For the past 100 years, life expectancy in the US has been on a relentless upward march. It was 69 when I was born in 1955. In 1994 it was 75.7. In 1998 it was 76.7. In 2002 it was 77.0. In 2006 it was 77.8. In 2010 it was 78.7. That’s when Obamacare was passed. In 2014 it was just 78.8. That’s the smallest 4-year increase since annual data began (in 1970).
I actually don’t think that’s a very good argument against Obamacare. But supporters of Obamacare often used arguments that were equally lame, such as the claim that life expectancy in the US is lower than in Western Europe. Yes, but what does that mean?
To give you an idea of just how misleading life expectancy data can be, consider the case of Hawaii. This source suggests that Asians in Hawaii live shorter lives than Asians in any other state, in some cases by a wide margin. (Note Asian life expectancy data is only available for 28 states.) OK, but how about Hispanics? Again, life expectancy for Hispanics is lowest in Hawaii, of all the states with data (again 28 states.) There is no data for blacks in Hawaii. By now you must have concluded that Hawaii is some sort of hellhole with horrible life expectancies. And controlling for race it is. But Hawaii is also the state with the highest overall life expectancy in the entire US.
How is that even possible? One answer is that whites do fairly well in Hawaii. But whites are a minority in that tropical paradise. The real reason is even more bizarre. Both Hispanics and Asians have inexplicably long life expectancies in the US.
Let’s go back to Obamacare, which was going to improve health by eliminating the problem of people with without health insurance. The group that is far and away the least likely to have health insurance is Hispanics. They also have an obesity problem. And yet their life expectancy is 81.8, compared to 79.0 for whites. Why? I have no idea. But again, it suggests that health insurance isn’t the issue, something else is going on.
Asians are the biggest group in Hawaii, and they have a mind-boggling 86.5 life expectancy in the US, which is higher than even the richest countries in East Asia (Japan tops out at 84). And yet Asians in America have a higher poverty rate than whites. Even if it’s genetic, that doesn’t explain the comparison with East Asia. Nor does diet.
Once again the state level data might help. The two longest-lived Asian groups are in New Jersey and Massachusetts, both over 89 years. And it’s pretty clear what’s special about these two states—they both have a lot of recent immigrants who are highly educated and work in high tech (like my wife, who is from China, works in biotech, and will basically live forever, assuming cryonics is perfected within 40 years.) It’s not surprising that the well-educated live longer, that’s also true of whites. But nationally there are also plenty of Asians that don’t work in high-tech, so the overall life expectancy is still pretty hard to explain.
So Hawaii is the absolutely worst place for Asians and Hispanics. But there are so many Asians in Hawaii, and their life expectancy is so mindbogglingly long, that it pushes Hawaii to number one among US states, the very highest life expectancy. A good example of the need for control variables.
African-Americans present another puzzle. The black/white gap was 6 years in the early 1980s. By the late 1980s it had widened to 7 years, and was still 7 years in 1994. No reason for optimism, right? But then it started shrinking steadily, and was down to 3.8 years by 2010. As we know, total life expectancy in the US then leveled off, as did white life expectancy. But black life expectancy kept rising, and the gap is now (in 2014) only 3.4, less than half the gap of 20 years ago. The gap is still shrinking. Why? I have no idea. The falling murder rate is one factor, but hardly seems important enough to explain the whole story. Meanwhile the poor/rich gap is widening among whites, and blacks have some of the same socio-economic problems as poor whites. (Here’s where the Oxy/heroin epidemic may play a role for whites.)
Denmark has the shortest life expectancy in Western Europe. Diet? Lots of Danes who moved to the US became Mormons, who adopted their strong communitarian culture. So Utah has good social indicators, just like Denmark. Except life expectancy. Whereas Denmark is unusually low for Western Europe, Utah is relatively high for the US. Another mystery.
My conclusion? We don’t understand life expectancy very well. (Commenters: Before giving me your “theory” of Hispanics or Asians, ask yourself if you expected these numbers, before seeing them.)
PS. After I wrote this I noticed that Alex Tabarrok has a new post on this topic. His data set stops at 2010, and hence he doesn’t pick-up the leveling off of life expectancy after Obamacare was passed.
PPS. There are different sources for international life expectancy data, and they do not all agree.