Population Health

At a Glance Projects Publications Team


Why Does Health in the US Continue to Lag Behind?

Mikko Myrskylä, Marcus Ebeling, Enrique Acosta, Neil Kishor Mehta (University of Michigan, Ann Arbor, USA)

Detailed Description

Health and mortality in the United States rank poorly by international standards despite the nation’s robust economic and technological standing. In 2010, life expectancy at birth in the United States at age 78.8 was 1.0 year lower than the average of 27 European Union countries. Between 2010 and 2019, the US shortfall doubled to 2.1 years — largely a product of stalling US life-expectancy growth. Between 2014 and 2017, US life expectancy saw three consecutive year-over-year declines, unique among high-income countries. The COVID-19 pandemic has only served to exacerbate these preexisting shortfalls. The US lag is evident for both women and men, and it is not attributable to the racial/ethnic diversity of the US population.

In this project, a multidisciplinary group of researchers provides an updated and wide-ranging treatment of the issue. Our publications in this project encompass studies of mortality, disability, and chronic disease. As a set, they focus on various stages of life, addressing proximal causes as well as those related to social and economic conditions, and they consider the impact of the COVID-19 pandemic. The role of cardiometabolic health features also plays a prominent part across the studies.

Our results provide a detailed account of the myriad ways in which health in the United States continues to lag behind; this includes specifics on age groups, death causes, risk factors, and generational patterns. While details of the lag continue to be documented, the solutions continue to be evasive. Violence and drug overdoses, both important contributors to the lag, have both proximal and structural features, which likely interact with each other in complex ways. The proximal features include, e.g., the availability of firearms, prescribing regulations; the structural features include, e.g., economic and social factors. Cardiovascular diseases and their risk factors explain some of the lag and may be prominent in recent trends, but appropriate interventions are challenging and require multilevel social and health care interventions.

Research Keywords:

Aging, Mortality and Longevity

Region keywords:



Abrams, L. R.; Myrskylä, M.; Mehta, N. K.:
Proceedings of the National Academy of Sciences of the United States of America 120:42, e2308360120–e2308360120. (2023)    
Acosta, E.; Mehta, N. K.; Myrskylä, M.; Ebeling, M.:
Journals of Gerontology, Series B: Psychological Sciences and Social Sciences 77:Suppl. 2, S148–S157. (2022)    
Mehta, N. K.; Myrskylä, M.:
The Journals of Gerontology: Series B 77:Supplement_2, S113–S116. (2022)    
Abrams, L. R.; Mehta, N. K.; Myrskylä, M.:
International Journal of Epidemiology 50:6, 1970–1978. (2021)    
The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.