Health Disparity in Healthcare System and Life Expectancy in the World: Challenge and Opportunity

Objective: Significant differences in life expectancy (LE) exist among people with different race/ethnicity and those living in different countries. The present study aims to test the hypothesis that these differences in LE are significantly related to differences in healthcare systems.

Methods: To test the study hypothesis, data from the World Health Organization-coordinated healthcare system surveys from 194 countries in 2005 are used. Ecological study design is applied to examine the relationship between fifteen healthcare indicators and LE by taking the 194 countries as the observational units (i.e., n=194). Pearson correlation and linear regression analysis techniques are used in analyses.

Results: In 2005, among 194 countries, the LE ranged from 37 (Sierra Leone) to 80 years older (San Marino) in males, and from 37 (Swaziland) to 86 (Japan) in females. The United States ranked at the top 33 in males, and 36 in females. LE was significantly correlated positively with total expenditure on health as percentage of gross domestic product, general government expenditure on health as percentage of total expenditure on health, and the numbers of doctors and nurses per 1000 population (correlation coefficients ranged between 0.30 to 0.62, p<0.001). LE was significantly correlated negatively with infant, neonatal and maternal mortality rates, injury accidence rates, and mortality from communicable disease, cardiovascular disease and cancers (correlation coefficients ranged from -0.26 to -0.92) in males and females. Conclusion: Advancing and reforming healthcare system and improving public health infrastructure play a crucial role in eliminating health disparity in life expectancy worldwide.