That Whole Life Expectancy Thing?


Yeah…not so much.

It turns out that there are a number of problems in determining life expectancy numbers.  As I mentioned the other day, in some cases, nations aren’t reporting their “deaths” correctly.

And THAT could make a huge difference.

According to a couple of economists, it does make a difference.  And a big one.

And, it turns out, not all deaths are created equal.

Murders, suicides and accidents can have a big effect on life-expectancy stats because their victims die younger, on average, than victims of disease. And, they argue, the health-care system can’t do much to prevent those kinds of deaths.

Interesting.  When measuring just deaths, the time a person is alive, the US is ranked 30th in the world.  YIKES!  Horrible.

However, for the purposes of using life expectancy as a metric to measure health care services, the United States ranks:

After adjusting for those kinds of deaths, the U.S. ranks at or near the top of developed nations in life expectancy, health economists Robert Ohsfeldt (of the Texas A&M Health Science Center) and John Schneider (of Health Economics Consulting Group LLC) write in “The Business of Health,” a 2006 book published by the conservative American Enterprise Institute think tank.

Amazing!

Are there deficiencies to the study?  To be sure:

…there are several shortcomings to this analysis. First, death rates from accidents, homicides and suicide are dependent not only on how many people suffer injuries from such events but also on how effective the health-care system is at averting death in borderline cases (a point I made in a column earlier this year). Various factors influence that success rate; one of them is the distance emergency services must travel to reach victims, in which population density comes into play and the relatively spread-out U.S. is at a disadvantage.

Also, the authors didn’t directly adjust for these deaths. Instead, Dr. Ohsfeldt and Dr. Schneider performed a statistical calculation, called a regression, to estimate how much mortality rates from homicide, suicide and accident influenced mortality, on average, from 1980-1999 in 29 of the 30 developed countries in the Organisation for Economic Co-operation and Development (they skipped tiny Luxembourg).

However, to their credit, the authors note that the basis of the study was not to precisely measure life expectancy, only show that the current method may not be the best if the idea is to use it as a proxy for medical services by nation:

“We’re not trying to say that these are the precisely correct life-expectancy estimates,” he told me. “We’re just trying to show that there are other factors that affect life-expectancy-at-birth estimates that people quote all the time.” These factors (which could also include rates obesity and smoking, also arguably the result of lifestyle choices rather than health care) call into question the value of country rankings, especially where the difference between the leading countries is often less than a year.

As a note, when the economists DID account for the various forms of death…hazard a guess as to where the US ranks:

…they adjusted life-expectancy stats to get a rough handle on what life expectancy would have been like had the rates of these deaths been the same in all 29 countries. Their result: The U.S. would have ranked first, at 76.9 years of life expectancy — an increase of 1.6 years.

And the reigning world champ, all 77,000 of their 120 year old citizens?

Japan fell from 78.7 years to 76 years, indicating it had been benefiting inordinately from low rates of accidental deaths and homicides.

Interesting stuff.

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