Although the exact contribution of obesity to shortened lifespan isn't known, it might be responsible for one-fifth to one-third of the life expectancy gap between the United States and other developed countries, the report says.
Moreover, the obesity epidemic could make the years gained by reduced smoking moot, according to the report. However, recent data find the obesity epidemic leveling off and the risk of death associated with obesity may be in decline, the authors say.
"It's clear that our behavioral patterns are not what would lead to optimal health," Preston said. "That's partly a reflection of personal decisions. It's perhaps a reflection that we are not doing a good job in preventive medicine."
While lack of access to health care also affects lifespan, this is less of a factor because those over 65 have access to Medicare, the report notes.
Among aging Americans, cancer and cardiovascular disease remain the main causes of death, and diagnosis and survival rates from these diseases appear to be better in the United States than in most other industrialized countries, the report says.
Hormone replacement therapy did not appear to influence women's longevity, nor did social ties seem to have a bearing on life expectancy, the authors say.
However, the report, titled Explaining Divergent Levels of Longevity in High-Income Countries, suggests that gaps in research make it difficult to draw hard and fast conclusions about how factors such as diet, physical inactivity and social integration affect longevity.
Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said he believes the shortfalls revealed in the report are indicative of a problem much deeper than personal behaviors such as overeating and smoking.
"While we are an affluent country, we tolerate and even propagate enormous economic dispariti
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