained five years of expected life after starting at 70.

Other developed countries made slightly better progress. In France, life expectancy rose by 8 percent from 1970 to 1990 and by 5 percent from 1990 to 2011. In Japan, the world’s leader in life expectancy, babies born in 1970 were expected to live 72 years on average. That number grew by nearly 10 percent to 79 in 1990 before slowing to a 5 percent growth rate to stand at 83 in 2011. Norway’s growth parallel’s the United States’, progressing steadily from 74 in 1970 to 81 in 2011.

life-expectancy-elderlyStill, residents of nearly all European countries can expect current newborns to live longer than those born in the U.S., as can Kuwait, South Korea, Israel and Andorra.

In the developing world, life expectancy grew much faster during the same period, but also slowed somewhat in the two decades following 1990 relative to the two before.

Babies born in India and Indonesia saw their predicted life spans grow by nearly 20 percent between 1970 and 1990. Since then, India, Indonesia, China and Brazil have all seen life expectancy extend by 10 - 12 percent.

According to Mokdad, life expectancy depends on many factors: income and education, access to health care — which includes both physical proximity and affordability — and the quality of medical care. But most important of all is the element least affected by science and technology: lifestyle. And while people in developing countries have more opportunity to exercise and eat a full complement of fruits and vegetables, they are also more likely to become sick with diseases related to eating too much salt, cholesterol and sugar.

High-level statistics also hint at some of these tradeoffs. Life expectancy doesn’t simply rise as a country gets wealthier, for example. The World Health Organization breaks countries into four income categories, and between the poorest and the next poorest, life expectancy falls before rising through the other categories.

Imagine living in a rural, agrarian society. There are few roads and few health clinics. As the country develops, construction happens hurly-burly, bringing pollution and industrial accidents. There are roads, but they’re not necessarily safe and most citizens, if they have cars, are new to driving. Smoking also tends to increase in countries as their economies see major expansions (the U.S. in the 1950s and 60s and China in the 1970s and ’80s). Life expectancies fall until health care and government regulations catch up and smoking declines. Then they go up as the  benefits of living in a wealthier country manifest themselves.

So, what about the future — will gains in life expectancy shoot up again as techno-optimists like Ray Kurzweil posit? Not according to the WHO. The organization’s morbidity predictions for 2015 - 2030 don’t indicate that areas of medicine currently making strides will push longevity trend lines in developed countries back up.

Heart disease, linked to diet, is the single largest killer in the world. In upper-middle income countries, the WHO predicts that deaths caused by it will fall significantly. But in upper income countries, virtually no progress will be made against heart disease.

Okay, but surely we will make progress against cancer, you may say. Alas, not according to WHO statistics.

While medical advances have brightened the prognoses for many cancer patients, the WHO predicts that cancer will continue to account for about half of all deaths in upper-middle income and upper income countries. Alzheimer’s and Parkinson’s diseases are on a course to claim more lives.

Statistics do reflect some unqualified medical successes with effects big enough to push national life expectancy averages up significantly.

Major advances in the treatment of HIV have resulted in dramatically longer life spans in many African countries. To take but one example, a baby born in Botswana in 1990 would live, on average, 65 years. But 10 years later, a baby was only expected to live 49 due largely to the HIV epidemic. In 2011, life expectancy had made up its losses and gained a year to boot.

doctor-smartphoneExperts expect still more progress on infant mortality, which has been the rock star of longevity data, in both developed and developing countries. Since 1970, deaths of those under age four have fallen by more than 70 percent worldwide — and, according to one study, that dropoff accounts for half of all gains in life expectancy.

So what do these numbers reveal about the role of technology in improving health? The smartphone may be the most powerful tool in a doctor’s bag, Mokdad said. Simply following up with patients to ensure that they follow doctor’s orders will improve and extend more lives than a cutting-edge medical breakthrough, he said.

Cameron Scott

Cameron received degrees in Comparative Literature from Princeton and Cornell universities. He has worked at Mother Jones, SFGate and IDG News Service and been published in California Lawyer and SF Weekly. He lives, predictably, in SF.

Discussion — 4 Responses

  • Improbus Liber September 26, 2013 on 11:25 am

    Want to improve American’s health? Have them cook their own food instead of buying at the local fast food chain.

  • Matthew September 26, 2013 on 12:48 pm

    this economy is starting to piss me off. we have 25% of the world’s wealth and only 300 million people, WTF. if we tallied up all the deaths from inadequate healthcare and lack of jobs and education in this country, and the proliferation of post industrial mass manufactured weapons. if those 150 thousand needless deaths per year were caused by some foreign terrorist group we would be UP IN ARMS. why do we treat ourselves so awfully? why do we let government and unregulated corporations and financial systems and the FDA feed us such poison and get away with it? other countries look at us and our material excess and are like, ‘you’re crazy, what the hell are you doing’ … these corporations need to learn that they are NOTHING without the consumer based society that created this excess of wealth that they syphon out of circulation to buy another vacation home or yacht. SADLY, if people made as much money as they used to (minimum wage should be $15-$25 an hour, WHY would anyone argue against this?) THAN EVERYONE WOULD BENIFIT. The people, AND the corporations would be far better off. and now we’re seeing other countries with far less resources surpass our quality of life. house republicans are a TERRORISTIC NATIONAL SECURITY THREAT. corporations are cannibalizing themselves by not delegating marginal fractions of capital (that we the consumers create for them every time we fill up at the pump, buy some bread, buy an I-phone, etc.) of record profits to pull hundreds of thousands of americans out of POVERTY. the recession is a LIE. US and global gdp is on an exponential rise, and as it continues ad infinitum this gap between rich and poor will become ever more apparent. and no if minimum wage was $15 it would NOT make bread and milk $10 … inflation does not rise that quickly. but sure, let’s continue hating each other because of our race, sexual preferences, religion, and socio-economic well being or lack thereof. give it another 10 years and the unregulated people at the top could create a pathogen to target and wipe out all the blacks, homosexuals, and low income people of the world. because they won’t need the consumers anymore. maybe this subversive murder of our own people is the transition to that.

    • Matthew Matthew September 26, 2013 on 12:57 pm

      there is no limit. our technology is to the point where we can literally pull miracles out of our asses. corporations need to clue in to companies like Coca-Cola tapping the vast market potential of people in Africa simply by getting them water cheaply. it’s not only imperative, but it’s in our best economic interest to adhere to human rights and ecology. literally NOTHING is impossible. we can have our cake and eat it too. the people being richer WILL make the CEOs magnitudes richer. we can forgive their impulsive greed and let them become our benevolent benefactors. Wal-Mart needs to have an EDUCATION CENTER. I-phones and droids need to have an I NEED A EFFING JOB APP. we are solving our environmental problems. there is room for all 7 billion. we can live inside matrix like unmistakeably real virtual worlds in a box and not even impact the physical world. or we can teleport outside of that to colonize other planets in the physical world.

  • thomowen20 September 27, 2013 on 5:27 pm

    This is a terrible article. The first half isn’t that bad, citing a number of interesting statistics. The article goes downhill after this by clumsily trying to extrapolate the effects of future technology based on current statistics. They then follow up with ‘an example,’ modern AIDs treatment as a future technology. Again, the first part of the article is merely informative. The ending part worse than useless. You see, articles like this shape public opinion; public opinion shapes public policy; public policy shapes how and whether and what research gets funded. This is very irresponsible journalism.