1. Americans are living shorter, more unequal lives.

Americans now have the shortest life expectancy among the high-income OECD nations studied, despite U.S. life expectancy increasing slightly to 79 years in 2024. More troubling is who’s being left behind. Life expectancy for non-Hispanic Black Americans sits at 74, and for American Indians/Alaska Natives, at just 70.1, demonstrating the widening racial gaps that reflect decades of inequitable care access and social determinants of health. (Hispanics actually outpace Whites at 81.3 years, a well-documented demographic anomaly referred to as the Hispanic Paradox.) Most alarming is the steady decline in child health and life expectancy. A recent JAMA study traces rising pediatric mortality to a toxic mix of chronic physical and mental health conditions, obesity, sleep deprivation, early puberty, and sedentary lifestyles.

2. We’re spending nearly double on pharmaceuticals.

Americans spend almost twice as much on pharmaceuticals as people in other high-income countries, with average annual out-of-pocket costs topping $400. France, in comparison, tops out at under $100. A 2024 publication by the Rand Corp., a nonpartisan research organization, found that across all drugs, prices in the U.S. were 2.78 times higher than in 33 other OECD countries. And the gap was even bigger for brand-name drugs. When medication becomes a financial burden, adherence drops, and preventable complications rise.

3. Our primary care pipeline is broken.

The U.S. has the fewest primary care physicians per 1,000 people among OECD nations, and the shortage is worsening. The combination of the highest medical school tuition globally and limited residency slots results in just 8.6 new doctors per 100,000 Americans. Throw in systemic underfunding of community clinics and epidemic levels of physician burnout, and you get a system where most Americans can’t even see a doctor regularly enough to prevent crises.

4. Cost is keeping people from getting well.

The U.S. leads in the number of patients forgoing prescriptions, diagnostic tests, and follow-up appointments. Unlike our peer nations, which all have universal coverage, Americans routinely skip needed care because they can’t afford it. With roughly 8% of Americans uninsured and another quarter facing steep deductibles or high out-of-pocket limits, it’s no wonder that much-needed care is neglected. Access to care shouldn’t be a luxury item, but pricing structures in the U.S. make it feel that way for many.

5. Mental health and isolation are claiming lives at an alarming rate.

America has one of the highest suicide rates globally. This is due to several factors, including unmet mental health needs, access to firearms and prescription drugs, and societal strain. The crisis is worse in rural communities where Americans face suicide rates 50% higher than in urban areas. It’s believed rural mental strain is compounded by scarce mental health providers, geographic isolation, higher rates of depression, and economic stress.

6. Pregnancy remains deadly for too many women.

Though overall maternal mortality dipped slightly to 19 deaths per 100,000 live births in 2023, the U.S. still lags far behind other high- and middle-income countries, where rates rarely exceed five. For Black women in America, the number is devastating. 50 deaths per 100,000, a rate that far exceeds any other country studied. The pattern reflects more than a broken clinical practice or system pipeline. It points to widespread public health failures that warrant intervention on both community and civil rights fronts, and points to the racial and socioeconomic disparities that very much still exist in America.

7. We’re losing too many years of life, too soon.

Public health experts measure premature death through Years of Potential Life Lost (YPLL), which calculates how long someone would have lived had they reached 75 instead of dying earlier. The U.S. has one of the highest YPLL rates among high-income nations, driven largely by preventable causes rather than illness. The primary culprits are drug overdoses, gun violence, and obesity-related diseases. Worst of all, these very easily avoidable deaths are concentrated in younger demographics and point directly to policy gaps in prevention, safety nets, and community health.

Put together, this data tells a stark story about life in 2026. Americans pay more for health care, get less in return, and carry a heavier burden of illness, debt, and insecurity than their international peers. Of note, the U.S. is also the only high-income country that has not achieved universal coverage of care. Sadly, recent federal policies have pushed more people into insurance coverage gaps, making them financially vulnerable and less likely to seek care. While measuring ourselves against other countries is important for understanding our successes and failures, it’s also an opportunity to take cues from those with models that perform better than our own. Americans, particularly our children, shouldn’t fall further behind because we refuse to change course or make different decisions. This report, and others like it are learning opportunities we would be remiss to ignore.