The US is falling in global health rankings

This transcript has been lightly edited for clarity

This manuscript [The burden of diseases, injuries, and risk factors in the USA, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021] is showing that the United States is losing its rank and falling behind other countries when it comes to many of the metrics that we use. For example, life expectancy in the United States used to be [ranked] 35th, if you compare the US to 203 countries, or 204 in total, used to be 35th for males and 19th for females in 1990. We are now 46th and 47th.

Our data also showed that 14 states lost life expectancy from 1990 to 2021. So the life expectancy in 1990 was much higher in these 14 states. And, for example, West Virginia lost about 2.7 years of life expectancy between 1990 and 2021. So, for many of our states, they are left behind, even if the country is showing an increase in life expectancy, we need to keep in mind that there are so many disparities in the US – and many of our states, many of our counties, many of our races, ethnicities, are left behind as well.

If you look at our best-performing state, for example, Hawaii, when it comes to life expectancy, used to be the sixth highest. If you take Hawaii as a country and you have now 203, now total 204, so Hawaii would be sixth in the world for males and was fourth for females.

In 2021, that ranking dropped to 28th and 22nd, so rapid decline, unfortunately, compared to our peers, to rich countries. And also, at the same time, we are falling behind some of the middle-income countries in the world as well.

If we replace a state, instead of the United States, we have, the worst of our states in 2021 were ranked about 107th for males and 99th for females – that’s West Virginia. If you take West Virginia as a country, this is our ranking compared to other countries in the world.

If you look at the healthy life expectancy [HALE], which is a good measure of how long people live in a healthy status, again, you will see a decline, a rapid decline, in our ranking in the United States. For example, we used to be 42nd for males, 32nd for females.

We dropped to 69th right now, and 76th for females, a rapid decline, more decline in ranking for females than males in the United States.

If you look at the best-performing state in HALE, Hawaii used to be 14th for males and 15th for females. Right now, it’s 39th and 34th. What I’m telling you here is even our best-performing state is falling behind everybody else in the world. And if you look at a country, replace a state in the US as a country, and compare that state to the 204 countries that we have in our analysis, you will see that many of our states, for example, West Virginia, ranks 141st for males and 137th for females. That’s really a scary image that you see here when it comes to the ranking of our states in terms of life expectancy and HALE.

The other thing that we see in our publication is years lived with disability. We have only six countries that are behind us when it comes to years lived with disability. And when it comes also to our states, with years lived with disability, many of our US states are much worse than other countries in the world. And, in fact, West Virginia, Kentucky, Oklahoma, Pennsylvania, New Mexico, Ohio, Tennessee, and Arizona come at the top, followed by Afghanistan.