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Executive BriefIntroductionNational HighlightsFindingsHealth OutcomesSocial and Economic FactorsPhysical EnvironmentClinical CareState RankingsInternational ComparisonAppendixMeasures TableData Source DescriptionsMethodologyState Summaries
US Summary
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US SummaryAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingComparing the health of the U.S. to that of other countries can help indicate areas of progress and areas where improvement is needed at a national level. The Organization for Economic Co-operation and Development (OECD), the data source for this section, 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 data from the U.S. with other OECD countries using three health measures: infant mortality, life expectancy at birth and total health spending. Data presented were from 2021 unless otherwise specified. For infant mortality, the top and bottom states from the 2023 Health of Women and Children Report were included for reference. Top and bottom states were also included for life expectancy, using data from the National Center for Health Statistics’ National Vital Statistics System.
The U.S. had a higher infant mortality rate and lower life expectancy than most other OECD countries. Even the best-performing 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
Infant mortality includes all deaths among children younger than 1 year of age. 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 4.0 deaths per 1,000 live births in 2021. At 5.4 deaths per 1,000 live births, the U.S. ranked No. 33 of the 38 OECD countries, falling between the Slovak Republic (4.9 deaths per 1,000 live births, No. 32) and Chile (5.8 deaths per 1,000 live births, No. 34). Japan and Norway (both No. 1) had the lowest rates, with 1.7 deaths per 1,000 live births. Mexico (No. 37) and Colombia (No. 38) had the highest infant mortality rates of OECD countries at 12.7 and 16.5 deaths per 1,000 live births, respectively.
There were large racial/ethnic disparities among U.S. infants. In 2019-2020, the U.S. infant mortality rate was 3.2 times higher among Black infants at 10.5 deaths per 1,000 live births compared with Asian infants at 3.3 deaths per 1,000 live births.
According to the 2023 Health of Women and Children Report, Vermont had the lowest infant mortality rate at 3.1 deaths per 1,000 live births, placing it on par with Lithuania, Luxembourg and Switzerland (also 3.1, No. 18). The state with the highest rate, Mississippi, had an infant mortality rate of 8.4 deaths per 1,000 live births, more than twice the OECD average.
Life expectancy
Life expectancy at birth describes how long a newborn can expect to live, on average, assuming current death rates remain the same. Life expectancy has increased over the past 50 years in all OECD countries. However, the COVID-19 pandemic has had profound global effects on life expectancy due to the high number of deaths from COVID-19 and other related causes.
The average life expectancy at birth in OECD countries was 80.3 years in 2021. The U.S. life expectancy at birth was 76.4 years and ranked No. 32 out of the 38 OECD countries, falling between Colombia (76.8 years, No. 31) and Poland (75.5 years, No. 33).
Hawaii, the U.S. state with the highest life expectancy at 80.7 years, tied with Slovenia (No. 25) and fell between both Costa Rica and Germany (80.8 years, No. 23) and the United Kingdom (80.4 years, No. 26). Mississippi, the state with the lowest life expectancy at 71.9 years, fell below Latvia (73.1 years, No. 38), the OECD country with the lowest life expectancy.
Total health spending
Total health spending represents the consumption of health-related 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 $4,715 U.S. dollars per capita in 2021. The U.S. spent nearly three times that amount, totaling $12,197 U.S. dollars per capita, earning a spot as top health spender of all OECD countries. Switzerland, which spent the second most on health among OECD countries ($7,582), still spent only about two-thirds the amount the U.S. spent per capita.
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 56% of total health spending in the U.S. came from public funds in 2021, which was much less than the OECD average of 73%.
