The health of societies can be measured by a range of mortality indicators, and comparisons of national parameters with those of other societies can be symbolic of health status and progress. Over the past century, health outcomes have been steadily improving almost everywhere in the world, but the rates of improvements have varied. In the 1950s, the United States, having among the lowest mortality and other indicators of good health, ranked well among nations. Since then, the United States has not seen the scale of improvements in health outcomes enjoyed by most other developed countries, despite spending increasing amounts of its economy on health care services. Trends in personal health-related behaviors are only part of the explanation. Structural factors related to inequality and conditions of early life are important reasons for the relative stagnation in health. Reversing this relative decline would require a major national coordinated long-term effort to expose the problem and create the political will to address it.

Associated Article

There are media items related to this article:
A Lecture in Public Health: Health Status of the United States versus Other Nations

Article metrics loading...

Loading full text...

Full text loading...


Data & Media loading...

Supplemental Material

In this video Stephen Bezruchka, Senior Lecturer at the Departments of Health Services and Global Health of the University of Washington in Seattle, talks about his article "The Hurrider I Go the Behinder I Get: The Deteriorating International Ranking of U.S. Health Status," which he wrote for the 2009 Annual Review of Public Health. Using graphics to illustrate his points, Dr. Bezruchka describes how the United States has fallen to the 34th place in life expectancy, after Cuba, Chile, and Denmark. He also emphasizes the deteriorating health of women, as measured by their life expectancy, which has dropped in 30% of U.S. counties between 1987 and 2007. Finally, Dr. Bezruchka outlines his recommendations for improving health in the United States, including creating awareness about the nation's low ranking among developed countries and investing more in early life.

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error