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Why do Americans have shorter life expectancy and worse health than do people in other high-income countries?

Avendano, Mauricio and Kawachi, Ichiro (2014) Why do Americans have shorter life expectancy and worse health than do people in other high-income countries? Annual Review of Public Health, 35 (1). pp. 307-325. ISSN 0163-7525

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Identification Number: 10.1146/annurev-publhealth-032013-182411


Americans lead shorter and less healthy lives than do people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the built physical environment. Although these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage.

Item Type: Article
Official URL:
Additional Information: © 2014 Annual Reviews.
Divisions: Social Policy
LSE Health
Lifecourse, Ageing & Population Health
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
J Political Science > JK Political institutions (United States)
R Medicine > RA Public aspects of medicine
Date Deposited: 14 Apr 2014 15:42
Last Modified: 16 Jul 2024 21:24
Projects: R01AG040248 and R01AG037398, ERC grant 263684, NIA U01AG009740, 2RO1AG7644-01A1, 2RO1AG017644, QLK6-CT-2001-00360, U01 AG09740-13S2
Funders: National Institute on Aging, European Research Council, National Institute on Aging, English Longitudinal Study of Ageing, National Institute of Aging, European Commission through the fifth Framework Program, European Commission through the sixth Framework Program, European Commission through through the seventh Framework Program, National Institute on Aging

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