In many developed countries, life expectancy at birth is higher than in the United States. Newly available data permit, for the first time, reliable cross-national comparisons of mortality among persons 80 years of age or older. Such comparisons are important, because in many developed countries more than half of women and a third of men now die after the age of 80. We used extinct-cohort methods to assess mortality in Japan, Sweden, France, and England (including Wales) and among U.S. whites for cohorts born from 1880 to 1894, and used cross-sectional data for the year 1987. Extinct-cohort methods rely on continuously collected data from death certificates and do not use the less reliable data from censuses. In the United States, life expectancy at the age of 80 and survival from the ages of 80 to 100 significantly exceeded life expectancy in Sweden, France, England, and Japan (P < 0.01). This finding was confirmed with accurate cross-sectional data for 1987. The average life expectancy in the United States is 9.1 years for 80-year-old white women and 7.0 years for 80-year-old white men. For people 80 years old or older, life expectancy is greater in the United States than it is in Sweden, France, England, and Japan. This finding suggests that elderly Americans are receiving better health care than the elderly citizens of other developed countries.
