The four leading causes of premature death: smoking, high blood pressure, elevated blood glucose and being overweight or obese, according to a Harvard School of Public Health study. Those factors reduced life expectancy about five years for men and four years for women.
The researchers created eight demographic groups they called “Eight Americas.” The Eight Americas were defined by race, county, region and socioeconomic features to demonstrate the impact of health disparities. The Eight Americas were Asian-Americans; Northland low-income rural whites; middle American whites; low-income whites in Appalachia and the Mississippi Valley; Western Native Americans; middle American blacks; high-risk blacks and Southern low-income rural blacks.
For example, Southern rural black men lost almost seven years of life because of the risk factors, compared with less than four years for Asian-American women. Blacks, especially those in the rural South, had the highest blood pressure. Native Americans and Southern black women were the most obese. Native Americans and low-income whites smoked the most.
Health disparities exist on every health measure in the U.S. However, they are particularly pronounced in life expectancy. For example, a black man living in Washington, D.C., on average will die 17 years sooner than a white man in adjacent Montgomery County, Md.
Ralph Keeney, a Duke University professor, bluntly declares that nearly half the people who die before age 65 have only themselves to blame. The list of poor decisions is a familiar one: smoking; binge drinking; overeating; not exercising; unprotected sex; not wearing a seat belt; using drugs; suicide and homicide. By comparison, only 5 percent of deaths in 1900 and 25 percent in 1950 were self-inflicted.
Nearly one-quarter of American women and one-third of American men die before age 75 of causes that potentially could have been prevented by timely and effective health care. They either chose not to seek care or could not afford it. The U.S. ranked 15th out of 19 industrialized nations on regular use of health-care facilities. If the U.S. had performed as well as the top three nations – France, Japan and Australia – it would have averted more than 100,000 deaths a year.
In 1975, Americans who reached 50 years old could expect to live slightly longer than Europeans did. By 2005, the U.S. had fallen significantly behind Europe in life expectancy, primarily because of chronic disease among the near-elderly. Americans are twice as likely to have high blood pressure, be obese or have diabetes. Economists calculated that the U.S. could save up to $1.1 trillion by 2050 if its health status were comparable to that of its peers.
A Health Affairs study measured survival rates in 12 other industrialized nations and compared them with national health-care costs. In 1975, the U.S. was close to the average per-capita cost and ranked last. By 2005, health-care costs had tripled and were twice as much per capita than any other nation – and the U.S. still ranked last. This was despite the fact that smoking decreased more rapidly and obesity grew more slowly than in other nations.