History of Smoking - lower life expectancy..

January 26, 2011 - Life expectancy in the United States is lower than in many other high-income nations due in large part to the nation's history of heavy smoking and current high obesity levels, according to a report published online Jan. 25, by the National Research Council (NRC).

A panel commissioned by the National Research Council sought to explain why the U.S. spends more on health care than any other nation, yet Americans are dying younger than some of their counterparts in other high-income countries. Panel members relied on the latest data from the Human Mortality Database.

Over the past two and a half decades, life expectancies continued to rise in the U.S., but at a slower pace than those seen in Australia, Canada, Japan, Great Britain, and other high-income European countries. The average live expectancy for men in the U.S. was 75.6 years in 2007, compared to around 79 years among men in living in Australia, Japan, and Sweden and between 77 and 78 years among men living in the Canada, Italy, the Netherlands, Great Britain, and France. The life expectancy for women in the U.S. is 80.8 years, which is lower than for any other high-income country included in the analysis except Denmark (80.5 years).

But thanks to the decline in smoking over the last 20 years, the life expectancy of U.S. men is expected to rapidly improve in coming decades. That improvement will be a little slower for U.S. women, whose peak smoking rates occurred several years after men's. In countries where women's life expectancies are particularly high, women never smoked as much as men, said gerontologist Eileen Crimmins of the University of Southern California, who co-chaired the report. But in some Northern European countries, women's smoking was more similar to Americans' and life expectancy is too.

Even though just 20 percent of Americans smoke now, more than 40 percent of U.S. adults smoked in 1960 and the population is still paying the price, the report from the National Research Council found. "Other factors, such as obesity, diet, exercise, and economic inequality, also have likely played a role in the current gap and divergence between the United States and other countries," the panel of experts appointed by the council wrote.

Many experts have tried to explain why the United States, which spends more per capita on healthcare than any other country and which has a relatively wealthy and well-nourished population, should rank so poorly against other countries in terms of lifespan. Japan ranks No. 1 in terms of life expectancy, with a child born today likely to live to be nearly 83 on average, according to the United Nations. The United States ranks 36th, with a life expectancy of 78.3 -- below most of Europe, South Korea, Chile and right below Cuba.

NRC Publication: Explaining Divergent Levels of Longevity in High-Income Countries, National Academies Press (nap.edu), 1/25/2010.

Other experts have found just the opposite -- that smoking and obesity do not fully explain the U.S. lag. Last October, a team at Columbia University in New York determined that the lack of a coherent healthcare system in the United States was to blame. (Lagging U.S. life expectancy ranking blamed on health system, Courtesy of the Commonwealth Fund and World Science Staff, 10/9/2010) The NRC panel investigated the impact of access to health care on life expectancy in the U.S., finding little evidence that lack of access has contributed to the lag in life expectancy gains.

References: U.S. Smoking Rates Keep Life Expectancy Down
Study Shows High Smoking Rates in Earlier Decades Affects Life Spans in U.S. by Salynn Boyles (Reviewed by Laura J. Martin, M), WebMD Health News, 1/25/2011; Smoking, obesity why US lifespans lag a bit by Associated Press, staradvertiser.com, 1/25/2011; Smoking explains why Americans don't live longer by Maggie Fox, Health and Science Editor, Reuters, 1/25/2011.