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October 25, 2016

Improving Health and Health Care in the United States: Toward a State of Complete Well-being

Author Affiliations
  • 1Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Harvard Kennedy School, Cambridge, Massachusetts
JAMA. 2016;316(16):1679-1681. doi:10.1001/jama.2016.12414

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”1 For too many individuals living in the United States, this state remains well out of reach. Despite spending relatively more on health than any other country and ranking among the wealthiest of nations, the United States is far from the healthiest.2-4 Although life expectancy at birth has been gradually increasing, the United States ranks 43rd worldwide2 on this key measure, with residents demonstrating poorer health (compared with other high-income countries) at each life stage.2,3 Furthermore, between the top and bottom 1% of income distribution, life expectancy (at age 40 years) differs about 15 years for men and 10 for women, with further disparities by geography, race/ethnicity, and other dimensions.3,5