By most measurable standards, the United States is one of the least healthy wealthy nations in the world. Americans spend far more on healthcare than citizens of any comparable country, yet die roughly four years earlier on average. That gap between spending and outcomes shows up across nearly every major health indicator, from obesity and diabetes to heart disease and preventable death.
How the US Compares to Other Wealthy Nations
Life expectancy in the US falls between 75 and 80 years, placing it near the bottom among developed nations. The average across OECD countries is 80.3 years, with Japan, South Korea, and Switzerland leading the pack above that. The US doesn’t just lag behind on lifespan. A 2024 study published in The BMJ compared the US to nine other prosperous nations (including Australia, Canada, France, Germany, and the UK) and found that America has the highest rate of preventable and treatable deaths for all ages. It also had the most excess deaths among people under 75 during the pandemic.
What makes this especially striking is the price tag. The US spends 16.5% of its gross domestic product on healthcare. Australia and the Netherlands, which have better outcomes, spend 9.8% and 10.1% respectively. Americans aren’t getting less care. They’re getting less health for far more money.
Obesity and Severe Obesity
About 40.3% of American adults are obese, based on CDC survey data collected between August 2021 and August 2023. That number has hovered in a similar range since 2013, when it was 37.7%, but the more alarming trend is at the extreme end: severe obesity climbed from 7.7% to 9.7% over the same period. Nearly one in ten adults now qualifies as severely obese, with the highest rates (12.0%) among people aged 40 to 59.
Education level tracks closely with obesity rates. Adults with a bachelor’s degree or higher have an obesity prevalence of 31.6%, while adults with less education have significantly higher rates. That pattern reflects broader disparities in food access, work conditions, and neighborhood environments that shape health long before anyone sees a doctor.
What Americans Eat
More than half of all calories consumed in the US come from ultra-processed foods. The CDC measured this at 55.0% for everyone age one and older during 2021 to 2023. For children and teenagers, the number is even higher: 61.9% of daily calories. Adults fare slightly better at 53.0%, though “better” is relative when more than half your diet consists of foods engineered for shelf stability and flavor rather than nutrition.
Ultra-processed foods include things like packaged snacks, sugary cereals, frozen meals, fast food, and soft drinks. These products tend to be calorie-dense but low in fiber, vitamins, and minerals. They’re also cheap and convenient, which helps explain why they dominate the American diet, particularly in households with limited time or money for cooking.
Chronic Disease Is the Norm, Not the Exception
An estimated 129 million Americans live with at least one major chronic disease, including heart disease, cancer, diabetes, obesity, and high blood pressure. That’s not a niche problem. It’s roughly 40% of the population. Even more telling: 42% of people with chronic conditions have two or more, and 12% have five or more. Multiple overlapping conditions are now a standard feature of American health, not a worst-case scenario.
High blood pressure alone affects nearly half of all adults. The CDC puts hypertension prevalence at 47.7%. Of those with high blood pressure, only about one in five (20.7%) has it controlled to healthy levels. That means tens of millions of Americans are walking around with a major risk factor for heart attack and stroke that isn’t being adequately managed.
Diabetes and Prediabetes
About 29.1 million Americans have been diagnosed with diabetes, nearly all of them adults. But the larger and often overlooked number is prediabetes: 115.2 million US adults have blood sugar levels high enough to put them on a path toward full diabetes. Combined, that’s more than 144 million people with impaired blood sugar regulation. Many people with prediabetes don’t know they have it, which means they’re unlikely to make the dietary and activity changes that can reverse it.
Physical Inactivity
Federal guidelines recommend that adults get at least 150 minutes of moderate aerobic activity per week plus two sessions of muscle-strengthening exercise. Only 24.2% of American adults meet both targets. That means three out of four adults aren’t getting enough movement to maintain basic cardiovascular and muscular health. Inactivity contributes directly to obesity, diabetes, heart disease, and certain cancers, making it one of the most consequential health behaviors in the country.
Food Insecurity Adds Another Layer
In 2024, 13.7% of US households (18.3 million) experienced food insecurity at some point during the year. These are households that couldn’t reliably access enough food because of limited money or resources. Food insecurity doesn’t just mean hunger. It pushes people toward the cheapest available calories, which are almost always ultra-processed. The result is a paradox that defines American health: food-insecure households often have higher rates of obesity and diet-related chronic disease, not lower ones.
Why the Numbers Look This Way
No single factor explains America’s health crisis. It’s a combination of a food system that makes processed calories the default, built environments designed around cars rather than walking, healthcare that focuses on treatment rather than prevention, and deep income-based disparities in access to healthy food, safe places to exercise, and quality medical care. The US lost as many years of life expectancy during the first two years of COVID as it had gained in the entire previous decade, a sign of how fragile the system’s gains really were.
The core issue isn’t that Americans don’t care about their health. It’s that the environments most Americans live in make unhealthy choices the easiest ones. Changing those conditions requires shifts in food policy, urban planning, and healthcare priorities that go well beyond individual willpower.