We can match UK life expectancy by forging a healthier and safer nation

Elected officials from across the political spectrum are talking about the grave health problems in America and offering solutions — some proven, others unproven and still others disproven. Public health practitioners know that not all solutions are created equal. Policies based on evidence are the best path to a healthier nation.

A new report from the Bloomberg American Health Initiative illuminates the core issues. It shows that the U.S. trails England and Wales in life expectancy by 2.7 years and that the major reasons for this gap are preventable.

Specifically, heart disease, overdoses, firearm violence and motor vehicle crashes claim lives at far higher rates in the U.S. than in the United Kingdom.

The good news is that public health has identified proven solutions we can pursue right now to reduce these preventable deaths.

For example, untreated hypertension is a major cause of preventable heart attacks and strokes. There are safe, effective medications that can help reduce our 700,000 heart disease deaths every year, but we need innovations in our health care systems to be sure they can reach everyone, including low-income, underserved and marginalized populations.

What’s more, hypertension can be prevented by reducing sodium in our diets, exercising more and eating healthier foods like fruits and vegetables, leading to a more optimal weight.

Overdose deaths are finally falling, in part because the U.S. is doing more of what works, including distributing naloxone and providing greater access to addiction treatment.

We can accelerate this trend by making sure that correctional facilities provide access to medications that not only reduce the chance of overdose and relapse but also reduce rates of recidivism. The U.S. can make life-saving medications more accessible through pharmacies and can help people in recovery to earn a living and support their families.

Motor vehicle crashes used to be called accidents, but then we realized they can be prevented. By incorporating new intelligent speed technology that alerts drivers when they are over the speed limit, enforcing penalties for impaired driving and including a hazard perception test as part of driver licensing requirements, experts have estimated that the U.S. could save 18,000 lives a year.

Gun violence is a particularly American health challenge. In the U.S., nearly 45,000 people died in 2023 from homicide or suicide by gun. In the U.K., the number was 90. Even with our constitutional protections for gun ownership, the U.S. can implement effective policies to reduce this enormous toll.

For example, requiring a license for firearm purchase is associated with a significant reduction in firearm-related deaths. Creating processes to temporarily remove firearms from individuals at risk of self-harm or harming others has been associated with a reduction in suicides. A study analyzing extreme risk protection order laws in four states found that for every 13-to-18 orders issued, one suicide was prevented.

These are real solutions that need political support and funding to have a major impact on America’s collective health and the length and quality of people’s lives.

The adoption of these and other ideas based on evidence will not only help close the life expectancy gap with the U.K. but also the disparities among groups that exist inside the U.S.

Recent research published in the medical journal The Lancet found a 20-year life expectancy gap between groups defined by their demography and geography. This is a devastating figure that underscores how much work there is to do.

With a new administration and new Congress next year, there will be many discussions ahead about how best to improve the trajectory of health in our country. The federal government has the opportunity to make a difference, but whether that difference is positive or negative will depend on the choices that are made.

Now is not the time to back away from proven interventions that have saved millions of lives in the U.S. and around the world. Now is the time for using evidence to guide national efforts to improve health and extend lives.

Ellen J. MacKenzie, Ph.D., is dean of the Johns Hopkins Bloomberg School of Public Health and Joshua M. Sharfstein, MD, is director of the Bloomberg American Health Initiative.

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