Australia outpaces other English-speaking nations in life expectancy, offering a model for the U.S. to address preventable causes of death and improve health outcomes.
Despite being home to some of the world’s most dangerous animals, Australia has led the English-speaking world in life expectancy for the last three decades. Among other high-income Anglophone nations, the Irish experienced the most significant improvements in life expectancy, while Americans have ranked dead last since the early 1990s, according to a team of social scientists led by a Penn State researcher.
The team published their findings in the journal BMJ Open.
“One lesson we Americans can learn about life expectancy from looking at comparable countries is where the frontier of best performance lies,” said Jessica Ho, associate professor of sociology and demography at Penn State and senior author on the paper. “Yes, we’re doing badly, but this study shows what can we aim for. We know these gains in life expectancy are actually achievable because other large countries have already done it.”
The researchers compared life expectancy in the United States, Canada, Ireland, the United Kingdom, Australia and New Zealand using data from the Human Mortality Database and the World Health Organization Mortality Database between 1990 and 2019. They analyzed the data by sex, age, and 18 individual and comprehensive cause of death categories, including cancers, drug- and alcohol-related deaths, firearms, and motor vehicle collisions.
They also examined life expectancy within each country to identify geographical inequalities in life expectancy by region.
Findings on Longevity and Geographical Inequalities
The researchers found that Australians had the longest life expectancy at birth over the study period, with women living nearly 4 more years and men 5 more years than their American counterparts. The Irish showed the largest gains in life expectancy, with men’s lifespans increasing by approximately 8 years and women’s lifespans by more than 6.5 years. Americans had the shortest life expectancy at birth, with women living an average of almost 81.5 years and men an average of nearly 76.5 years in 2019.
The United States also showed some of the largest geographical inequalities in life expectancy compared to the other countries, according to the researchers. Women and men in California and Hawaii had some of the highest life expectancies at birth, with women averaging 83 to 83.9 years and men averaging 77.5 to 78.4 years. States in the American Southeast saw some of the lowest life expectancies at birth of all subnational regions studied, with women averaging 72.6 to 79.9 years and men averaging 69.3 to 74.4 years.
Challenges and Recommendations
“One of the main drivers of why American longevity is so much shorter than in other high-income countries is our younger people die at higher rates from largely preventable causes of death, like drug overdose, car accidents, and homicide,” said Ho, who is also an associate of Penn State’s Social Science Research Institute.
In midlife — the 45 to 64 age range — some of these causes continue, like high death rates from drug- and alcohol-related mortality, Ho explained, adding that Americans also see higher rates of cardiovascular disease mortality.
“Some of the latter could be related to a sedentary lifestyle, high rates of obesity, unhealthy diet, stress, and a history of smoking,” she said. “It’s likely that these patterns of unhealthy behaviors put Americans at a disadvantage in terms of their health and vitality.”
Australian Model for Improvement
Australia offers the U.S. a model for improving its life expectancy, Ho added. Like the U.S., Australia is large in terms of land area and has a comparable history of personal vehicle ownership. The two countries have some cultural similarities, including historically greater use of firearms. However, Australia implemented a number of policies in recent decades including gun law reforms that helped vault them to the top of the life expectancy rankings.
“What the study shows is that a peer country like Australia far outperforms the U.S. and was able to get its young adult mortality under control,” Ho said. “It has really low levels of gun deaths and homicides, lower levels of drug and alcohol use, and better performance on chronic diseases, the latter of which points to lifestyle factors, health behaviors, and health care performance.”
Ho said policies like investing in public transit infrastructure, adding more roundabouts, and having fewer large cars on the road could decrease traffic deaths in the United States. More support for programs designed to reduce drug dependence and reducing barriers to treatment and prevention of drug overdose could help lower drug-related mortality, she said. And having a strong combination of public health effort, health care access, and community interventions to encourage healthier lifestyles and the use of preventive medicine could reduce cardiovascular disease mortality, she added.
“Australia is a model for how Americans can do better and achieve not only a higher life expectancy but also lower geographic inequality in life expectancy,” Ho said.
Reference: “Life expectancy and geographic variation in mortality: an observational comparison study of six high-income Anglophone countries” by Rachel Z Wilkie and Jessica Y Ho, 1 July 2024, BMJ Open.
DOI: 10.1136/bmjopen-2023-079365
The study was funded by the National Institute on Aging.
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8 Comments
There are many factors that influence mortality rate, and this study does not show any causality, only comparisons between cultures. The author then makes some leaps of assumptions that reveal a bias. Keep in mind the author is a sociologist. (I am a medical anthropologist.) For example, the author states, “However, Australia implemented a number of policies in recent decades including gun law reforms that helped vault them to the top of the life expectancy rankings.” Clearly, the author wants more gun control. Other social issues are also promoted using these statistics, but with no proof of causality. There could be a million reasons for these differences in mortality. This makes this article more political than anything else.
It would also be helpful to have a quality of life survey alongside a mortality survey. It’s not just how long you live, but how much you enjoy life that also counts. Maybe Australians are the happiest, too. But measuring quality of life is another subjective issue, and ascribing contributing factors is another exercise in bias projection.
Less guns available in the general populace leading to less gun related deaths is no more hard to understand than less illegal drug use leads to less drug overdose deaths, or better diet and less obesity lead to less heart attacks. The fact that the author would undoubtedly advocate for some greater amount of gun control, less illicit drug use, and better diet and health care is perfectly obvious. The fact that you singled out gun control for criticism is also very telling of your political/social leanings is I suspect that your conclusions as a medical anthropologist would would lead to the conclusions such as that weapons or projectiles impacting or piercing the human body core lead to an increase in the probability of reduced lifespan.
The countries that have longer life expectancies than U.S. are more socialistic and have universal health care. What dollar value does American society place on their lives?
Agreeing much with and adding some to what Mr. Singer wrote, for forty-three years and counting now of mostly mild chronic illness, in 2024 I’m still painfully aware that premature mortality has been self-inflicted on America through medical ignorance and incompetence and failed official authority. There are a (my) kind of practically harmless individual very, very mild food allergy reactions which mainstream US medicine still fails to recognize, research, practice and/or teach, which are easily turned chronic and deadly dangerous long-term (months to decades, highly individual) naturally and/or artificially. First identified, studied and reported on by Dr. Arthur F. Coca by 1935, excessive dosing (e.g., meals/snacks) and/or dosing with insufficient intervals between doses are two ‘natural’ ways to intensify and/or extend my kind of still very, very mild allergy reactions to make them ‘harmful.’ Inherently toxic FDA approved food additives are a way in which my kind of allergy reactions can be ‘artificially’ extended and/or intensified to become ‘deadly.’ Regrettably, no cohort medical studies I’ve ever heard of, or Dr. Ho it seems, factor-in those two possibilities; ultimately, too-typical fatally flawed “evidence-based” medicine.
More to the article, by the early 1970s about 95% of US soy was being more cheaply processed with toxic hexane with some residue, said to be safe by the FDA. The US female breast cancer epidemic presented by 1979. More dramatically harmful by 1990, the FDA approved the expanded use of added artificially cultured “free” (can cross the blood-brain barrier) MSG in 1980, knowing full-well then it would be harmful to some of us. As to “…cancers, drug- and alcohol-related deaths, firearms, motor vehicle collisions…” and other accidents, chronic diseases and suicides, how ‘peerish’ are the population, immigration, inflation, housing, hunger and overcrowding factors in Australia?
With allergies being mostly to protein substances, obesity and lung cancer in the US are more likely undiagnosed-allergy-aggravated-with-FDA-approved-food-poisoning-caused diseases/symptoms with allergies, being the most relevant factor in both obesity and the minority of smokers who do get seriously ill from smoking. Neither author’s fault, the study was fatally flawed before it was even conceptualized.
The first line surprised me. Australia does not have any dangerous animals that I’m aware of. Dangerous reptiles maybe…….
F*** mate. The Quokka is lethal. You can die smiling just looking at one
As an Australian, I can say the ‘dangerous animals’ beat-up by non-Australians is tiring. The vast majority of Australians live in the south east or south west of Australia, whereas the vast majority of dangerous animals are in the north. Even then they aren’t exactly marauding around the countryside or in the cities.
It’s the equivalent of thinking the US is full of dangerous animals because there are bobcats, rattlesnakes and bears ergo, they must affect every American daily.
It is much easier to control illegal immigration on an island. This cuts down on disease, drugs, cost of health care, crime, and a multitude of problems. We have a lot of things in which we can improve, but we still remain the place it seems everyone wants to come to.