The U.S. Is Dying Younger Than Other Wealthy Nations, Study Finds

The United States loves the idea of longevity. The wellness industry keeps growing, biohacking has gone mainstream, and healthcare spending in the U.S. now far exceeds every other wealthy nation in the world, both per person and as a percentage of GDP.

So why are Americans still dying younger than people in other high-income countries?

That question sits at the center of a massive new analysis1 published in the journal JAMA Internal Medicine. And their findings reveal the two biggest drivers of America’s widening longevity gap: cardiovascular and metabolic diseases. 

To understand why Americans are dying younger than people in other high-income nations, researchers analyzed more than 63 million U.S. deaths between 1999 and 2022 and compared them with mortality data from 17 peer countries.

The findings were staggering. Researchers estimated that nearly 12.7 million U.S. deaths during that time period could have been avoided if the United States had mortality rates similar to those countries.

The study looked at all major causes of death across age groups, which allowed researchers to build what they described as a “population autopsy.” Instead of focusing on one disease in isolation, they examined the broader patterns driving America’s widening longevity gap.

Drug overdoses, alcohol-related deaths, and suicide accounted for a significant portion of the rising deaths, especially among younger adults. But they weren’t the biggest driver overall.

Circulatory and metabolic diseases, including heart disease, stroke, hypertension, diabetes, and kidney disease, accounted for more than half of excess U.S. deaths in 2022.

What makes cardiometabolic disease complicated is that it doesn’t usually arrive all at once. It builds slowly through overlapping systems: insulin resistance, chronic inflammation, disrupted sleep, poor diet quality, stress overload, physical inactivity, and social conditions that make healthy choices harder to sustain consistently.

And while the U.S. has access to advanced medical technology, this study highlights that treatment is not the same thing as prevention.

Other wealthy countries have access to similar medications, imaging tools, and hospitals. Yet Americans still die at higher rates, particularly from preventable chronic disease. Researchers point toward broader structural issues, including food environments dominated by ultra-processed products, healthcare inequities, economic instability, and weaker social safety nets.

One of the more revealing findings was the age pattern. Excess cardiovascular deaths in Americans ages 45 to 64 began climbing years before they increased in older adults. That suggests the problem often starts much earlier than people think.

Metabolic dysfunction develops gradually. By the time someone experiences a cardiac event or serious disease diagnosis, the underlying processes may have been progressing for decades. Elevated blood sugar, hypertension, visceral fat accumulation, sleep disruption, and inflammation all compound over time.

The takeaway here is bigger than any one disease or habit. America’s longevity crisis doesn’t appear to be driven by a single factor so much as the cumulative effect of a lifestyle and environment that slowly erodes metabolic resilience over time.