The USA spends the greatest amount of money per capita on health care. This hasn’t translated into the highest life expectancy. Their life expectancy lags behind poorer countries. Pure medical solutions compete with the lifestyles of their population. If a population is unwilling to embrace a non-toxic lifestyle they’ll die ‘young’.1 This disregards the quality of health care available.
American states have variable life expectancies. Hawaii’s highest life expectancy, at 82.3 years, exceeds the USA’s 79 years. If Hawaii was a country, it would rank 25th. West Virginia has the worst life expectancy in the USA. Its life expectancy is 74.8 years with a global ranking of 97th.2
OECD countries fund about 71% of health care costs whereas the USA finances 50%.3 America’s for-profit model of health care provision ‘punishes’ the poor and reduces international rankings. Cuba spends 11.34% of GDP on health care; the USA spends 16.77%.4
“Life expectancy at birth in the United States declined by 1.5 years from 2019 to 2020.”5 States like West Virginia share this decline, making a bad case worse.
West Virginia’s citizens have lifestyle issues, which impact life expectancy.6 The USA publishes data which tabulates regional life expectancy sub-divided into racial groups.7 The variation between different racial groups is startling.
Miami-Dade County, Florida
Average: 82.4 years; White people 80.1; Hispanic people 84.4; Black-Americans 77; Asian people 91.1
In New Haven, Connecticut, Asian-Americans have a 98.8 years life expectancy. Contrast that with Holmes County, Mississippi, which is 83% Black-American. Male life expectancy is 67 years placing it 155th in world rankings below Gabon, a third world country.8
Blaming America’s for-profit model of health care for their unimpressive life expectancy outcomes is glib and wrong.9 Race is significant in the USA and British social class is equally important. “In 2017–19, males in the least-deprived 10 per cent of areas in England could expect to live to 83.5 years, almost a decade longer than males in the 10 per cent most-deprived areas (74.1 years).”10 Health care is a universal right in Britain but outcomes are radically different for social reasons.
Lifestyle is as important as medical care in terms of life expectancy. In Mississippi, “….over 2 million people are overweight or obese in this state alone, and face substantially increased risks of life-threatening health conditions.”11 (my emphasis) In Britain obesity and a ‘post-code’ lottery of health care provision reduces the life expectancy of the poorest people.
Data from New Haven, Connecticut for Asian-Americans tragically suggests that race, lifestyle and wealth are a combination which guarantees longevity. British access to universal health care resolves one of those problems. The other two problems are a lottery of willpower and luck. Additional years aren’t necessarily joyful, “…people living in the most-deprived areas have the shortest life spans, they also live more years in poor health.”12
The objective of the American and British health care services is to enhance people’s lives. They’ve failed. They created a sickness service. Promoting the health of the population lies in education, the kitchen and playing fields as much as in the operating theatre. Hong Kong has the world’s highest life expectancy and they attribute this directly to lifestyle factors highlighting their anti-smoking policy. “Successful tobacco control has allowed Hong Kong’s life expectancy to exceed populations around the world.”13
Good health is a joint enterprise as opposed to something that’s done to the population. People have to take ownership of their health with the back-up of government targeted intervention supporting the population.
1 U.S. Life Expectancy 1950-2022 | MacroTrends See table in descending order. Cuba’s life expectancy is a counter-factual to that of the USA. Data shows that Cuba’s expectancy and infant mortality are superior to the USA. The USA inflicted economic sanctions on Cuba for 60 years, which seems to have improved outcomes. About that Cuban Life Expectancy – Econlib
2 Life Expectancy by Country and in the World (2022) – Worldometer (worldometers.info) Hawaii is 25th and West Virginia is 97th
3 Public funding of health care – Brief (oecd.org) Jamaica doesn’t appear on this table as it isn’t an OECD country, being too small GDP wise. For the OECD see OECD – Wikipedia which explains its purpose and eligibility criteria for entry.
4 Current health expenditure (% of GDP) – Jamaica | Data (worldbank.org) Data shows that Cuba’s expectancy and infant mortality are superior to the USA. The USA inflicted economic sanctions on Cuba for 60 years, which seems to have improved outcomes. About that Cuban Life Expectancy – Econlib
8 Life Expectancy by Country and in the World (2022) – Worldometer (worldometers.info) Gabon’s GDP is $15.6 billion see Gabon GDP – 2021 Data – 2022 Forecast – 1960-2020 Historical – Chart – News (tradingeconomics.com)
10 loc.cit. Internationally this places Britain’s most deprived regions at 101st in the rankings. Life Expectancy by Country and in the World (2022) – Worldometer (worldometers.info)