Less comprehensive social policies may contribute to lower life expectancies and worse health in the U.S. compared to other high-income countries

Americans lead shorter and less healthy lives than people in other high-income countries. Is this US health disadvantage specific to some US populations, diseases, or particular age groups? And what explains these variations in the length and quality of life between Americans and other high-income countries? Mauricio Avendano and Ichiro Kawachi review the evidence and find the American health disadvantage begins at birth and extends across the life-course, and it is particularly marked for American women and for regions in the US South and Midwest. They propose explanations that include differences in health care, individual behaviors, socioeconomic inequalities, and the physical and the built environment. However, crucial differences in social policy between the US and other high income countries may also underlie an important part of the US’ health disadvantage.