ON LIFE EXPECTANCY. The United States ranks 42 in life expectancy among 222 countries. Why is this the case when the U.S. leads the world in health care spending?

There are several explanations, many of them discussed in the linked article, that focus on the changes the U.S. health care system needs. But it's also important to note what life expectancy measures: The number of years a person born in a particular year can expect to live, on average. Because of its construction, the measure is very sensitive to deaths in early life. At the same time, curing, say, cancer, might not raise life expectancy very much, simply because most cancers strike later in life, and hence the years saved per person might not be that many.

This suggests that one reason for the low ranking of the U.S. in life expectancy statistics might be greater death rates at earlier ages. The article mentions the higher American infant mortality rate. But it fails to mention the higher American rates of accidental and violent deaths at younger ages. Car accidents and murders, in short. Note that the ability of the health care system to affect the latter types of deaths is fairly limited.

Much more can be done about infant mortality rates, and that is the reason why they are often seen as a useful proxy of how well the health care system of a country is operating. Much more could also be done about the racial differences in life expectancy rates by a fairer system of health care access. Such changes would raise life expectancy figures. That addressing cancer, heart disease and lung disease, as the article recommends, might not have as dramatic impact on this one measure does not mean that those recommendations are somehow wrong. There's more to life than just its length, after all.

--J. Goodrich