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America’s “Health Disadvantage” Leads to Shorter Life Spans

Saturday 8 October 2022, by Dan La Botz

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Americans have in the last two years suffered a dramatic decline in life expectancy, from nearly 79 years in 2019 to 76 in 2021. This is a historic decline; nothing like it has been seen since the 1920s.

According to Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, this decline is due to what he calls the “U.S. health disadvantage.” The disadvantage results from several factor, he says: the country’s disjointed, profit-driven health care system, many in the population with poor nutrition and lack of physical activity, as well as smoking, pollution, and easy access to guns. Racism and segregation make these problems worse for marginalized groups.

U.S. life expectancy has been declining for several years. The principal cause of short life expectancy has been the COVID epidemic, though addiction to opioids has also played a role. Before COVID, the epidemic of opioid use reduced the average life span by .3 years, but the COVID pandemic has had a much greater impact.

The United States did significantly worse than other countries in dealing with the COVID epidemic, in part because instead of one national health care system to set policies there are 50 states each with its own system. “The growing polarization of red [Republican] and blue [Democratic] states in recent years has widened the divide on policies even more, and that has affected our health and safety,” said Woolf. Florida, a Republican state, had more than three times the number of excess deaths, as the Democratic state of New York, though both have similar populations.

The fall in average life spans is not spread out evenly. While the average life expectancy of all Americans has fallen, it has dropped most dramatically among Native Americans and Alaska Natives, according to the National Center for Health Statistics. Native American life expectancy fell from 71.8 to 65.2 years. Those populations now have the lowest life expectancy of any country in the Americas but Haiti.

Blacks had the second biggest drop, from 74.8 to 70.8. Non-Hispanic white people fell from 78.8 to 76.4. Hispanics dropped from 81.9 to 77.7. Asians, who live longest, saw their life expectancy fall from 85.6 to 83.5. As one can see, the impact on life expectancy was greatest for people of color, except Asians. Native Americans, Blacks, and Hispanics tend to have lower incomes, fewer assets, and suffer segregation and racial discrimination. The indigenous groups in particular have less access to health care.

In part, failure to vaccinate is responsible for COVID’s impact. Black Americans, have by far the lowest vaccination rates, followed by whites, while Asians, Hispanics, and Native and Alaskan Americans have higher rates. Black Americans have historically mistrusted the health care system, which in part explains their lower vaccination rates. While whites’ lower vaccination rates can be largely attributed to Republican politics and anti-vax conspiracy theories.

No other high-income nation did as poorly as the United States. “None of them experienced a continuing fall in life expectancy like the U.S. did, and a good number of them saw life expectancy start inching back to normal,” Dr. Woolf said.

While the United States has, from one point of view, an excellent health care system—excellent research institutions, hospital with the latest technology, doctors and nurses with fine education and training—from the point of view of serving the population the country is failing. There is no national public health policy, there is no right to health care and many people have no health insurance. Hospitals, doctors, and the best technology are often readily available to the better off and unavailable for working class and poor people, especially if they are people of color.

We have to continue the fight for the historic slogan of the left and the public health activists: “Health care is a human right.”


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