By some measures, you now have a better chance of living the American dream in Canada or Western Europe than in the United States. And while Americans generally gained longevity during the late 20th century, those gains have gone disproportionately to the better-off. Those without a high school education haven’t experienced much improvement in life span since the middle of the 20th century. Poorly educated whites have lost a few years of longevity in recent decades.
A National Research Council report, meanwhile, found that Americans were generally sicker and had shorter life spans than people in 16 other wealthy nations. We rank No. 1 for diabetes in adults over age 20, and No. 2 for deaths from coronary artery disease and lung disease. The Japanese smoke more than Americans, but outlive us — as do the French and Germans, who drink more. The dismal ranking is surprising given that America spends nearly twice as much per capita on health care as the next biggest spender.
But an analysis by Elizabeth H. Bradley, an economist at the Yale School of Public Health, suggests that how you spend money matters. The higher the spending on social services relative to health care, she’s found, the greater the longevity dividends.