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Low Life Expectancy in the United States: Is the Health Care System at Fault?

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Author Info
Samuel H. Preston
Jessica Y. Ho
Abstract

Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 15213.

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Date of creation: Aug 2009
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Handle: RePEc:nbr:nberwo:15213

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Find related papers by JEL classification:
I0 - Health, Education, and Welfare - - General
I1 - Health, Education, and Welfare - - Health
I12 - Health, Education, and Welfare - - Health - - - Health Production
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
J1 - Labor and Demographic Economics - - Demographic Economics
J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends and Forecasts
J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped
J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy

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  1. Arie Kapteyn & James P. Smith & Arthur van Soest, 2007. "Vignettes and Self-Reports of Work Disability in the United States and the Netherlands," American Economic Review, American Economic Association, vol. 97(1), pages 461-473, March. [Downloadable!]
  2. Alan M. Garber & Jonathan Skinner, 2008. "Is American Health Care Uniquely Inefficient?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 27-50, Fall.
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  3. David M. Cutler & Edward L. Glaeser, 2006. "Why Do Europeans Smoke More than Americans?," NBER Working Papers 12124, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. David Cutler & Edward Glaeser & Jesse Shapiro, 2003. "Why Have Americans Become More Obese?," NBER Working Papers 9446, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  5. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
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