A twenty-first century demographic challenge: Comparatively low life expectancy in the United States

Abstract

The United States is currently characterized by a lower fertility rate and higher life expectancy than most countries around the world. However, overall U.S. life expectancy lags behind that of most low fertility (and high-income) countries. We review trends in U.S. life expectancy, as well as the most prominent causes of death and behavioral factors that contribute to the relatively higher mortality in the United States. Compared to other low fertility, highincome countries, U.S. males and females exhibit the highest age-specific mortality in early life, but average or better age-specific mortality at older ages. High mortality in the United States due to behavioral-related causes-cigarette smoking, obesity, alcohol and drug abuse, risky driving, use of firearms-is in part responsible for the lags in U.S. life expectancy compared to other low fertility, high-income countries. It will take very substantial reductions in U.S. age-specific mortality in the next few decades to achieve the levels of life expectancy already experienced by the vanguard countries of the world. Nevertheless, some trends in the United States appear favorable, and we are guardedly optimistic that the United States will continue to experience gains in U.S. life expectancy over the next few decades.