Working Paper: NBER ID: w15213
Authors: Samuel H. Preston; Jessica Y. Ho
Abstract: Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.
Keywords: Life Expectancy; Health Care System; Mortality Rates; Cancer Treatment
JEL Codes: I01; I12; I18; J11; J14; J18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| U.S. health care system performance (I18) | mortality rates from prostate and breast cancer (I12) |
| effective screening and treatment methods (I12) | faster declines in mortality from prostate and breast cancer (I14) |
| U.S. health care system performance (I18) | life expectancy ranking (I14) |
| personal behaviors (D14) | health outcomes (I14) |