New Health Rankings: Of 17 Nations, U.S. Is Dead Last

Will seeing just how far we've fallen behind other countries, across almost all measures of health, finally motivate change?

Carlo Allegri/Reuters

We've known for years that Americans tend to be overweight and sedentary, and that our health care system, despite being the priciest in the world, produces some less-than-plum results. Health nerds who closely follow the news may even have known that we live shorter lives than people in other rich nations, and that infants in the U.S. die from various causes at far higher rates.

But a fresh report, out Wednesday, tapped vast stores of data to compare the health of affluent nations and delivered a worrisome new message: Americans' health is even worse than we thought, ranking below 16 other developed nations.


"The news is that this is across the lifespan, and regardless of income," said Georges Benjamin, executive director of the American Public Health Association, who was not an author of the study. "A lot of people thought it was underserved populations that were driving the statistics -- the poor, the uninsured. They still are a big part of our challenge, but the fact that even if you're fairly well-to-do you still have these problems shatters that myth."

The question is: Will it make a difference?

The report was prepared by a panel of doctors, epidemiologists, demographers, and other researchers charged by the National Research Council and the Institute of Medicine to better understand Americans' comparative health. They examined when and why people die in the U.S. and 16 other countries, including Australia, Japan, Canada, and nations in Western Europe. The data they pulled -- from such bodies as the World Health Organization and the Organization for Economic Cooperation and Development -- already existed, but no one had yet examined it this comprehensively.

The results surprised even the researchers. To their alarm, they said, they found a "strikingly consistent and pervasive" pattern of poorer health at all stages of life, from infancy to childhood to adolescence to young adulthood to middle and old age. Compared to people in other developed nations, Americans die far more often from injuries and homicides. We suffer more deaths from alcohol and other drugs, and endure some of the worst rates of heart disease, lung disease, obesity, and diabetes.

These disproportionate deaths especially affect young people. For three decades, Americans, particularly men, have had either the lowest or near the lowest likelihood of surviving to age 50. The most powerful reasons found for that were homicide, car accidents, other kinds of accidents, non-communicable diseases, and perinatal problems like low birth weight and premature birth, which contribute to high infant mortality.

Among the most striking of the report's findings are that, among the countries studied, the U.S. has:

The report does reveal bright spots: Americans are more likely to survive cancer or stroke, and if we live to age 75 we're likely to keep on living longer than others. But these advances are dwarfed by the grave shortcomings.

The authors took pains to counteract the possible assumption that U.S. numbers must be negatively skewed by poor and underserved populations. In fact, the report cites data suggesting that even white, well-off Americans live sicker and die sooner than similarly situated people elsewhere.


In presenting their findings Wednesday, the authors seemed to be urging the U.S. to do some soul searching. Our culture "cherishes independence" and "wants to limit the intrusion of government in our personal lives," said Steven Woolf, director of the Center for Human Needs at Virginia Commonwealth University, the panel chairman. While those values serve us in some ways, he said, our resistance to regulation "may work against our ability to achieve optimal health outcomes."

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Grace Rubenstein is a reporter and multimedia producer based in the San Francisco Bay Area. Her work has appeared in The New York Times, The Boston Globe, and Parenting and Edutopia magazines.

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