Get on the cutting edge. States where people take the latest drugs have longer life expectancies.

It is no surprise that Americans are living longer today than in previous generations. A typical baby born in 1900 was expected to live to about age 45. Today, life expectancy at birth is about 78. Less well known, however, is the fact that the gains in life expectancy have not been uniform across the country. In his new study—the first of its kind—Columbia University researcher Frank Lichtenberg set out to find out which states are the leaders, which ones are the laggards, and why.

Lichtenberg began by constructing life-expectancy estimates of residents in all fifty states using data from the National Center for Health Statistics. He found that in 2004, on average, residents of Hawaii (81.3 years) and Minnesota (80.3 years) lived six or seven years longer than residents of Mississippi and Louisiana (74.2 years).

In addition, he found that while nationwide life expectancy increased by 2.33 years from 1991 to 2004, the increase varied greatly among the states. Certain states—New York (4.3 years), California (3.4 years), and New Jersey (3.3 years)—led the way, while others–Oklahoma (0.3 years), Tennessee (0.8 years), and Utah (0.9 years) trailed the national average by significant margins.

See the full article for a list of life expectancies by state. But since there are differences in life expectancy due to genetic effects of race and ethnicity and also due to regional dietary differences and other causes you can't assume that moving to a state with higher average life expectancy will increase your own life expectancy. Better to adopt life extending practices right where you are.

The newer the average age of used drugs the greater the increase in longevity. This argues against use of generic drugs (though they can be best of breed in some cases).

Lichtenberg then set out to examine why this “longevity increase gap” exists by measuring the impact of several factors that researchers agree could affect life expectancy. He found that, although some obvious suspects—obesity, smoking, and the incidence of HIV/AIDS—played a role, the most important factor was “medical innovation.”

Specifically, Lichtenberg found that longevity increased the most in those states where access to newer drugs—measured by mean “vintage” (FDA approval year)—in Medicaid and Medicare programs has increased the most. In fact, about two-thirds of the potential increase in longevity—the longevity increase that would have occurred if obesity, income, and other factors had not changed—is attributable to the use of newer drugs. According to his calculations, for every year increase in drug vintage there is about a two-month gain in life expectancy. These represent important findings given the fact that the costs of prescription drugs continue to receive a great deal of attention in the ongoing debate over health-care policy, while their benefits are often overlooked.

Attempts to regulate and reduce drug prices will slow the growth rate in longevity by reducing the economic incentive to develop new drugs. We need more new drug development. More new chemical compound drugs can raise life expectancy even further. But we need to move to new types of medical treatments in order to achieve a really big burst in medical treatment efficacy. In particular, stem cells, gene therapies, and nanodevices will some day stop aging altogether and even reverse the aging process.

Economists who favor ever increasing income growth need to come up with an answer to Lichtenberg's claim that rising incomes work against growth in life expectancy.

• Growth in obesity and, interestingly, growth in income were both inversely related to (and presumably reduced) the growth in life expectancy.

• If obesity and income had not increased, life expectancy at birth would have increased by 3.88 years from 1991 to 2004, instead of the actual 2.33-year increase. Thus, 3.88 years is the “potential increase in life expectancy at birth.”

• Of the 3.88-year potential increase in life expectancy at birth, medical innovation (i.e., the increase in Medicaid and Medicare drug vintage) accounted for 2.43 years (63%). The declines in AIDS incidence and smoking accounted for 0.23 and 0.12 years (6% and 3%), respectively. About 1.1 years (28%) of the potential increase in life expectancy at birth is unexplained.

• If obesity and income had not increased, life expectancy at age 65 would have increased by 2.15 years from 1991 to 2004, instead of the actual 1.29-year increase. Thus, 2.15 years is the “potential increase in life expectancy at age 65.”

• Of the 2.15-year potential increase in life expectancy at age 65, medical innovation (i.e., the increase in Medicaid and Medicare drug vintage) accounted for 1.19 years (55%). The declines in AIDS incidence and smoking accounted for 0.07 and 0.12 years (3% and 5%), respectively. About 0.8 years (36%) of the potential increase in life expectancy at age 65 is unexplained.

Did the income growth come as a result of harder worker and more daily stress? Or does the income effect come because people who do less physical work earn more money on average but get less daily exercise?

I see the effects of rising incomes as a mixed bag. On the positive side (and probably more important in the long run), people with higher incomes can afford to pay more for health care directly and through taxes. Their high incomes provide the incentives for medical centers and drug companies to develop new treatments. Rising affluence makes more money available for medical care and for research.

Rising affluence also allows more people to do science and technology because a declining portion of the population needs to grow food and do other basic activities needed for short term survival. The general advance in science and technology produces technologies from other industries which greatly speed up work in biomedical research laboratories.

When gene therapies, stem cell therapies, replacement organ growth techniques, and nano repair devices become usable in medical treatment we are going to witness an increase in life expectancy measured in decades and centuries. What we are seeing now with our latest drugs is a small harbinger of what will come.