Americans also had the lowest probability overall of surviving to the age of 50.
The report’s second chapter details health indicators for youths where the US ranks near or at the bottom. There are so many that the list takes up four pages.
Chronic diseases, including heart disease, also played a role for people under 50.
“We expected to see some bad news and some good news, but the US ranked near and at the bottom in almost every heath indicator. That stunned us,” Woolf said.
There were bright spots. Death rates from cancers that can be detected with tests, like breast cancer, were lower in the US. Adults had better control over their cholesterol and high blood pressure. And the very oldest Americans — above 75 — tended to outlive their counterparts.
The panel sought to explain the poor performance. It noted the US has a highly fragmented healthcare system, with limited primary care resources and a large uninsured population. It has the highest rates of poverty among the countries studied.
Education also played a role. Americans who have not graduated from high school die from diabetes at three times the rate of those with some college education, Woolf said.
In the other countries, more generous social safety nets buffer families from the health consequences of poverty, the report said.
Still, even the people most likely to be healthy, like college-educated Americans and those with high incomes, fare worse on many health indicators.
The report also explored less conventional explanations. Could cultural factors like individualism and dislike of government interference play a role? For example Americans are less likely to wear seat belts and more likely to ride motorcycles without helmets.
The US is a bigger, more heterogeneous society with greater levels of economic inequality and comparing its health outcomes to those in countries like Sweden or France may seem lopsided. However, the panelists said that the US spent more on healthcare than any other country in the survey. And as recently as the 1950s, Americans scored better in life expectancy and disease than many of the other countries in the current study.