Why do Americans have a shorter lifespan than people in other countries?

By Jules Murtha | Fact-checked by Barbara Bekiesz
Published October 28, 2022

Key Takeaways

  • The average life expectancy in America is 78.8 years, which is significantly lower than that in other high-income countries.

  • Research suggests that Americans have lower life expectancy due to lack of affordable, universal health coverage, well-resourced social services, healthcare that can be accessed with few administrative barriers, and a focus on community-driven primary care, all of which other countries offer.

  • The AMA encourages doctors to promote preventive health practices by keeping up with current preventive health guidelines, educating patients about risk factors, and collaborating with patients to determine the most effective recommendations.

The US spends more on healthcare than any other nation. It may come as a shock, then, that individuals who live in the US are more likely to die younger than those in other middle- and high-income countries, according to a 2022 Commonwealth Fund report.[]

As researchers investigate the reasons why, clinicians can support patients by employing preventive health strategies to promote well-being and healthy lifestyles associated with increased life expectancy.

Why do Americans die sooner?

As of 2019, the life expectancy of US newborns was 78.8 years.

This number is significantly lower than that for other nations, including Canada (82.3), Switzerland and Spain (both 84.0), and Japan (84.4). At the same time, the US has above-average avoidable mortality rates, reaching 272 per 100,000 deaths in 2019.

Avoidable mortality can be defined as “deaths before age 75 from conditions that are either preventable through effective public health and primary prevention (before the onset of disease) or treatable when they’re detected early and effective care management is provided,” according to the Commonwealth Fund. Examples include deaths related to diabetes, breast cancer, and renal failure.

What circumstances led to these outcomes?

The authors of the Commonwealth Fund report wrote that the answer may involve a lack of available resources and programs offered to patients in the US.

Chief among them is the fragmentation of healthcare coverage and delivery in the US. In particular, as noted in a 2021 international comparison by the Commonwealth Fund, many other middle- and high-income countries offer universal insurance coverage with few financial barriers.[5][] Their healthcare systems also present fewer administrative barriers to access.

On top of that, US health systems do not always prioritize community-based primary care like other countries do. Furthermore, well-resourced social services are less readily available in the US. Such services not only serve healthier populations; they also diminish the burden on care delivery systems.

Simply put, the US doesn’t approach healthcare the same way other middle- and high-income countries do, which could be why the life expectancy here is lower.

Quality vs quantity 

There are two other factors that may affect life expectancy (and quality of life): healthy lifestyles and objective well-being.

A study published by BMJ found that men and women who established healthy lifestyles (determined by each participant’s diet, level of cognitive and physical activity, and smoking and alcohol consumption) were expected to live longer than those who did not.[]

People who exhibited healthy lifestyles also lived more of their remaining years without Alzheimer disease.

A study published by JAMA Network Open found that participants who exhibited subjective well-being (marked by enjoyment of life and a lack of depressive symptoms) were more likely to live longer and remain free of disability and chronic illness.[]

Research therefore points to the possibility that taking care of one’s health may not only prolong one’s life, but make it more enjoyable, too.

As clinicians, it’s your responsibility to promote health and well-being to patients—and you can use preventive health practices to do so.

Encouraging preventive healthcare practices

There are a handful of practices that physicians can employ to get patients on board with preventive health.

According to an article published by the American Medical Association, clinicians can:[]

  • Stay up to date on the latest and most applicable preventive health practices.

  • Teach patients about risk factors they may have some control over.

  • Recommend vaccinations and screenings as needed.

  • Initiate open conversations about maintaining a healthy lifestyle or managing chronic illness and inquire about any potential barriers your patient may face (transportation, social support systems, home or work environments) in doing so.

  • Work with your patients to determine the most effective recommendations.

  • Model the behaviors you wish to see in your patients.

These strategies act together as a patient-centered process that teaches patients to take responsibility for maintaining their health.

This, in turn, sets them up for a longer, happier life—a win for everyone.

What this means for you

Americans have a shorter life expectancy than individuals in other countries. Research shows that establishing a healthy overall lifestyle and subjective well-being may increase life expectancy. To promote good health among patients, follow AMA guidelines and facilitate an open dialogue about the value of prevention. Educate patients about certain risk factors and collaborate with them to agree on the most effective recommendations.

Read Next: What’s killing Americans and driving down life expectancy?
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