Americans are, by many measures, less healthy than people in other wealthy nations, despite living in the country that spends more on healthcare than any other. Life expectancy in the U.S. reached 79.0 years in 2024, a meaningful rebound from pandemic lows, yet that number still trails most high-income peers. The picture is complicated: medical advances keep improving survival for some conditions, while obesity, chronic disease, and mental illness remain stubbornly widespread.
Life Expectancy Is Rising but Still Lags
The average American born in 2024 can expect to live to 79, up from 78.4 the year before. Women live longer at 81.4 years, while men average 76.5. That gender gap, nearly five years, narrowed slightly in 2024 as male life expectancy improved faster than female. For someone who has already reached 65, the outlook adds roughly 19.7 more years of life.
Those numbers sound reasonable in isolation, but they fall short when stacked against comparable countries. The U.S. has the lowest life expectancy at birth among high-income nations, and the highest rate of deaths from conditions that are either preventable or treatable. Countries like Norway, Switzerland, and Japan routinely outlive the U.S. by three to five years.
Chronic Disease Is Widespread
The most striking feature of American health is how many people live with chronic conditions. About 40% of U.S. adults have obesity, and nearly one in ten has severe obesity. Heart disease kills more Americans than anything else, claiming roughly 681,000 lives per year, followed by cancer at 613,000. Stroke, accidents, and chronic respiratory diseases round out the top five causes of death.
Diabetes illustrates how deeply these conditions are embedded. Among adults with household incomes below the federal poverty level, 13.1% have diabetes, compared with 5.1% among those in the highest income bracket. That same income gradient shows up across nearly every chronic illness: high blood pressure, arthritis, asthma, and heart disease are all more common in lower-income households. Three in ten American adults report having been diagnosed with two or more chronic conditions at some point in their lives, a rate nearly double that of France and higher than any other high-income country studied.
How the U.S. Compares Globally
The U.S. spends nearly 18% of its GDP on healthcare, far more than any peer nation. That spending hasn’t translated into better outcomes. Beyond the life expectancy gap, the U.S. has the highest maternal mortality among wealthy countries, with nearly 24 deaths per 100,000 live births, more than triple the rate in most comparable nations. Infant mortality tells a similar story: 5.4 deaths per 1,000 live births in the U.S. versus 1.6 in Norway.
The American obesity rate is roughly double the average among developed nations. This single factor cascades into higher rates of diabetes, joint problems, heart disease, and certain cancers. It also helps explain why Americans accumulate chronic conditions faster and earlier in life than people in countries with similar wealth and medical technology.
Mental Health Challenges
In 2024, about 61.5 million American adults, or 23.4% of the adult population, experienced some form of mental illness over the course of the year. For 14.6 million people (5.6%), the illness was serious enough to substantially interfere with daily life. These figures encompass conditions ranging from anxiety and depression to bipolar disorder and schizophrenia. The prevalence of reported mental illness has climbed over the past decade, though it’s difficult to separate a genuine increase from greater willingness to seek diagnosis.
Diet and Exercise Fall Short
The federal government scores the American diet using a 100-point scale called the Healthy Eating Index. The average score for people aged two and older is 58 out of 100. That failing grade reflects diets that are consistently too high in added sugars, sodium, and saturated fat, and too low in fruits, vegetables, and whole grains. Toddlers fare only slightly better at 63 out of 100, suggesting dietary patterns start slipping early in life.
Physical activity paints a similarly bleak picture. Federal guidelines recommend a combination of regular aerobic exercise and muscle-strengthening activity. In 2024, only 26.4% of adults met both benchmarks during their leisure time. That means roughly three out of four Americans aren’t getting enough of both types of exercise. The figure has barely budged in recent years, inching up from 25.2% in 2020.
Preventive Care Remains Underused
Having insurance is a prerequisite for routine health maintenance, and 92% of Americans had some form of coverage in 2024. But coverage alone doesn’t guarantee people use it. Annual wellness visit rates hover around 20%. Lipid testing, one of the simplest ways to catch cardiovascular risk early, reaches only about 26% of patients in a given year. Mammogram rates among women sit at roughly 18% annually, and colonoscopy rates have actually declined, dropping from about 3% to 2% of patients between 2018 and 2022.
These low screening numbers matter because many of the conditions that kill Americans most often, including heart disease, cancer, and diabetes, are far more manageable when caught early. The gap between available preventive tools and actual use represents one of the most fixable problems in American health.
Income Shapes Health More Than Most People Realize
Wealth is one of the strongest predictors of health in the U.S. Lower-income Americans are more than twice as likely to have diabetes as those in the highest income group. The same pattern repeats for high blood pressure, heart disease, stroke, and asthma. These disparities aren’t just about access to doctors. They reflect differences in neighborhood safety, food availability, housing quality, work conditions, and chronic stress, all factors that accumulate over a lifetime.
The result is that the American health picture varies enormously depending on who you are and where you live. Affluent Americans in certain ZIP codes enjoy health outcomes comparable to Scandinavia. Low-income Americans in others face life expectancies closer to developing nations. The national averages, while useful, smooth over a level of inequality that is itself a defining feature of American health.