Spending More, Dying Sooner: America’s Life Expectancy Failure

The ultimate measure of public health is death, particularly avoidable mortality. A study in JAMA Internal Medicine, March 24, 2025 looked at such preventable deaths of adults under 74 in the United States and in comparable high-income countries between 2009 and 2021. Avoidable mortality included both deaths that could have been prevented with public health measures and those that should have been avoided with timely and appropriate medical care. The report card reveals that in the United States we experience life expectancy failure despite spending far more than most other comparable countries.

Mortality rates rose in the US during the analysis while they dropped in other wealthy countries. The authors note that:

“Despite spending more on healthcare than every other high-income country, the US has comparably higher avoidable mortality, which includes deaths that can be avoided through timely prevention and access to high-quality health care.”

Have You Seen the Trivago Commercial?

The commercial I am referring to shows two men approaching a hotel desk. One of them is told that he is eligible for the 10% loyalty discount and his nightly charge will be $250. He smiles and says “not bad.” Then other guy at the counter is told that his bill for a similar room will be $155. The first man now looks indignant and asks “how?” The smiling gentleman let’s the upset man know that Trivago is his secret. The announcer then says, Hotel? Trivago. The savings…”up to 40%.”

I share this commercial with a twist. Imagine the two gentlemen arriving at the counter. One get’s a tiny room without a view. The cost in the United States for this broom closet of a room: $350. The other gets a suite in Marseille looking out on the Mediterranean for $150.

That is the best way I can demonstrate the difference between the American health care system compared to European countries. I know it’s a crude and imperfect analogy, but read on to get a sense of the life expectancy failure in the US compared to Japan or European countries.

Mortality Statistics Over the Years:

Please climb into my time machine as we travel back to the last century:

• Life Expectancy in 1950: 68.14 years
• Life Expectancy in 1960: 69.84 years
• Life Expectancy in 1970: 70.78 years
• Life Expectancy in 1990: 75.19 years
• Life Expectancy in 2000: 76.75 years
• Life Expectancy in 2010: 78.49 years
• Life Expectancy in 2019: 78.79 years
• Life Expectancy in 2020: 77.0 years
• Life Expectancy in 2021: 76.1 years
• Life Expectancy in 2022: 77.5 years
• Life Expectancy in 2023: 78.4 years

Let’s compare life expectancy to other countries in 2023:

• Monaco in 2023: 89.6 years
• Hong Kong: 85.8 years
• Japan in 2023: 84.8 years
• South Korea in 2023: 84.4 years
• Spain in 2023: 84.2 years
• Switzerland in 2023: 84.2 years
• Sweden in 2023: 83.3 years
• France in 2023: 83.1 years

Our Life Expectancy Failure Costs Americans the Most Money:

What do we get for our money? Not nearly enough. We spend more on health care per person in the United States than other developed countries. According to Investopedia (July 23, 2024) and the Organisation for Economic Co-Operation and Development (OECD) here are the per capita numbers for 2022:

• United States = $12,555
• Switzerland    = $ 8,049
• Germany         = $ 8,010
• Norway           = $  7,771
• Austria            = $  7,275
• Netherlands   = $ 6,729
• France             = $ 6,629
• Sweden           = $ 6,438

So, just for comparison, let’s compare the US to Sweden. Every year the average expenditure per person in the US is about twice as much ($12,555 vs $6,438). The average person in Sweden lives to 83.3 years while the average person in the US lives to 78.4 years. You do the math. We are paying a lot more for substantially less benefit.

Let’s put put this in another framework. If we were comparing cars, Americans would be paying twice as much for our automobiles as the Swedes, yet their vehicles would be lasting five years longer.

America’s Life Expectancy Failure Keeps Getting Worse:

Most people assume that Americans have the latest and greatest technology and pharmaceuticals. And because we spend more than any other country on earth for our healthcare, we should be seeing the benefits in our mortality stats.

An article in JAMA Internal Medicine, Nov. 13, 2023 was titled “Widening Gender Gap in Life Expectancy in the US, 2010-2021.” It pointed out that life expectancy for a man in 2022 had dropped to 73.2 years. For a woman it was 79.1 years. The gap between men and women was the worst it has been in more than two decades. Since then longevity has rebounded a bit thanks to the gradual reduction in deaths from COVID. But the stats still aren’t great.

One of the authors of the report, Elizabeth Arias told NPR (Nov. 29, 2023): .

“The not-so-good news is that the increase in life expectancy only accounted for less than 50% of the loss that was experienced between 2019 and 2021.”

Another expert told NPR:

“‘To me, these numbers are rather bleak,’ says Jacob Bor, associate professor of global health and epidemiology at Boston University School of Public Health, ‘The extent to which life expectancy has recovered is far short of what people had hoped.’”

America’s Healthcare Workers Are Burning Out:

Claudia reveals behavior that should never have been acceptable during COVID:

“As a healthcare worker, I and so many colleagues have experienced aggressive, violent behavior, cursing (one colleague was struck in the face) by an angry parent. Our staff has been overworked, abused, and burned out. Many are leaving healthcare – then people are angry and wonder why they cannot get an appointment with primary care or specialists!

“People don’t believe ANYTHING anymore. Society has to have some level of trust to function. It is hard to be ‘nice’ in the face of such stupidity and callousness and utter disregard for others’ lives and family members. I have been told repeatedly to ‘get over it’ and ‘move on’ when it comes to COVID. How when the misinformation and lack of compassion and aggression continue to flow right on as if nothing has happened.”

The Latest Data on Life Expectancy Failure

Covid took a terrible toll, but why did the US fare so much worse than many other countries. Perhaps it’s because our health care system is not working well. Statistics from the article published in JAMA Internal Medicine, March 24, 2025 reveal a dismal reality:

The investigators looked at data from the US and compared our stats to 40 European Union and OECD (Organization for Economic Co-operation and Development) countries. Remember, we spend more on  healthcare than every other high-income country in the world. Here is what the authors discovered:

Between 2009 and 2019 (pre COVID), our mortality stats got worse while most other countries in the analysis got better numbers.

The authors state:

“The stark contrast in prepandemic trends in US states vs comparator countries suggests that there are concerning broad and systemic issues at play.”

They analyzed data during COVID and found that during the pandemic:

“…all countries experienced an increase in avoidable mortality between 2019 and 2021, reversing the downward trend observed in the prior decade. However, US states still fared worse than most of the observed countries.”

Many Americans blame our higher level of deaths on COVID vaccines, despite the fact that we had one of the lowest levels of COVID vaccination (68%) compared to countries like Singapore (90%), Spain (87%), Portugal (87%), Australia (85%), Japan (83%) and Canada (84%).

Final Words on America’s Life Expectancy Failure:

Death is the ultimate statistic. It is the bottom line on how well a country is performing when it comes to healthcare. The authors of the study published in JAMA Internal Medicine, March 24, 2025 conclude:

“The findings from this study provide important insights to better understand worsening life expectancy in the US over time. Despite variation in avoidable deaths across US states, the study reveals an increase in avoidable deaths—including both treatable and preventable deaths—and across most causes of illness throughout the US before and during the COVID-19 pandemic. This is in stark contrast to improving trends in EU and OECD countries.”