International Comparison

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 used data from the Organization for Economic Co-operation and Development (OECD)

, which comprises 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 U.S. data with data from other OECD countries for three health measures: infant mortality, life expectancy at birth and total health spending. Data presented are from 2023 unless otherwise specified. Infant mortality rates for the top- and bottom-ranked states from the 2025 Health of Women and Children Report were included for comparison.

Infant mortality

includes all deaths among children younger than 1 year of age and contributes to the nation’s premature death rate.⁷² 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 maternal risk factors.⁷³

The average infant mortality rate among OECD countries in 2023 was 4.2 deaths per 1,000 live births. At 5.6, the U.S. ranked No. 32 among the 38 OECD countries, tied with the Slovak Republic (also 5.6, No. 32) and falling between New Zealand^ˠ (4.8, No. 31) and Chile^* (6.5, No. 34). Estonia (1.7, No. 1) had the lowest infant mortality rate. Mexico (No. 37) and Colombia^ˠˠ (No. 38) had the highest infant mortality rates at 13.4 and 16.5, respectively.

According to the 2025 Health of Women and Children Report, New Hampshire^ˠˠˠˠ had the lowest infant mortality rate in the U.S. at 3.2 deaths per 1,000 live births in 2022-2023, placing it on par with Australia and Germany (both also 3.2, No. 21). The state with the highest rate, Mississippi,^ˠˠˠˠ had an infant mortality rate of 9.0, more than twice the OECD average.

There are large racial/ethnic disparities in U.S. infant mortality rates. In 2022-2023, the U.S. infant mortality rate was 3.1 times higher among Black (10.9 deaths per 1,000 live births) compared with Asian (3.5) infants.

Life expectancy at birth

describes how long a newborn is expected to live on average, assuming current death rates remain the same.⁷⁴ Life expectancy increased over the past 50 years

across all OECD countries, but progress stalled before the COVID-19 pandemic.⁷⁵ The COVID-19 pandemic then led to a significant global decline in life expectancy

in many countries.⁷⁶

The average life expectancy at birth in OECD countries was 81.1 years in 2023. The U.S. life expectancy at birth was 78.4 years, ranking No. 30 out of the 38 OECD countries, placing it on par with Poland (also 78.4, No. 30) and between Estonia (79.1 years, No. 29) and the Slovak Republic (78.2 years, No. 32).

Between 2003 and 2023, the gap in life expectancy between the U.S. and the OECD average grew considerably. In 2003, life expectancy in the U.S. was 77.2 years, compared with the OECD average of 77.4 years. By 2019, that 0.2-year gap had widened to 2.2 years (78.8 years in the U.S. compared with the OECD average of 81.0 years). The gap in life expectancy was widest at the height of the COVID-19 pandemic in 2021, with U.S. life expectancy (76.4 years) falling to 3.7 years below the OECD average (80.1 years). In 2023, the U.S. life expectancy of 78.4 years was still 2.7 years less than the OECD average of 81.1 years.

Total health spending

comprises all expenses for the consumption of health-related goods and services, including personal health care, prevention and public health services.⁷⁷

The average total health spending per capita in OECD countries was $5,477 in 2023. The U.S. spent 2.5 times that amount — $13,818 per capita — and remained the top spender among OECD countries. Switzerland, which ranked No. 2 in health spending among OECD countries ($9,301), 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%).⁷⁸ Inpatient and outpatient care accounted for a larger share of health spending in 2021 than in 2013. However, roughly 56% of total health spending

in the U.S. came from public funds in 2021, well below the OECD average of 73%.⁷⁵