Measured by every relevant metric, and reported by every major health agency in the world, such as the American Public Health Association. The U.S. is ranked somewhere around 25 to 30.
If life expectancy and infant mortality are not measures of health, and healthcare, what do they measure? Surely they measure healthcare in the larger sense, including public health and education, which are essential to good health. Anyway, if you don't like those metrics, use any of the other common ones, from the American Public Health Association:
- Shorter lives — over the past 25 years, U.S. life expectancy has grown, but at a lower rate than in other countries.
- Bad birth outcomes — we have the highest rates of infant mortality, low birth weight, women dying due to complications of pregnancy and childbirth and children less likely to live to age 5.
- More injuries and homicides — deaths from motor vehicle crashes, non-transportation injuries and violence happen at much higher rates.
- Heart disease — the U.S. death rate from ischemic heart disease is the second highest. Adults over age 50 are more likely to develop and die from cardiovascular disease.
- Obesity and diabetes — for decades, the U.S. has had the highest obesity rate across all age groups, and American adults have high rates of diabetes.
- Chronic lung disease — lung disease is more common and associated with higher risk for death.
- Disability — Older U.S. adults report a higher prevalence of arthritis and limits to their daily activities.
- Adolescent pregnancy and sexually transmitted disease — our youth have the highest rate of pregnancy and are more likely to acquire sexually transmitted diseases.
- HIV and AIDS — we have the second highest prevalence of HIV infection and the highest incidence of AIDS.
- Drug-related death — we lose more years of life to alcohol and other drugs even when deaths from drunk driving are excluded. In fact, the president's 2014 National Drug Control Strategy noted overdose deaths now surpass homicides and car crash deaths.
One of the ironies here is that we tend to think in terms of the quality of interventions to help ill people, when they get ill. Unsurpassed (for those who get all of them) in the US.
However health has always been MOSTLY about arranging society with good preventive health systems so that people don't get ill in the first place:
- Occupational health and pollution control to reduce lung disease (big cities throughout the world have a way to go there)
- Dietary nudges to prioritise high fibre low sugar diets
- Town planning to encourage exercise
- Access to local "known personally" primary care as much to deal with mental and social health as medical matters
And this matters most for the poorest 25% of society, who have the largest burden of illness. Reduce poverty and you increase health. But, also, put in place strong preventative measures and health goes up more per dollar spent than putting money into curing those who get ill. It has become a pressing issue in the last 30 years since modern society is increasingly designed to make people obese - we have not yet found a way to change that although it should be the very highest health priority. Mobile phones (and in general screen-based leisure) don't help much!
It is pretty obvious, and true generally, that taking better care of things pays. Unfortunately it is not glamorous, not interesting, and benefits are seen down the line so there is a big communication job for politicians to do when they spend money in this way.
