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Executive BriefIntroductionNational HighlightsKey FindingsSocial and Economic FactorsPhysical EnvironmentClinical CareBehaviorsHealth OutcomesInternational ComparisonState Summaries
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US SummaryAppendixMeasures TableData Source DescriptionsThe Team
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryAppendixMeasures TableData Source DescriptionsThe TeamComparing the health of the United States to that of other countries is an indicator of how healthy our nation is and shows the potential this country has to improve measures of health and create healthier communities. The Organization for Economic Co-operation and Development (OECD) is composed of 38 member countries, including the United States. OECD’s mission is to promote the economic development and social well-being of people worldwide. OECD collects and analyzes data from each member country on a wide range of social, economic and health-related topics.
The following analysis compared the U.S. with other OECD countries using three health measures: infant mortality, life expectancy at birth and total health spending. For infant mortality, the top and bottom states from the 2021 Health of Women and Children Report were included for reference. The top and bottom state data for life expectancy from the National Center for Health Statistics were also included.
The U.S. had a higher infant mortality rate and lower life expectancy than most other OECD member countries. Even top U.S. states ranked poorly among member countries for the infant mortality and life expectancy measures, despite the U.S. having the highest total health spending of all OECD countries.
Infant mortality
Over the past 50 years, the U.S. infant mortality rate has not improved at the same pace as that of other OECD countries. The average rate of infant mortality among OECD countries was 4.2 deaths per 1,000 live births in 2019. At 5.7 deaths per 1,000 live births, the U.S. ranked No. 33 out of the 38 OECD countries in 2019. Iceland (No. 1) had the lowest rate in 2019 with 1.1 deaths per 1,000 live births. Mexico (No. 37) and Columbia (No. 38) had the highest infant mortality rates of OECD countries at 13.1 and 17.3 deaths per 1,000 live births, respectively.
Massachusetts and New Hampshire were the states with the lowest infant mortality rates both at 3.9 deaths per 1,000 live births in 2019, placing them on par with France and Poland (tied for No. 27). The state with the highest rate, Mississippi, had an infant mortality rate of 8.6 deaths per 1,000 live births, which was twice the OECD average.
Life expectancy
Life expectancy at birth 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 was 81.0 years in 2019. The U.S. life expectancy at birth was 78.9 years and ranked No. 29 out of the 38 OECD countries, falling between the Czech Republic (79.3 years, No. 28) and Estonia (78.8 years, No. 30).
Hawaii, the U.S. state with the highest life expectancy at 81.0 years, fell between Germany and the United Kingdom (both 81.4) and Chile (80.6). West Virginia, the U.S. state with the lowest life expectancy at 74.4 years, fell below Mexico (75.1), the OECD country with the lowest life expectancy.
Total health spending
Health spending represents the total consumption of goods and services; this includes personal health care (such as curative, rehabilitative and long-term care) and collective services (such as prevention and public health services).
The average total spending on health in OECD countries was $4,087 U.S. dollars per capita. The U.S. spent nearly 3 times that amount, totaling $10,948 U.S. dollars per capita in 2019. Switzerland, which spent the second most on health among OECD countries, still spent two-thirds the amount the U.S. spent in 2019.
Spending on inpatient and outpatient care accounted for the largest share of the difference between the U.S. and other countries, and represented a greater share of health spending in 2018. Roughly 50% of total health spending in the United States came from public funds in 2017, which was much less than the OECD average of 71%.
