Countries where English is the official language have a lot in common due to their shared British colonial history – but a new study has found that life expectancy varies greatly between Anglophonic nations.
What's more, one nation in particular – Australia – appears to stand head and shoulders above the rest in terms of life expectancy, presumably thanks to its superior healthcare system, and comparatively few deaths from drugs and firearms.
Population health scientist Rachel Wilkie from the University of Southern California and demographer Jessica Ho from the Pennsylvania State University teamed up to create a detailed picture of life expectancy in high-income, English-speaking countries, and to learn what might be giving the best countries their edge on longevity.
"Life expectancy in high-income countries indicates the frontiers of what is attainable in contexts with high standards of living and ample resources directed towards improving health and well-being," Wilkie and Yo write.
They compared data from 1990 to 2018 on six high-income countries where English is the main language – the United States, Canada, the United Kingdom, the Republic of Ireland, Australia, and New Zealand – which was drawn from the WHO Mortality Database and each country's vital statistics agencies. For regional comparison, information on non-English-speaking countries was included from the Human Mortality Database.
"These countries share a common language and some cultural similarities (eg, diet and lifestyle), as well as current and historically high levels of income inequality," the authors write.
And yet, as their study found, these similarities don't mean their citizens can necessarily expect to enjoy similar lifespans.
They assessed life expectancy at birth and at age 65; how life expectancy is affected by age and cause of death in different countries; and how widely each country's life expectancy varied within their own geographic regions.
Australia performed the best across the board compared to all other countries, with lower mortality for both men and women at nearly all ages, especially between the ages of 45 and 84.
"Australia is the clear best performer in life expectancy at birth, leading its peer countries by 1.26–3.95 years for women and by 0.97–4.88 years for men in 2018," the researchers write in their paper.
The study found the nation has a particular advantage over the other countries when it comes to deaths from circulatory and respiratory diseases, cancers, perinatal and congenital conditions, and mental and nervous system diseases like Alzheimer's. This was especially true for Australian men.
The authors note reduced risk of death from these conditions "are linked to superior healthcare system performance (eg, cancer screening and treatment, influenza vaccination, and cardiovascular disease prevention, diagnosis and treatment)."
This is supplemented by Australia's lower mortality rates related to both firearms and drug overdoses, compared with other countries.
Canada, which is also known for its quality public healthcare system, had the second highest life expectancy at birth between 1990 and 2019, though New Zealand and Ireland have also caught up to this position more recently.
In fact, things are really looking up in the Emerald Isle. Across the years analyzed, life expectancy at birth in Ireland increased by 8.29 years for men, and 6.66 years for women.
"[The Republic of] Ireland experienced remarkable life expectancy gains between 1990 and 2018," the authors write.
"Initially, Irish men and women had the lowest or second-lowest life expectancy among these countries; by 2019, they ranked second (men) and third (women)."
When data was broken down into geographic regions, both the UK and Ireland had very little variation – life expectancy was about the same regardless of where you live in these countries.
Australia also did well in this regard, except for the Northern Territory, a population with a high proportion of Aboriginal Australians who are known to have shorter life expectancies, especially in remote areas like the NT, because of the many issues they face disproportionately as First Nations peoples, like higher rates of disease burden.
"Notably, sizeable mortality inequalities across socioeconomic status and geographic region exist within most of these countries and have tended to widen in recent decades," the authors write.
The United States had the lowest life expectancy at birth for every year since 2001, and similarly finished last in the rank for life expectancy at age 65. Based on data from 2019, Australian men (at birth) can expect to live nearly 5 years longer than those in the United States.
"Overall, Australia offers a potential model for lower-performing Anglophone countries, such as the USA and UK, to follow to reduce both premature mortality," the authors note.
This research is published in BMJ Open.