Failing health of the United States

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k496 (Published 07 February 2018) Cite this as: BMJ 2018;360:k496
  1. Steven H Woolf, director1,
  2. Laudan Aron, senior fellow2
  1. 1Center on Society and Health, Virginia Commonwealth University, 830 East Main Street, Suite 5035, Richmond, Virginia 23298-0212, USA
  2. 2Urban Institute, 2100 M Street, NW, Washington, DC 20037, USA
  1. Correspondence to: S Woolf steven.woolf{at}vcuhealth.org

The role of challenging life conditions and the policies behind them

Life expectancy in the US has fallen for the second year in a row.1 This is alarming because life expectancy has risen for much of the past century in developed countries, including the US. The decline in US health relative to other countries, however, is not new; it has been unfolding for decades (fig 1). In 1960, Americans had the highest life expectancy, 2.4 years higher than the average for countries in the Organisation for Economic Cooperation and Development (OECD). But the US started losing ground in the 1980s. US life expectancy fell below the OECD average in 1998, plateaued in 2012, and is now 1.5 years lower than the OECD average.2

Fig 1

Life expectancy at birth in the US and the Organisation for Economic Cooperation and Development, 1995-2015.2 Members of the Organisation for Economic Coordination and Development include Australia, Austria, Belgium, Canada, Chile, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Latvia, Luxembourg, Mexico, the Netherlands, New Zealand, Norway, Poland, Portugal, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, …

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