A study published in the open-access journal BMJ Open reveals that Australians live longer than their counterparts in five other high-income English-speaking countries, including the UK and the US, with a lifespan advantage of 1 to 4 years. The analysis, which scrutinised international longevity data from 1990 to 2019, shows that most of Australia’s longevity benefits range from 45 to 84. Australians generally experience lower mortality rates from issues such as drug and alcohol misuse, treatable cancers, and cardiovascular and respiratory diseases.
Despite significant gains in life expectancy during the 20th century across high-income nations, progress has slowed markedly since the beginning of the 21st century. This slowdown, even before the disruptions caused by the COVID-19 pandemic, is concerning. Factors contributing to this include plateauing reductions in cardiovascular disease deaths and increases in fatalities related to drug overdoses, mental health issues, and neurological conditions. Furthermore, the disparity in life expectancy between the wealthiest and poorest segments of these countries has expanded over recent years, highlighting the issue of inequality.
The researchers aimed to explore differences in lifespan among six affluent English-speaking countries: Australia, Canada, Ireland, New Zealand, the UK, and the USA, representing some of the most prosperous global economies. They utilised national life tables from the Human Mortality Database and detailed mortality data by age, sex, and cause from the World Health Organization Mortality Database to assess these disparities.
The study’s key findings reveal that Australia consistently outperformed its peers in terms of life expectancy at birth from the early 1990s onwards. Australian women led by 1.26 to 3.95 years and men by 0.97 to 4.88 years as of 2018. Notably, Australia had a significant 4 to 5 year life expectancy advantage over the USA and a 1 to 2.5 year advantage over the other mentioned countries.
Canada generally held the second-highest life expectancy throughout the observed period, recently matched by Ireland and New Zealand. However, the USA consistently lagged, recording the lowest life expectancy every year since 2001, and the UK frequently occupied the second lowest position in the most recent decade. The disparities in life expectancy at birth between the best and worst-performing countries have widened over time, with the gaps doubling for men and increasing by 30% for women between Australia and the USA from 1990 to 2019.
The research highlighted that Australians benefit from lower death rates across nearly all age groups, particularly between ages 45 and 84. Critical health issues contributing to life expectancy differences in this age range include ischaemic heart disease, other circulatory diseases, cancers, respiratory diseases, and neurological conditions, predominantly Alzheimer’s disease and related dementias. Additionally, Australia shows lower mortality from external causes like drugs, alcohol, and certain cancers.
Regarding regional differences within countries, the study found the lowest life expectancy in certain US states. In contrast, all regions in the UK and Ireland surpassed life expectancy thresholds of 81 years for women and 76.5 years for men. Australia exhibited the least within-country inequality in life expectancy, particularly noticeable after age 40, with Canada following. In contrast, inequality among both sexes was most pronounced in New Zealand, Ireland, and the USA.
While acknowledging limitations such as potential inconsistencies in the cause-of-death coding at older ages, the researchers suggest several factors for Australia’s superior performance, including a high proportion of overseas-born residents and robust public health policies on issues like smoking, gun ownership, and mental health. Despite its leading position, Australia faces challenges in reducing health disparities, especially among its indigenous populations and in combating obesity.
The study concludes by positing that Australia could serve as a model for other English-speaking countries, particularly those performing less well like the USA and UK, to improve both lifespans and reduce inequalities in life expectancy.
More information: Rachel Z Wilkie et al, Life expectancy and geographic variation in mortality: an observational comparison study of six high-income Anglophone countries, BMJ Open. DOI: 10.1136/bmjopen-2023-079365
Journal information: BMJ Open Provided by BMJ Group
