Why The US Tops The List Of Nations With The Worst Health Outcomes

Despite the United States spending 18% of its gross domestic product (GDP) on healthcare, it still rates the lowest among high-income countries in health outcomes, according to a report from The Commonwealth Fund. The study compared U.S. health-related budgets, outcomes, status, and services to 13 other countries such as Germany, France, South Korea, the United Kingdom, and Japan. It also tracked averages of certain outcomes from 38 other countries.

The United States had the lowest life expectancy of 77 years. Germans live four years longer, yet Germany spends 13% of its GDP on healthcare. France spends a little more than 12% on health for its people, and French citizens have a life expectancy of 82.5 years. The United States also leads other high-income countries in infant deaths and maternal mortality from childbirth complications.

The United States leads all the nations in death rates from assault — including gun violence — at 7.4 deaths per 100,000. This is seven times higher than all higher-income countries except for New Zealand. Although the United States doesn't rank highest in suicide rates, it is third behind South Korea and Japan. The Centers for Disease Control and Prevention (CDC) considers suicide to be a serious health problem.

The report also found the United States leads other nations in people over 65 who get their flu vaccinations. It ranks second in breast and colorectal cancer screenings. It somewhat lags behind other countries in COVID-19 vaccinations. The United States also has the highest COVID-19 death rate.

Some deaths can be prevented if preventative care (like diet and exercise) and interventions (such as health screenings) are available. The United States leads other nations in avoidable deaths, and they've been rising since 2015. Its 42.8% obesity rate is well above the 25% average across other countries as well. According to the Centers for Disease Control and Prevention, a little more than half of people in the United States get the minimum exercise guideline of 150 minutes of moderate exercise a week. About 25% of people get no physical activity.

A 2016 study in BMJ Open found that almost 60% of calories in the U.S. diet come from ultra-processed foods, and almost 90% of our foods have added sugars. Ultra-processed foods can lead to obesity and chronic disease (via Harvard School of Public Health), and added sugar is linked to cardiovascular disease (via a 2014 study in JAMA Internal Medicine).

The study suggested that the United States make its health coverage more affordable and work on reducing the high prices of health services. It also suggested enacting changes that will better support the management of preventable health conditions.