It’s time for a discussion about life after being born in America
While public protests, political debate, controversial legislation and court decisions have embroiled the United States on the issue of life before birth, comparatively little of America’s attention, concerns and demonstrations are being directed to life after birth.
At virtually every age from birth to old age, Americans have lower chances of life than no less than 40 countries, including Australia, Canada, France, Germany, Greece, Israel, Italy, Japan, the Netherlands, Norway, South Korea, Spain, Sweden, Switzerland and the United Kingdom.
During the first year of life, for example, the chances of a baby born in America reaching age one are well below those of most developed countries. The U.S. infant mortality rate is double the rates of Austria, Italy, Norway, Portugal, Spain and South Korea, and triple the rates of Finland, Japan, Singapore and Sweden.
A similar pattern is observed for the life chances of young children. America’s mortality rate of children under the age of 5 years is markedly higher than the rate of some 35 countries. Moreover, America’s child mortality rate is approximately three times as high as the rates of 10 developed countries.
By age 15, Americans also have fewer years of life remaining than dozens of other countries. In 10 of those countries, including Italy, Japan, Spain, Sweden and Switzerland, life expectancy at age 15 is about five years greater than America’s.
In addition, America has a much higher rate of maternal mortality than comparable developed countries. Women in the U.S. are more than four times as likely to die due to complications from childbirth than women in other developed countries.
America’s lower life chances persist throughout adulthood and well into old age. At age 65, the remaining years of life for Americans are a couple of years less than those for approximately 10 countries, again including Australia, France, Italy, Japan, Singapore, Spain and Switzerland.
The lower life chances in the U.S. are largely because for most of the major causes of death, mortality rates are higher in America than in comparable countries. For example, the mortality rate due to diseases of the circulatory system, which include heart diseases and stroke, is 20 percent higher in America than in other developed countries. Also, the death rate for diseases of the respiratory system is 35 percent higher in America than in other developed countries.
Various studies have confirmed that America spends more on healthcare but has worse outcomes and lower life chances than comparable countries around the world. Several major factors are believed to contribute to America’s comparatively lower life chances.
Other comparable countries, for example, provide universal healthcare coverage. The U.S. remains the only high-income country lacking universal health insurance coverage. That situation results in millions of Americans being uninsured or underinsured, and consequently, most of them are unable to meet their healthcare needs.
Other developed countries also invest in and strengthen primary care systems. They remove cost barriers and ensure access to healthcare services is available to their respective populations. In addition, administrative burdens for healthcare are reduced in those countries and investments are made in social services, especially for children.
Another important factor for the comparatively lower life chances in America centers on the prevalence of unhealthy related behaviors and lifestyles. Prominent among those behaviors are cigarette smoking, obesity, alcohol abuse and drug overdoses.
America’s mortality rate for external causes, which include drug overdoses, accidents, intentional self-harm, poisonings and assaults, is the highest among comparable developed countries, with approximately 37 percent more deaths than the comparable country average.
For many years, America has had the highest obesity rate among high-income countries. High prevalence rates for obesity are seen in U.S. children and in every age group thereafter. Beginning from age 20, American adults have among the highest prevalence rates of diabetes among comparable countries and the U.S. population is facing a Type 2 diabetes epidemic largely due to a lack of exercise and poor diet.
Americans lose more years of life due to alcohol consumption and the use of drugs than people in other comparable countries. Also, U.S. death rates from car crashes and gun violence — leading causes of lower life chances for children, adolescents and young adults — are also higher than the rates of other advanced countries.
In order to increase the life chances of America’s population of roughly 333 million men, women and children, the United States could join other developed countries in providing universal health care. Doing so would not only raise the life chances of Americans, but it would also be advantageous for the overall well-being and economy of the United States.
Getting Congress to pass universal healthcare legislation, however, remains a challenge. While congressional Democrats are largely in favor of some sort of universal coverage system, congressional Republicans are largely opposed to government-run healthcare, preferring free market approaches.
In addition to universal healthcare, modifying the unhealthy behaviors and lifestyles of most Americans, especially cigarette smoking, diet, alcohol consumption, and drug abuse, would significantly contribute to increasing life chances and improving the health status of America’s population.
Given the recent Supreme Court decision overturning a woman’s constitutional right to an abortion, it appears certain that for the foreseeable future America will continue to be embroiled with the issue of life from conception to birth. That issue is now being debated, reviewed, negotiated and adjudicated by state legislatures, local officials, U.S. courts and Congress.
The issue of life before birth, however, should not diminish America’s attention from the vital issue for the country of life after being born. Given the country’s wealth, resources and talents, the United States can significantly improve the life chances of Americans after being born so that they are similar to the levels of comparable developed countries.
Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division and the author of numerous publications on population issues, including his book, “Births, Deaths, Migrations and Other Important Population Matters.”