The U.S. is falling behind globally in health progress. While life expectancy is expected to rise slightly from 78.3 years in 2022 to 80.4 years by 2050, the U.S. global ranking will drop from 49th to 66th, according to a study in The Lancet.
Healthy life expectancy rankings are also set to decline significantly. Key concerns include:
- Rising obesity rates, which could affect over 260 million people by 2050, and
- A dramatic increase in drug-related deaths, forecasted to reach the highest rate worldwide.
Addressing major risk factors like obesity, smoking, and high blood pressure could save millions of lives but won’t significantly improve the U.S.'s global health standing without broader systemic changes, the study warns.
The study urges immediate action on health strategies and policies to prevent further declines in outcomes and their economic impact. Universal access to high-quality healthcare and investments in preventive care are emphasized as critical solutions.
About the study
The study draws on a detailed analysis of all 50 states and Washington, D.C., published in The Lancet. Researchers at the Institute for Health Metrics and Evaluation (IHME) produced health estimates and forecasts (the most likely future) of life expectancy, mortality, and morbidity due to more than 350 diseases and injuries and 68 risks in the U.S. from 1990 to 2050.
U.S. life expectancy improvements slow, global ranking drops
Life expectancy in the U.S. is forecast to increase from 78.3 years in 2022 to 79.9 years in 2035 and to 80.4 years in 2050 for all sexes combined. This modest increase lowers the country’s global ranking from 49th in 2022 to 66th in 2050 among the 204 countries and territories included in the latest Global Burden of Disease (GBD) study.
Nationally, mortality rates declined between 1990 and 2021 for many leading causes of death, most notably for heart disease, cancer, and stroke. That contributed to improvements in life expectancy.
Despite the progress the U.S. has made over the last three decades, the country is forecast to rank progressively lower than other nations globally in the average number of years a person can expect to live in good health. Known as healthy life expectancy (HLE) or health-adjusted life expectancy, its global ranking is forecast to drop from 80th in 2022 to 108th by 2050.
Women’s health in the U.S. is falling behind other peer countries faster than men’s. Female healthy life expextancy is forecasted to decline by 2050 in 20 states, including Ohio, Tennessee, and Indiana. Only three states remain unchanged: Arizona, Idaho, and North Dakota.
“In spite of modest increases in life expectancy overall, our models forecast health improvements slowing down due to rising rates of obesity, which is a serious risk factor to many chronic diseases and forecasted to leap to levels never before seen,” said co-senior author Professor Christopher J.L. Murray, Director of IHME.
“The rise in obesity and overweight rates in the U.S., with IHME forecasting over 260 million people affected by 2050, signals a public health crisis of unimaginable scale.”
Alarming forecasts in U.S. mortality rates and causes of death
The nation also faces other alarming trends. From 1990 to 2021, the U.S. recorded an 878% increase in the mortality rate (from 2.0 deaths to 19.5 deaths per 100,000) from drug use disorders, including from opioid use disorder, amphetamine use disorder, cocaine use disorder, and a group of other drug use disorders. The death rate is forecasted to climb another 34% between 2022 and 2050 (from 19.9 deaths to 26.7 deaths per 100,000).
That’s the highest drug use–related mortality rate in the world and more than twice as high as the second-highest country, which is Canada.
“The stark contrast that’s forecasted in the next 30 years comes after a concerted effort by federal, state, and local government agencies and health systems launched after the opioid crisis was declared a public health emergency in 2017. The opioid epidemic is far from over, and greater effectiveness and continued expansion of programs to prevent and treat drug use are still needed,” said lead author Professor Ali Mokdad from IHME.
Major risk factors, 12 million deaths
If major risk factors like obesity, high blood sugar, and high blood pressure were eliminated by 2050, 12.4 million deaths could be averted in the U.S. That said, if these risk factors were eliminated globally, the health gains wouldn’t be enough for the U.S. to improve its global ranking, and it would still fall behind some peer countries, the researchers said.
Some countries, like Canada, are so far ahead of the U.S. that U.S. would only catch up to Canada if these risks were totally eliminated in the U.S.
“The rapid decline of the U.S. in global rankings from 2022 to 2050 rings the alarm for immediate action. The U.S. must change course and find new and better health strategies and policies that slow down the decline in future health outcomes,” said co-senior author Dr. Stein Emil Vollset, Affiliate Professor from IHME.