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Comment by jandrewrogers | Hacker News Reader

If you dig into the statistics, the reason is not what most people assume. The US has anomalously high death rates due to unintentional injury (accidents) in the young adult age groups, which skews the average for the overall population. If young people died in accidents at similar rates to the rest of the world, the average life expectancy would look quite good. This is the 3rd most common cause of death in the US, generally.

The primary source of injury in young people creating this situation? Car accidents. And remembering how me and my friends were behind the wheel at that age, this is completely unsurprising. Young people in many other countries do not drive nearly as much.

Everyone looks for medical reasons but it is largely fatal accident rates.

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Sorry, car accidents won't cut it. Here are the life tables: https://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_03.pdf which link to this spreadsheet: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/...

Here are traffic deaths by age group: https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a8.htm. Let's pad those numbers up by a significant amount and assign 20 per 100,000 from birth, and remove those deaths from the life tables (ie let's say noone dies from traffic accidents in the USA). That still only lifts life expectancy by 1 year (from 78.6 to 79.6)

You can keep adding other parts of accidental deaths but: 1) they don't fit the story of USA dying more from driving 2) the leftovers are already below the accidental death rate from countries with much higher life expectancy 3) a big chunk of the rest is accidental falls which predominantly affects very old people so doesn't have a big impact on life expectancy

Even if this is a fundamental part of the explanation, there are features of US culture and geography at work. Most of the rest of the wealthy countries have smaller geographies and denser population centers, and a corresponding lower rate of car travel. With our huge suburban sprawl, many youngs find their entry into adulthood coupling excessive commute responsibility for entry level jobs with the new freedom and responsibility of a vehicle. (I grew up in the DC suburbs, this was my life.)

People vastly underprice the mortality/morbidity costs of driving in the US (or mostly anywhere).

I wince when I hear 1 hour commute times. The risk of injury and death from driving 10k miles per year versus 25k miles per year is material in my opinion.

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