Can money buy a longer life?

• Author: Kane, Hal
• Position: Life expectancy and government health programs

Armed with epidemiological studies showing rising disease rates, the head of the Russian Academy of Medical Sciences recently announced yet another warning sign for the troubled new republic. "We have already doomed ourselves for the next 25 years," said Vladimir Pokrovsky. "The Soviet economy was developed at the expense of the population's health. The new generation is entering adult life unhealthy." Pokrovsky's findings on Russians' declining health alerted the world to an unusual phenomenon: Russia and a handful of other countries in Central Asia and Africa are expected to see their people's life expectancy rates slide backward in the coming years.

Historically, the trend has been toward longer lifetimes, as health care and sanitation improved in both rich and poor countries. In the past 40 years alone, the average human being has seen his or her lifetime expand from 46 to 65 years of age, so declining life expectancy rates are a new and alarming development. The good news is that trends in life expectancy are reversible: countries can increase the longevity of their people simply by the choices they make about using the resources they have.

Though citizens of richer countries tend to live longer, it is not wealth per se that brings longevity, but rather the services that wealth can buy. Rich or poor, the countries that have higher longevity rates are generally those that use the money they do have to provide sanitation, nutrition, immunizations, education, and other basic services. When countries spend more money on other expenses instead, such as building up their military operations, their national longevity rates usually reflect the void of social programs. Saudi Arabia's oil money has helped to boost its average income to $7,000 a person, but its people only live to an average age of 69--no longer than the average Sri Lankan, who earns less than $500 per year. The Sri Lankans, it turns out, have support services comparable to those of many Saudis. Likewise, in Gabon, where oil money has raised per capita incomes to more than six times those of Sri Lanka, the average life expectancy is only 54, probably because much of the Gabonese population does not have access to even minimal health services.

Japan, on the other hand, exemplifies how both the quality and length of life can be improved when a country uses its wealth toward that end. Japan was devastated at the end of World War II, but by the mid-1950s, the malnutrition of the...