U.S. life expectancy trailing that of other industrialized nations
The United States currently ranks 41st among industrialized nations in average life expectancy — hardly something to be proud of — according to a recent study by the Institute for Health Metrics and Evaluation, part of the University of Washington. Even more disturbing, our life expectancy ranking has been slipping for decades as other countries improve their lifestyles, per capita incomes and health care systems.
Many analysts have blamed declining U.S. life expectancy on the high number of uninsured Americans and the high cost of health care relative to other industrialized nations. While those two issues are certainly factors, they aren’t solely responsible.
External factors can have an effect
Erich Widemark, PhD, RN, FNP-BC, is Director of Nursing and Campus College Chair for the College of Nursing at University of Phoenix, Phoenix Campus. He also works as a nurse practitioner in private practice. According to Widemark, the U.S. economy directly impacts life expectancy in several ways. “Life expectancy may be more the reflection of our health care and economic system,” he says. “We may have the right medications and treatments for a host of age-related diseases, but if our population can’t afford these treatments, or our health care system is unable to deliver these treatments consistently and effectively, then our average life expectancy will decrease.”
Widemark also says other major contributors that lower U.S. life expectancy are high infant mortality and maternal mortality rates relative to other nations, as well as the prevalence of hospital medical errors.
Addressing our nation’s mental health
Widemark believes that life expectancy isn’t just about physical health. “We need to look at life expectancy from a holistic standpoint,” he says. “While we focus on the health care aspects in treatment of diseases of aging, we ignore the psychological factors that impact these physical problems. We have stressed-out, depressed and anxious people in the U.S. who fear the economy, terrorists and [the stability of] their own livelihoods.”
Furthermore, Widemark argues that the continued stigma against mental health treatment and wellness promotion compound these problems. “We all but ignore mental health treatment, which I believe severely impacts our population’s ability to cope productively with their issues of anxiety and depression,” he says.
Widemark says that stress and poor mental health can lead to many poor lifestyle choices, including increased cigarette smoking, alcohol use, drug use and compulsive overeating. “These coping mechanisms — while used to combat depression, anxiety, fear and more — impact life expectancy.”
In order to reverse these downward trends in U.S. life expectancy, Widemark says individuals and the health care system at large need to take responsibility for improving and making better choices. “People should identify their unhealthy behaviors and obtain proper treatment for the underlying causes — that is, if they smoke or overeat, they need to get treatment for the underlying anxiety or depression they may have,” he says. “An increase in physical activity and making healthier choices for living will also increase life expectancy.”
A policy shift towards prevention can also make a real difference
In addition to addressing mental health issues and improving individual lifestyle choices, the U.S. health care system itself must change, according to Widemark. “By shifting services to concentrate on prevention instead of treatment, and by rewarding the health care system for healthy people rather than sick people, we could go a long way toward improving life expectancy,” he says. He offers suggestions like making health insurance policies cover things like gym memberships and nutrition counseling, and paying providers more money for keeping people healthy versus treating illness.
And Widemark thinks that taking a more long-term view of health can also prove beneficial. “We live in a society that thrives on instant gratification,” he says. “That outlook is counterproductive to life expectancy.”