Overcoming Obstacles to Health in 2013 and Beyond

Why Isn't America Healthier?

Despite leading the world on medical care spending, Americans have worse health and shorter lives than people in other affluent nations. Our international ranking has been slipping over time, and it is not only poor Americans who are affected. Middle-class and even wealthy Americans also are less healthy than their counterparts in other affluent countries.

The results of new analyses in this report, Overcoming Obstacles to Health in 2013 and Beyond, show dramatic differences in health among Americans from different income, education, and racial or ethnic groups. These differences—between the United States and other countries, and within our own borders—adversely affect almost everyone, with serious human and economic costs. As a nation, we are failing to achieve our health potential.

This report reviews existing knowledge and interprets new analyses to address three questions:

  • What does the evidence tell us about America’s unrealized health potential?
  • Why are Americans not as healthy as they could be?
  • What do we know about solutions that can help all Americans reach their full health potential?


Explore the charts & maps

Losing Ground in Health: Life Expectancy

In 1980, the U.S. ranked 15th among affluent countries in life expectancy (LE) at birth. By 2009, we had slipped to 27th place.

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The U.S. Is Not Getting Good Value for Its Health Dollar

The United States spends more money per person on health than any other country, but our lives are shorter—by nearly five years—than expected based on health expenditures.

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Higher Parental Income, Healthier Children

Compared with children in the highest-income families, children in poor families are more than four times as likely to be in less than “very good” health.

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Income Is Linked With Health Across Racial or Ethnic Groups

Differences in health status by income do not simply reflect differences by race or ethnicity; differences in health by income can be seen within each racial or ethnic group. Both income and racial or ethnic group matter for health.

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The U.S. ranks 27th out of 34 industrialized countries in life expectancy, though we are the third wealthiest country.