Is America the Unhealthiest Country? US Health vs the World in 2025

If you’re asking this, you want a straight answer, not a sugar-coated pep talk. Short answer: globally, no-the United States is not the unhealthiest country on Earth. But among wealthy nations, the US lands near the bottom on many big outcomes like life expectancy, infant and maternal deaths, and chronic disease. The numbers are ugly, the reasons aren’t a mystery, and there are moves-personal and policy-that actually shift the curve. I’ll keep it simple, show you the receipts, and give you a clear way to judge any claim you see next.

TL;DR: The short answer

Is America the unhealthiest country? Not worldwide. But among high‑income peers, the US ranks near the bottom on core health metrics while spending far more.

• Among rich countries, the US has the lowest life expectancy and the highest obesity and infant/maternal mortality rates in recent years.
• It’s not about genetics. It’s the food environment, chronic disease, injuries and violence, drug overdose, and a pricey, fragmented health system.
• Smoking is lower in the US than many peers-so the problem isn’t every risk factor, it’s a few heavy hitters.
• Compared with low‑income countries, the US still fares better on many outcomes. The gap is vs. its economic peers.
• What to do right now: fix the daily basics (sleep, protein/fiber, strength work), use preventive care, push for safer streets and better primary care access. Policy levers matter.

The scorecard: where the US ranks in 2025

Here’s how the US stacks up against other high‑income countries using the latest widely reported figures (most from 2022-2024 data releases). These are the workhorse metrics researchers lean on: life expectancy, infant and maternal mortality, obesity, and health spending.

What this table says, in plain English:

• The US spends nearly double per person yet lives fewer years than its peers.
• Babies and moms are at higher risk in the US than in other rich countries.
• Obesity is the outlier: roughly four in ten US adults. That cascades into diabetes, heart disease, and some cancers.

Source notes: Figures synthesize the latest releases from OECD Health at a Glance (2024 updates), CDC/NCHS (2023-2024), the Commonwealth Fund (2023), and the Institute for Health Metrics and Evaluation’s Global Burden of Disease (latest post‑COVID updates). Life expectancy for the US rebounded a bit after the pandemic drop but remains the lowest among its peers; 2023 provisional sits around 77.5 years. Maternal deaths in the US fell from a 2021 spike to roughly 22 per 100,000 in 2022-still far above peers.

Outside the club of wealthy nations, the picture changes. Many lower‑income countries still face higher infant and maternal mortality and lower life expectancy than the US. So, “unhealthiest country” depends on the comparison group. Relative to income and spending, that’s where the US underperforms.

Why the gap exists: seven forces dragging our health

This isn’t about weaker willpower or “American genetics.” It’s about environment, incentives, and a few heavy risks stacking up. Here’s the short list I keep handy when I’m walking my dog, Charlie, and friends ask me why the US struggles despite sky‑high spending.

1. The food environment makes weight gain the default. Ultra‑processed foods are cheap, everywhere, and portion sizes are outsized. When 42% of adults live with obesity, chronic disease follows. GLP‑1 medications are a real advance for some, but they don’t rewrite the environment that led us here.
2. Chronic disease starts early and compounds. High rates of insulin resistance, hypertension, and fatty liver show up in people’s 20s and 30s. By the time they meet the health system, it’s late.
3. Access is patchy and costly. The US has world‑class specialty care and research, but everyday primary care is hard to reach for many. Insurance churn and high out‑of‑pocket costs delay routine care. Medical debt keeps people from getting care before problems escalate.
4. Injuries and violence are a bigger slice of mortality. Firearm deaths and car crashes push US mortality higher, especially among younger adults. That moves life expectancy more than people think.
5. Substance use-especially synthetic opioids. Overdose deaths hovered around 107,000 in 2023. Fentanyl made the drug supply more lethal, and that bleeds into mental health and family stability.
6. Social determinants bite hard. Housing, wages, childcare, food deserts, and stress load add up. The US has wider income inequality than many peers; health tracks with it.
7. System design rewards procedures, not prevention. We expertly treat complications that better primary care could have prevented. Payment models are improving in pockets, but not at scale yet.

To be fair, not every risk factor is worse in the US. Smoking rates in the US are lower than many peers. On exercise, Americans aren’t bottom of the barrel. The problem is a few high‑impact risks backed by a system that catches problems late and treats them expensively.

How to sanity‑check health claims and numbers

If you scroll social media, you’ll see charts tossed around without context. Here’s an easy way to separate heat from light.

Step‑by‑step way to vet a claim

1. Pin the comparison group. Is it the whole world, high‑income OECD countries, or a single neighbor? Claims flip depending on the group.
2. Check the metric. Life expectancy, infant/maternal mortality, obesity, DALYs (disability‑adjusted life years), or deaths amenable to care? Each says something different.
3. Check the year and source. Post‑COVID numbers bounce. Use recent data (2022-2024 releases). Look for CDC/NCHS, OECD, WHO, IHME, or the Commonwealth Fund.
4. Adjust for age where needed. Age‑standardized rates matter when populations are older/younger.
5. Look for consistency. One metric can mislead. If multiple credible metrics point the same way, you’re on firmer ground.

Quick checklist you can screenshot

• Group = high‑income OECD? Then US is near worst on life expectancy, infant/maternal deaths, obesity.
• Group = all countries? US is mid‑pack or better on many outcomes, worse on some injuries/overdose.
• Recent release? Aim for 2022-2024 datasets.
• Apples‑to‑apples? Same definitions, age‑standardized where required.
• Costs included? US spending dwarfs peers-flag any claim ignoring this.

Rules of thumb

• Life expectancy is a summary signal. If it’s low, multiple upstream problems exist.
• Infant and maternal mortality reflect the strength of basic care and the social floor.
• Obesity levels predict health‑care needs and costs a decade out.
• When the US “wins,” it’s usually in specialty care and rapid access to new drugs/tech. When it “loses,” it’s prevention and basic care.

Two practical examples

• Example 1: “US infant mortality is the worst in the world.” False if you mean all countries. True or near‑true if you mean high‑income peers. Vet the group and year.
• Example 2: “US life expectancy dipped because of COVID; it’ll snap back.” It rebounded some by 2023, but the pre‑COVID gap vs. peers existed for decades. COVID widened it; it didn’t create it.

What this means for you (and a quick FAQ)

Big systems move slowly. Your daily choices don’t. Here’s a people‑first playbook that pays off regardless of what Congress or insurers do next.

Simple personal playbook

• Sleep 7-9 hours. If you snore or wake up tired, ask about sleep apnea-it’s a hidden driver of high blood pressure and fatigue.
• Protein + fiber at every meal. Build plates around lean protein, beans, veggies, fruit, yogurt. Ultra‑processed stuff is fine as a side, not the main act.
• Lift twice a week. Muscle is metabolic armor against insulin resistance and aging.
• Walk more. I tack on an extra 10 minutes when I take Charlie out. Tiny habit, big impact.
• Know your numbers yearly: blood pressure, A1c/fasting glucose, lipids, waist circumference, vaccinations.
• Medication choices: If your doctor suggests GLP‑1s or statins, ask about benefits, side effects, and cost. Pair meds with habits for durability.

Family and community moves

• Use preventive visits you already pay for. Most US plans cover annual checkups and many vaccines without copays.
• Advocate locally: safer crosswalks, school meals with higher protein and less added sugar, naloxone access, and clean syringe programs. These save lives fast.
• For teens: mental health screening, sleep routines, and limits on late‑night driving reduce real risks.

Policy levers that actually move the needle

• Primary care access: more clinicians, better pay for prevention, team‑based care.
• Food policy: clear labels, limits on added sugar in school meals, incentives for healthier staples.
• Injury prevention: proven road safety measures and sensible firearm risk reduction.
• Addiction care: low‑barrier treatment (buprenorphine/methadone), fentanyl test strips, naloxone everywhere.

Mini‑FAQ

• Is the US the unhealthiest country? Not globally. Among wealthy countries, it’s near the bottom on major outcomes.
• Why does the US spend more and get less? High prices, administrative complexity, later care, and more chronic disease and injuries.
• Is it diet or healthcare? Both, but diet and daily environment do more damage than people think. Prevention beats rescue care.
• Are weight‑loss drugs the fix? They help some people a lot. They don’t fix food environments, and weight often rebounds if habits don’t change.
• What about smoking? US smoking is relatively low now. That’s a bright spot-proof policy + culture change can work.
• Will life expectancy fully recover? It’s climbing from the pandemic dip, but the pre‑existing gap vs. peers won’t close without deeper changes.

Next steps and troubleshooting by persona

• Busy parent: Buy two high‑protein, high‑fiber staples you’ll actually eat (Greek yogurt, canned beans). Schedule your annual checkup during your kid’s sports practice window.
• Desk‑bound professional: Two 20‑minute strength sessions weekly. Walk calls outside. Automate grocery delivery with a simple list so impulse buys don’t steer.
• Policy advocate: Push your city for protected bike lanes and traffic‑calming on school routes; support budgeting for community health workers in clinics.
• Employer/HR: Cover primary care without deductibles; include GLP‑1 coverage with step therapy and nutrition support; add EAP sessions that actually include adolescent mental health.
• Clinician: Screen for food insecurity and sleep apnea; default to team care (nurse + pharmacist + social worker) for diabetes and hypertension.

Credibility check: The rankings and patterns above line up with OECD Health at a Glance 2024, the Commonwealth Fund’s 2023 comparison of 11 high‑income countries, CDC/NCHS mortality and maternal/infant reports through 2023, and IHME’s Global Burden of Disease updates. If you see a claim that clashes with these sources, it’s worth a second look.