Table 1-2 lists other conditions for which the U.S. mortality rate is at or below the average of the 16 other peer countries.


Not surprisingly, higher mortality rates affect life expectancy in the United States. Perhaps the single most impressive achievement of the past century is the striking increase in longevity in nearly all parts of the world. At the turn of the 20th century, North American and Western European countries experienced life expectancies at birth of 40-50 years (Preston and Haines, 1991): 100 years later (in 2007), no country in these regions had a life expectancy of less than 75 years, and most had levels of more than 80 years (Human Mortality Database, 2012).

However, as shown in Table 1-3, there remain large differences in life expectancy at birth among high-income peer countries. In 2007, men in Switzerland and women in Japan enjoyed the longest life expectancies for their sexes. In contrast, the United States ranked last among males and next to last among females.8 These differences with the top-performing countries amount to approximately 3.7 years for males and 5.2 years for females (Ho and Preston, 2011).9

We emphasize that these large cross-national differences are often eclipsed by even larger within-country disparities in life expectancy. As discussed in Box 1-2, such disparities are substantial in the United States (Agency for Healthcare Research and Quality, 2011; Bleich et al., 2012; Braveman et al., 2011a; Satcher et al., 2005; Woolf et al., 2004), and they may be part of the reason that the United States compares so unfavorably with its peers.

The U.S. disadvantage in life expectancy relative to other high-income countries is not a recent phenomenon (although the gap has grown over time), nor is this the first report to call attention to the problem. Jenkins and Runyan (2005) reported that U.S. survival rates for each of the five decades


8The life expectancy of females was lower in Denmark than in the United States in 2007. Life expectancy in aggregate (for males and females) has historically been lower in Denmark than in the United States, but not since 2005. These findings are from the Human Mortality Database (2012), which provides regularly updated detailed mortality and population data to researchers, students, and others interested in the history of human longevity. It is available at

9Ho and Preston’s analysis for this panel is modeled on a similar analysis of mortality above age 50 that they conducted for the National Research Council (2011) panel and also published in Ho and Preston (2010). The current analysis draws on data from three sources: the Human Mortality Database, the WHO Mortality Database, and Statistics Canada. The data were downloaded July 2011, and, for each country, the latest year of data available between 2006 and 2008 was extracted. Dana Glei of Georgetown University provided the panel with a focused mid-project technical review of this analysis.

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