U.S. fares poorly in new global analysis of health outcomes, life expectancy

The United States spends up to four times as much on health care as most other high-income nations yet continues to experience far worse health outcomes and lower life expectancy. This distressing news comes via a new Commonwealth Fund study.

“Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” Munira Gunja, a senior researcher for The Commonwealth Fund’s International Program in Health Policy and Practice Innovations and lead author of the new report, says in a statement. “To catch up with other high-income countries, the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population.”

The report, titled U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes, is part of an ongoing series of Commonwealth Fund reports providing international insights to help spur change in U.S. health care. The private organization’s mission is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency.

Researchers compared health care spending and outcomes, health status, and health care usage in the U.S. with 12 other high-income nations belonging to the Organization for Economic Co-operation and Development (OECD): Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, and the United Kingdom. U.S. health system performance also was compared to the average for all 38 OECD member nations.

The results of the analysis reflect the fact that the U.S. remains the only nation within the OECD that does not offer universal health coverage, despite spending nearly 18% of its GDP on health care, according to the study.

Here are four other eye-opening takeaways:

1. The U.S. has the lowest life expectancy and highest rate of avoidable deaths. Americans have the lowest life expectancy – 77 years, a full three years lower than the average for other wealthy nations. The U.S. also continues to have the highest rates of avoidable deaths from such causes as diabetes, hypertensive diseases, and certain cancers (all of which are considered preventable and treatable with timely access to primary care, screenings, and treatment).

2. The U.S. has the highest COVID-19 death rate. More people in the U.S. have died from coronavirus since the start of the COVID-19 pandemic than in any other high-income country in the analysis. For every 1 million cases between January 22, 2020, and January 18, 2023, there were more than 3,000 deaths in the U.S.

3. More people die in the U.S. from physical assault. The U.S. is an outlier in deaths from physical assault, which includes gun violence. Its 7.4 deaths per 100,000 people is far above the OECD average of 2.7.

4. The U.S. has the highest rate of infant and maternal deaths. U.S. women have the highest death rate from complications of pregnancy and childbirth, with nearly 24 maternal deaths for every 100,000 live births. That is more than triple the rate for most other high-income countries.

Related: Health care spending results in improved health outcomes, report says

“This analysis continues to demonstrate the importance of international comparisons,” Reginald D. Williams II, who leads the Commonwealth Fund’s International Program, says in a statement. “It offers an opportunity for the U.S. to learn from other countries and build a better health care system that delivers affordable, high-quality health care for everyone.”