TY - JOUR AU - Preston,Samuel H. AU - Ho,Jessica Y. TI - Low Life Expectancy in the United States: Is the Health Care System at Fault? JF - National Bureau of Economic Research Working Paper Series VL - No. 15213 PY - 2009 Y2 - August 2009 DO - 10.3386/w15213 UR - http://www.nber.org/papers/w15213 L1 - http://www.nber.org/papers/w15213.pdf N1 - Author contact info: Samuel H. Preston School of Arts and Sciences 289 McNeil Building University of Pennsylvania Philadelphia, PA 19104-6298 Tel: 215/746-5396 Fax: 215/898-2124 E-Mail: spreston@sas.upenn.edu Jessica Y. Ho 417 Chapel Drive Department of Sociology Box 90088 Duke University Durham, NC 27708-0088 E-Mail: jessica.ho@duke.edu M2 - featured in NBER digest on 2009-11-24 AB - Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system. ER -