By John Haaga, PhD who retired as director of the National Institute on Aging’s (NIA) Division of Behavioral and Social Research (BSR) within the National Institutes of Health (NIH) in December 2019.
The COVID-19 pandemic has sparked a surge of interest in the press and social media in comparisons with other countries. When did the new virus reach other countries, how did they handle it, and how well did they do? I have lost count of the number of times I have read that the first COVID-19 deaths happened in the United States and South Korea at about the same time in January 2020, but it seems clear that the Koreans got on top of the epidemic, at least the first wave, while the United States did not.
This interest should survive this pandemic and broaden to include all sources of poor health, disease and death. South Korea did not suddenly start to outperform the United States in health last January. This has been true for decades. Life expectancy at birth (a weighted average of death rates at all ages) is the best single metric for the health of a population. In 2004, Korea and the US had almost exactly the same life expectancy at birth, even though the US spent a much larger percentage of its (much larger) gross national product (GNP) on the health sector. By 2018, before the discovery of the novel coronavirus, the US had gained one full year of life expectancy. Life expectancy in Korea improved by five years during the same period. Looking across the developed countries, it becomes clear that Korea’s improvement was better than most countries, but the US is really the outlier. We were caught up to and passed in this fundamental measure of population health by dozens of countries, many of which are considerably poorer, and all of which spend much less that the US on health services and research (Portugal, Costa Rica, Slovenia, Chile—not to mention all other rich countries of Europe, Canada and Japan). We need to ask difficult questions about our performance in the COVID-19 pandemic, but also about the obesity epidemic, the opioid epidemic, heart disease, cancers, stroke, injuries and all other causes of death and disability.