Preventable injury deaths shorten U.S. life expectancy

(Reuters Health) - About half of the difference in life expectancy between the U.S. and other high-income countries like Austria and the U.K. is due to injuries sustained from guns, drug poisonings and motor vehicle crashes, according to a new study.

Guns are seen inside a display case at the Cabela's store in Fort Worth, Texas, June 26, 2008. REUTERS/Jessica Rinaldi

As of 2012, U.S. life expectancy at birth was 78.7 years, compared to 81.5 years in the U.K. and 82.6 years in France, according to World Bank data.

“Part of the reason there is such a large difference is that people who die from these injuries usually have several decades left to live,” said lead author Dr. Andrew Fenelon of the National Center for Health Statistics in Hyattsville, Maryland.

The researchers used data from the U.S. National Vital Statistics System and the World Health Organization Mortality Database to calculate death rates by age, sex and cause for the U.S. and 12 high-income countries: Austria, Denmark, Finland, Germany, Italy, Japan, the Netherlands, Norway, Portugal, Spain, Sweden and the U.K.

Overall, life expectancy for U.S. men was 76.4 years, compared to 78.6 years in the other countries. For U.S. women, it was 81.2 years versus 83.4 years in the comparison countries.

Underlying those differences was a rate of 865 deaths per 100,000 men in the U.S. in 2012, compared to 772 per 100,000 men in other countries that year. A similar difference was seen among women, with a rate of 625 deaths per 100,000 in the U.S. compared to 494 deaths per 100,000 in other countries.

For men, about half of the life-expectancy gap was attributable to injury deaths, including 21 percent of it due to firearm deaths, 14 percent to legal and illicit drug poisonings and 13 percent to motor vehicle crashes, according to the results in JAMA.

For U.S. women, injury deaths only accounted for about 19 percent of the difference, or about five months of the gap, compared to the other countries.

Firearms, poisonings and vehicle crashes were responsible for a total of 6 percent of deaths among men and 3 percent of deaths among women in the U.S.

“Against what people would commonly expect, life expectancy in the U.S. is considerably reduced compared to many other countries,” said Benedikt Fischer of the Center for Applied Research in Mental Health and Addiction at Simon Fraser University in Toronto, Canada, who was not part of the new study.

“All three major problems we know are modifiable, and targeted well-informed effective policies can make a great difference,” especially as most drug poisonings are due to prescription drug overdoses, Fischer told Reuters Health.

But for a variety of reasons, those policies are not in place, so “obviously something is really not going well in the U.S. in these areas,” he said.

“This should ring all available alarm bells,” he said. “If places like Japan or Europe or Canada manage to handle these problems, why wouldn’t the U.S. be able to do that? It’s a clear policy failure.”

Canada was not included in the comparison because their available data was only complete through 2011, but the differences with the U.S. would likely have been similar, Fenelon told Reuters Health.

Firearm and drug deaths have been well-known issues in the U.S. for a long time, but motor vehicle crashes may be more surprising – driving isn’t necessarily more dangerous in the U.S., but driving is more common than in other countries, he said.

SOURCE: JAMA, online February 9, 2016.