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Comparing the health of the U.S. to that of other countries can help indicate areas of progress and areas for improvement. The following analysis uses data from the Organization for Economic Co-operation and Development (OECD), which is made up of 38 countries, including the U.S. The OECD collects and analyzes data from each member country on various social, economic and health-related topics, with the mission of promoting economic development and social well-being worldwide.
The following analysis compared data from the U.S. with data from other OECD countries using three health measures: infant mortality, life expectancy at birth and total health spending. Data presented are from 2022 unless otherwise specified. The top and bottom states for infant mortality were included for comparison from the 2024 Health of Women and Children Report. Top and bottom states were also included for life expectancy, using data from the National Center for Health Statistics’ National Vital Statistics System.
Despite having the highest total health spending of all OECD countries, even the top-performing U.S. states ranked poorly in measures of infant mortality and life expectancy compared with other member countries.
Infant mortality
Infant mortality includes all deaths among children younger than 1 year of age and contributes to the nation’s premature death rate. Factors contributing to the high infant mortality rate in the U.S. include a high rate of cesarean deliveries, inadequate prenatal care and socioeconomic inequalities that are associated with obesity, diabetes and heart disease.
The average rate of infant mortality among OECD countries in 2022 was 4.1 deaths per 1,000 live births. At 5.4, the U.S.ˠˠˠ ranked No. 32 of the 38 OECD countries, tied with the Slovak Republic and falling between Canada (4.7, No. 31) and Chile* (5.9, No. 34). Japan and Swedenˠˠˠˠ (both 1.8, No. 1) had the lowest rates. Mexicoˠˠˠˠ (No. 37) and Colombiaˠˠˠˠ (No. 38) had the highest infant mortality rates at 12.7 and 16.5, respectively.
According to the 2024 Health of Women and Children Report, Massachusetts had the lowest infant mortality rate in the U.S. at 3.3 deaths per 1,000 live births in 2021-2022, placing it on par with Belgium, Iceland, Ireland* and the Netherlandsˠˠˠˠ (also 3.3, No. 21). The state with the highest rate, Mississippi, had an infant mortality rate of 9.3, more than twice the OECD average.
There are large racial/ethnic disparities among U.S. infants. In 2021-2022, the U.S. infant mortality rate was 3.0 times higher among Black infants (10.7 deaths per 1,000 live births) compared with Asian infants (3.6).
Life expectancy
Life expectancy at birth describes how long a newborn is expected to live, on average, assuming current death rates remain the same. Life expectancy increased over the past 50 years across all OECD countries, but progress had stalled before the COVID-19 pandemic. The COVID-19 pandemic then led to a significant global decline in life expectancy in many countries.
The average life expectancy at birth in OECD countries was 80.6 years in 2022. The U.S.ˠˠ life expectancy at birth was 76.4 years and ranked No. 34 out of the 38 OECD countries, falling between Colombia (76.9 years, No. 33) and Hungary (76.0 years, No. 35).
Hawaii,ˠˠ the U.S. state with the highest life expectancy (79.9 years), fell between the Czech Republic (79.0 years, No. 28) and the United Kingdomˠ (80.4 years, No. 27). Mississippi,ˠˠ the state with the lowest life expectancy (70.9 years), had a lower life expectancy than Latvia (74.5 years, No. 38), the OECD country with the lowest life expectancy.
Total health spending
Total health spending represents all expenses related to the consumption of health-related goods and services. This includes personal health care (such as curative, rehabilitative and long-term care) and collective services (such as prevention and public health services).
The average total spending on health in OECD countries was $4,986 U.S. dollars per capita in 2022. The U.S. spent 2.5 times that amount, totaling $12,555, and remained the top health spender of all OECD countries. Switzerland, which spent the second most on health among OECD countries ($8,049), spent only about two-thirds the amount the U.S. spent per capita.
Spending on inpatient and outpatient care accounted for the largest share of the difference between the U.S. and other countries (61.5% vs. 45.6%). Inpatient and outpatient care represented a greater share of health spending in 2021 than 2013. Roughly 56% of total health spending in the U.S. came from public funds in 2021, much less than the OECD average of 73%.
