A recent analysis of international longevity data published in BMJ Open highlights that Australians have a notable advantage in life expectancy compared to their peers in five other high-income English-speaking nations, including the United Kingdom and the United States. The findings reveal that Australians live, on average, one to four years longer, with the majority of this advantage accruing between the ages of 45 and 84. This edge is attributed to lower mortality rates from drug and alcohol misuse, screenable and treatable cancers, as well as cardiovascular and respiratory diseases.
The study underscores that while high-income countries made significant gains in life expectancy throughout the 20th century, these improvements have slowed considerably in the 21st century, even before the onset of the COVID-19 pandemic. The researchers point to stagnating declines in cardiovascular disease deaths, along with an increasing death toll from drug overdoses, mental illness, and neurological diseases, as major contributing factors. Moreover, the gap in life expectancy between the wealthiest and poorest individuals within these countries has widened in recent decades.
Although these English-speaking high-income countries share many similarities, they also exhibit significant differences in healthcare and welfare systems, racial and ethnic composition, and immigration history. To explore whether these differences impact life expectancy, the researchers compared Australia, Canada, Ireland, New Zealand, the UK, and the USA, which represent some of the world’s wealthiest economies.
The researchers utilized national life tables from the Human Mortality Database (HMD) for men and women in these countries, as well as for additional European countries, between 1990 and 2019. They also accessed detailed information on deaths by sex, age, and cause from the World Health Organization Mortality Database for all six English-speaking countries.
The analysis revealed that since the early 1990s, Australia has consistently led its peer countries in life expectancy at birth. In 2018, Australian women lived 1.26 to 3.95 years longer, and Australian men lived 0.97 to 4.88 years longer, than their counterparts in the other five nations. Specifically, Australia has a 4 to 5-year advantage over the USA and a 1 to 2.5-year advantage over Canada, New Zealand, Ireland, and the UK. Canada ranked second in life expectancy for most of the period between 1990 and 2019, though Ireland and New Zealand have recently matched Canada’s performance.
Conversely, the USA has consistently performed the worst in life expectancy since 2001. Over the past decade, the UK has generally ranked second-lowest in life expectancy among these countries. Similar trends are observed for life expectancy at age 65, with Australia typically ranking the highest and the USA the lowest, a trend that has become more pronounced in recent years.
The study also found that the gap in life expectancy between the best and worst performers has widened over time. In 1990, Canadian men and women had the highest life expectancies at 74 and 80 years, respectively, while American men and Irish women had the lowest at 71 and 77 years. By 2019, these gaps had nearly doubled for men and increased by 30% for women between Australia and the USA.
Interestingly, while women in these English-speaking countries have never ranked among the top performers in female life expectancy within the group of 20 high-income nations, men (except in the USA) have typically ranked in the top half over the past decade. Australian men, in particular, have ranked in the top four in all but one year between 1990 and 2019, whereas American men have had the lowest life expectancy since 2005.
The study identifies the 65–84 age group as contributing the most to the life expectancy gaps between Australia and the other five countries. This age group accounts for 39% to 78% of the gap among women and 30% to 100% among men. Ischaemic heart disease, other circulatory diseases, cancers, respiratory diseases, mental illness, and neurological diseases, particularly Alzheimer’s, are key contributors to these gaps. Additionally, Australia has lower mortality rates from external causes, including drug and alcohol-related deaths, treatable cancers, cardiovascular diseases, and respiratory infections like flu and pneumonia.
In terms of within-country inequality, Canada and the USA fare the worst, with 13 US states falling into the lowest category for life expectancy. On the other hand, all regions in the UK and Ireland have life expectancies above 81 for women and 76.5 for men. Australia, particularly for those over 40, exhibits the lowest within-country inequality, followed by Canada. For women, inequality is highest in New Zealand, Ireland, and the USA, while for men, it is most pronounced in New Zealand, the UK, and the USA.
The researchers acknowledge limitations in their analysis, such as the inability to account for differences within local neighborhoods and potential variations in cause-of-death coding, especially in older populations where multiple conditions may coexist. They suggest that Australia’s top ranking may be due to its high proportion of immigrants, low smoking prevalence, public health initiatives on gun ownership and mental health, and a highly rated healthcare system. These factors likely contribute to Australia’s position at the top of the life expectancy league table.
