{"text":[[{"start":7.6,"text":"What could Europe possibly have to learn from America on crime, health and mortality? Perhaps more than you might think."}],[{"start":14.399999999999999,"text":"For decades the stereotype of the US has been of an unhealthy and dangerous society, with eye-watering rates of violent crime and obesity, and appallingly low and stagnant life expectancy. In terms of levels, much of that remains true. But on direction of travel the story is beginning to change."}],[{"start":34.3,"text":"Life expectancy has increased in most countries in recent years as mortality rates receded from their Covid highs. But US lifespans have not merely returned to pre-pandemic (or even pre-fentanyl) levels, they are on a record-setting climb. Today, American men can expect to live to 77.3 years, 1.5 years longer than a decade ago. In the UK the equivalent gain has been a mere six months. In Germany it has been essentially zero. The American lifespan deficit to western Europe is on course this year to be its narrowest since 2012."}],[{"start":null,"text":"
"}],[{"start":70.5,"text":"Similarly, US rates of homicide and crime more broadly have not merely returned to their baseline after the wave of deadly disorder between 2020 and 2023 — rates of violence and criminality are setting all-time record lows in cities and states across the country."}],[{"start":86.9,"text":"These two stories overlap to a certain extent. Violence and drugs disproportionately take young lives, meaning they have exerted an outsized drag on average US lifespans. As these distorting scourges subside, we can begin to see what the underlying trends in America’s health and society look like. The answer is perhaps less grim than some might have imagined."}],[{"start":null,"text":""}],[{"start":107.7,"text":"As always, such trends are shaped by a huge number of factors, but it is worth unpacking some of the leading theories behind such robust improvements."}],[{"start":116.55,"text":"On health, a big part of the story is cancer, where US mortality rates are lower than those in western Europe and also falling faster. Discussions about the merits and performance of US and European healthcare systems often gloss over the fact that poor American outcomes are concentrated in the conditions most related to unhealthy lifestyles such as cardiovascular disease and diabetes. But diseases like cancer afflict a wide range of people regardless of behaviour, making death rates a more direct reflection of outcomes in the healthcare system. On this score Americans’ above-average healthcare spending comes with above-average success. "}],[{"start":null,"text":""}],[{"start":154.65,"text":"What is more, as high US uptake of GLP-1 weight-loss drugs begins to reduce obesity-related disease, it’s possible the US will see further catch-up."}],[{"start":165.15,"text":"On crime there are several factors to note. The clearest lesson is that policing matters. The wave of violence that swept much of the US between the murder of George Floyd in 2020 and 2022 coincided with American police pulling back from frontline enforcement. The exact contribution of this relative to other factors remains contested, but its role has broad support. It aligns with the finding that police station closures in the UK during austerity were followed by sharp upticks in violent crime in the surrounding area."}],[{"start":197.25,"text":"A particularly interesting addition to the debate on crime has been the role of America’s pandemic relief public spending: billions of dollars were spent by local governments on public safety and community infrastructure. This unexpected injection of money allowed local officials to tackle long-term problems — cleaning up areas of urban decay and trialling new approaches to combating gun violence. In one notable success, Detroit used money from the American Rescue Plan to fund new dedicated local ShotStoppers groups, which could receive a bonus equivalent to 100 per cent of their initial funding for achieving reductions in shootings. The areas these groups operated in saw far larger reductions than elsewhere."}],[{"start":237,"text":"The story of well-funded local governments having the means to tackle their most pressing problems contrasts with the UK, where local government funding has never recovered from austerity measures, leaving resources stretched and infrastructure crumbling."}],[{"start":251.35,"text":"America has long been a cautionary tale on crime and healthcare. Certainly in many ways its deeply imperfect system remains a lesson in what not to do. But when a bad situation improves — and does so beyond most reasonable expectations — we should pause to consider what it may be getting right."}],[{"start":270.55,"text":"john.burn-murdoch@ft.com, @jburnmurdoch"}],[{"start":282.40000000000003,"text":""}]],"url":"https://audio.ftcn.net.cn/album/a_1779543503_7665.mp3"}