International Comparison

This section evaluates how U.S. population health compares with the 36 countries of the Organization for Economic Co-operation and Development (OECD), of which the United States is a member. The organization’s mission is to promote economic development and social well-being of people worldwide. It collects and analyzes data from each of the member countries on a wide range of social, economic and health-related topics.
The following international perspective offers insight into how the health of the United States compares with the health of its peers in key measures of population health. This analysis compares with OECD member countries with the top U.S. state, bottom state and national average for three health measures: infant mortality, obesity and life expectancy.
Results show the United States has a higher infant mortality rate, a higher prevalence of obesity and a lower life expectancy compared with most OECD member countries. Even the top U.S. state in each of these measures ranks low among member countries.
Infant Mortality
Over the past 50 years, improvements in the U.S. infant mortality rate has not kept pace with improvements in other OECD countries. Today, the average rate of infant mortality among OECD countries is 3.8 deaths per 1,000 live births. At 5.8 deaths per 1,000 live births, the United States ranks No. 33 out of 36 OECD countries (Figure 24). Japan (No. 1) has the lowest rate with 1.9 deaths per 1,000 live births. Turkey (No. 35) and Mexico (No. 36) have the highest infant mortality rates of OECD countries at 9.2 and 12.1 deaths per 1,000 live births, respectively. Massachusetts is the top U.S. state with 3.8 deaths per 1,000 live births, on par with Denmark (No. 25). The bottom-ranked state, Mississippi, has an infant mortality rate of 8.6 deaths per 1,000 live births, which is 2.3 times higher than the OECD average and the U.S. state with the lowest rate.
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Obesity
The prevalence of obesity has been increasing over the past three decades in the United States. This trend has also been observed internationally and is projected to continue. Obesity has increased 11% since 2012 in the United States, with nearly a third of the population self-reporting a height and weight that equates to a body mass index above 30.0. Among the 33 OECD countries with self-reported obesity data available, the United States ranks last (Figure 25). Korea (No. 1) has the lowest prevalence at 3.4% of adults followed by Chile (10.1%) and Italy (10.6%). Colorado, the top-ranked U.S. state, has an obesity prevalence of 22.9%, a level that is higher than all other OECD countries except for Iceland (26.6%), and a prevalence that is 1.4 times higher than the OECD average of 16.7%. West Virginia and Mississippi, which are tied for the least healthy U.S. state in obesity, have an obesity prevalence of 39.5% among adults, and a prevalence that is 2.4 times higher than the OECD average.
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Life Expectancy
Life expectancy is a common and important long-term population health indicator. It describes how long a newborn can expect to live, on average, if current death rates remain the same. The average life expectancy in OECD countries is 80.7 years. The U.S. life expectancy at birth of 78.6 years ranks No. 28 out of the 36 OECD countries, below the Czech Republic (79.1 years) and above Estonia (78.2 years) (Figure 26). Hawaii, the U.S. state with the highest life expectancy at 82.5 years, is tied at No. 11 with Sweden. Mississippi, the U.S. state with the lowest life expectancy at 74.8 years, is tied with Latvia (No. 36).
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