Life Expectancy in the U.S. vs. Other Developed Nations: Why the Gap Persists
U.S. life expectancy vs. other developed nations: a 2025 snapshot
The U.S. has regained ground since the pandemic shock, but it still sits below many peer nations on the most basic outcome measure: life expectancy at birth. The latest final U.S. mortality release shows life expectancy rose to 79.0 years in 2024, up from 78.4 in 2023 and 77.5 in 2022. Internationally comparable series (harmonised across countries) still place the U.S. well behind Western Europe and the longest-lived Asia-Pacific systems.
Table 1. Life expectancy and health spending in the U.S. vs comparable wealthy countries (2023)
| Country | Life expectancy (2023) | Gap vs U.S. (years) | Health spending per capita (2023, USD PPP) |
|---|---|---|---|
| United States | 78.4 | 0.0 | 13,432 |
| Switzerland | 84.1 | +5.7 | 9,688 |
| Japan | 84.0 | +5.7 | 5,640 |
| Sweden | 83.3 | +4.9 | 7,522 |
| Australia | 83.1 | +4.7 | 6,931 |
| France | 82.9 | +4.5 | 7,136 |
| Belgium | 82.4 | +4.0 | 7,380 |
| Netherlands | 81.9 | +3.5 | 7,737 |
| Canada | 81.6 | +3.3 | 7,013 |
| Austria | 81.5 | +3.2 | 7,811 |
| United Kingdom | 81.2 | +2.9 | 6,023 |
| Germany | 80.5 | +2.2 | 8,441 |
Chart 1. Life expectancy across the U.S. and 11 comparable high-income countries (2023)
Chart view is unavailable. The key comparison is still visible in Table 1 above: the U.S. (78.4 years) trails Japan and Switzerland (≈84.0–84.1) by about 5–6 years in harmonised 2023 data.
| Top of peer group (2023) | Life expectancy | Gap vs U.S. |
|---|---|---|
| Switzerland | 84.1 | +5.7 |
| Japan | 84.0 | +5.7 |
| U.S. | 78.4 | 0.0 |
Why the gap persists (even as the U.S. rebounds)
The U.S. disadvantage is not driven by a single disease or a single policy choice. Research comparing age-specific mortality across rich countries repeatedly points to a combination of (1) higher midlife mortality from injuries and substance-related deaths, (2) slower improvements in cardiovascular mortality after 2010, and (3) large internal disparities linked to income, education, and place.
Methodology (what these numbers mean)
Life expectancy at birth is a period measure: it summarises mortality rates observed in a given year as if a newborn experienced those rates throughout life. For the U.S., we use the latest final national mortality release (2024) to describe the newest level and direction of change. For cross-country comparisons, we use harmonised international series (2023) so that the same concepts and methods apply across countries. Health spending per capita is shown for a standard peer set of wealthy OECD countries, reported in PPP-adjusted U.S. dollars for 2023 to reduce price-level distortions. Key limitations: sudden shocks (pandemics, drug supply changes, heat waves) can move one-year life expectancy sharply; revisions happen as death registration is finalised; and averages can mask large within-country inequalities.
What this means for readers
A 3–6 year gap in national life expectancy is a signal about the broader risk environment: safety, prevention, chronic-disease management, and how evenly health gains are shared. It does not predict any individual’s lifespan, but it helps explain why outcomes like avoidable deaths, disability, and financial strain from illness remain more common in the U.S. than in many peer nations—despite very high spending.
FAQ
Is U.S. life expectancy “79 years” in 2025?
The most recent final national release reports 79.0 years in 2024. That is the newest confirmed level, commonly used as a practical proxy for a “2025 snapshot” because full-year 2025 mortality data are not final yet.
Why compare with a harmonised 2023 series instead of only national 2024 figures?
Countries finalise and publish mortality data on different timelines and sometimes use different methods. A harmonised series applies consistent definitions across countries, making cross-country gaps easier to interpret.
How can the U.S. spend so much and still rank lower on longevity?
Spending reflects prices, administrative complexity, and intensity of treatment—not just prevention or population health. Many U.S. deaths that weigh on life expectancy occur at younger ages (injuries, overdoses), where medical care alone cannot fully offset risk.
Does life expectancy at birth mainly reflect older-age care?
Not only. A key reason the U.S. ranks lower is that mortality is relatively high in working-age adulthood compared with peers. Deaths at younger ages pull the average down more than deaths at very old ages.
Is the gap closing now that the U.S. is improving again?
The rebound after 2021–2022 is real, but whether the gap narrows depends on whether progress continues on the drivers of premature death—especially substance-related deaths, injuries, and cardiovascular risk—while improving access to prevention and chronic-disease management.
Can some U.S. regions match peer-country life expectancy?
Yes. The U.S. contains places with outcomes similar to top peer nations and places far below. National averages blend these extremes; that is why policies that reduce within-country gaps can move the national number materially over time.
Interactive peer table + spending vs longevity chart (2023)
This peer set is commonly used in wealthy-country comparisons because it is large enough to show meaningful variation and small enough to keep definitions consistent. Use the tools to search, filter by region, and sort by either life expectancy or health spending.
Table 2. Comparable wealthy countries (life expectancy and health spending, 2023)
| Country | Life expectancy (2023) | Gap vs U.S. (years) | Health spending per capita (2023, USD PPP) |
|---|---|---|---|
| United States | 78.4 | 0.0 | 13,432 |
| Switzerland | 84.1 | +5.7 | 9,688 |
| Japan | 84.0 | +5.7 | 5,640 |
| Sweden | 83.3 | +4.9 | 7,522 |
| Australia | 83.1 | +4.7 | 6,931 |
| France | 82.9 | +4.5 | 7,136 |
| Belgium | 82.4 | +4.0 | 7,380 |
| Netherlands | 81.9 | +3.5 | 7,737 |
| Canada | 81.6 | +3.3 | 7,013 |
| Austria | 81.5 | +3.2 | 7,811 |
| United Kingdom | 81.2 | +2.9 | 6,023 |
| Germany | 80.5 | +2.2 | 8,441 |
Figure 2. Health spending per person vs life expectancy (peer set, 2023)
The relationship is positive on average—richer systems tend to spend more and live longer—but the U.S. stands out: exceptionally high spending with a materially lower life expectancy than peers.
Scatter view is unavailable. The table above still shows the pattern: the U.S. spends 13,432 USD PPP per person in 2023—well above Switzerland (9,688) and Germany (8,441)—yet its harmonised 2023 life expectancy (78.4) is lower than every peer in this set.
Interpreting the U.S. longevity gap in 2025
A country can improve its life expectancy while still lagging peers if the underlying drivers remain: high rates of premature death in working-age adulthood, slower progress against cardiovascular risk, and large inequality in how health gains are distributed. That is the core story of the U.S. gap.
What the evidence consistently points to
- Premature deaths weigh heavily: injuries and substance-related mortality occur at younger ages and pull life expectancy down more than deaths at very old ages.
- Chronic disease management is uneven: progress against cardiovascular mortality slowed after 2010, and risk factors remain high in many communities.
- Access and affordability matter: a fragmented financing system can delay prevention and treatment, especially for lower-income households.
- Within-country gaps are large: place, income, and education strongly predict outcomes—so national averages hide extremes.
Policy takeaway: what tends to move life expectancy
Longevity gains typically come from a portfolio approach: prevention, safer environments, earlier detection and treatment, and stronger social foundations.
- Reduce deaths from injuries and substance use (overdose prevention and treatment continuity; safer roads; violence prevention).
- Accelerate cardiovascular risk reduction (blood pressure control, tobacco control, diabetes prevention, and medication adherence).
- Lower financial barriers to care (coverage stability; primary care access; easier navigation of services).
- Target the biggest geographic and socioeconomic gaps (maternal/infant health, rural access, and high-risk counties/cities).
How to read the recent rebound
The rise to 79.0 years in the latest U.S. final year reflects real improvements after the pandemic peak—helped by falling COVID-19 mortality and a sharp reduction in drug overdose deaths. The key question is whether these gains are durable and broad-based, and whether the U.S. can reduce the specific causes of premature death that are less common in peer countries.
Primary sources (official and research)
-
CDC / NCHS — Final mortality and life expectancy releases (2023 and 2024).
https://www.cdc.gov/nchs/products/databriefs/db521.htm
https://www.cdc.gov/nchs/products/databriefs/db548.htm -
OECD — Health at a Glance 2025: life expectancy and health spending context for OECD countries.
https://www.oecd.org/en/publications/2025/11/health-at-a-glance-2025_a894f72e/full-report/life-expectancy-at-birth_8a8dee48.html
https://www.oecd.org/en/publications/2025/11/health-at-a-glance-2025_a894f72e/full-report/health-expenditure-per-capita_affe6b0a.html -
World Bank (WDI) via FRED — Harmonised life expectancy series used for cross-country comparability (latest value: 2023).
https://fred.stlouisfed.org/series/SPDYNLE00INUSA
https://fred.stlouisfed.org/series/SPDYNLE00INJPN
https://fred.stlouisfed.org/series/SPDYNLE00INCHE -
Peterson-KFF Health System Tracker — OECD-based peer comparisons for per-capita health spending (2023, PPP adjusted).
https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/ -
National Academies (NASEM) — Working-age mortality and the U.S. life expectancy disadvantage (drivers such as substance-related deaths and slowed cardiovascular progress).
https://www.nationalacademies.org/projects/DBASSE-CPOP-18-02/publication/25976 -
Peer-reviewed research — Cause decomposition of the U.S. shortfall (injuries, overdoses, firearms, road deaths, and more).
https://pmc.ncbi.nlm.nih.gov/articles/PMC9154274/ -
Commonwealth Fund — Cross-country health system performance comparisons (Mirror, Mirror 2024).
https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024
