For most of my life, I rejected the assertion that America is a “sick society.” This judgment seemed too broad and lacking in nuance. Yes, there was regress in some areas, such as the surge of gun-related crimes in the 1980s. But there was progress on other fronts. Life expectancy increased steadily, and a rising share of Americans had access to healthcare. The rate of smoking among young people declined sharply, as did teen pregnancy. Many gaps among racial and ethnic groups were narrowing.
It’s no secret that life expectancy in the U.S. is much lower than it should be. In 2019, before the Covid-19 pandemic struck, we ranked 29th among the 38 member nations of the Organization for Economic Cooperation and Development. U.S. life expectancy trailed Germany’s by 2.5 years, Canada’s by 3.2 years, and France’s by four years.
Some of this disparity reflects the U.S.’s terrible performance in infant mortality. It ranked 33rd, behind every European and Asian country in the OECD. Some of it reflects huge geographical disparities within the U.S. The life expectancy gap in 2019 between America’s best state (Hawaii) and its worst was about seven years. Still, even Hawaii trailed 25 OECD countries. (West Virginia would have placed dead last, behind Mexico.)