IZA DP No. 14517 JUNE 2021 American Delusion: Life Expectancy and Welfare in the US from an International Perspective Recent increases in mortality have brought life expectancy back to the forefront of the public health debate in the US. Though unprecedented, this trend comes after an equally striking phenomenon: a decades long deterioration in the relative position of the US in the world’s life expectancy distribution, culminating in the late 2010s in a gap of close to 3 years to the OECD average. This paper takes a comparative approach and documents the relative performance of life expectancy in the US from an international perspective. We characterize the changes in this relative performance over time, its age and cause of death profiles, and estimate its welfare implications. We show that this phenomenon is not recent, is not restricted to very particular causes of death, but is mostly driven by adult and old age mortality. We calculate that welfare gains in the US over the last few decades could have been between 19% and 28% higher had the US been able to reproduce the average health performance of OECD countries at their typical health expenditures. JEL Classification: I1, I3, O5

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美国错觉：国际视野下美国的预期寿命和福利

IZA DP 第 14517 号 2021 年 6 月 美国错觉：从国际角度看美国的预期寿命和福利 最近死亡率的上升使预期寿命重新回到了美国公共卫生辩论的前沿。尽管史无前例，但这一趋势出现在一个同样引人注目的现象之后：美国在世界预期寿命分布中的相对地位长达数十年的恶化，最终在 2010 年代后期达到顶峰，与经合组织平均水平差距接近 3 年。本文采用比较方法，从国际角度记录美国预期寿命的相对表现。我们描述了这种相对表现随时间、年龄和死亡原因的变化，并估计了它对福利的影响。我们表明这种现象不是最近的，不仅限于非常特殊的死亡原因，而是主要由成人和老年死亡率驱动。我们计算出，如果美国能够以典型的卫生支出重现经合组织国家的平均卫生绩效，那么过去几十年美国的福利收益可能会高出 19% 到 28%。JEL分类：I1、I3、O5