COIOS
Power of data Item confirms peer-reviewed

US life expectancy ranked 38th in 2023 as the gap with peer countries widened

An analysis of US and comparator mortality data finds US life expectancy ranked 38th globally in 2023, with the gap against 16 high-income countries widening and the rising death rates concentrated at younger and working ages.

The authors assembled life expectancy and age- and cause-specific mortality for the United States from 1999 to 2023 alongside 16 high-income comparators, drawing on the US Mortality Database, CDC, OECD and UN sources, and added a state-level analysis of life expectancy against the governor's party from 1941 to 2022. The United States ranked 38th for life expectancy in 2023, with the shortfall driven by deaths below middle age, including drug overdose, alcohol, homicide, suicide and cardiometabolic disease. They attribute the divergence to health system, socioeconomic and policy factors, with state-level variation increasing.

Why it is interesting: It places the US working-age mortality shortfall and its substance and suicide component in one cross-national and state-level frame.

Source
The Milbank Quarterly, 23 September 2026
DOI
10.1111/1468-0009.70118
Type
Peer-reviewed article
Design
Descriptive cross-national and cause-specific mortality analysis (US 1999–2023; 16 high-income comparators) with state-level life expectancy by gubernatorial party, 1941–2022, plus literature review
Verdict
Confirms prior evidence
Driver
The sources behind the numbers
Driver
Inequalities in health and length of life
Driver
Alcohol, drugs and suicide