The United States has lower life expectancy than most similarly wealthy nations

Scope of the Problem

• Multiple comments stress that US life expectancy is lower not only overall but at every wealth level compared with Europe; even the richest Americans fare worse than rich Europeans and sometimes only as well as poor Europeans.
• The US also has fewer healthy years, with many living longer but in poor health.

Inequality, Stress, and Healthcare Access

• Inequality, stress, loneliness, and “deaths of despair” (addiction, mental health, etc.) are repeatedly cited as core drivers.
• “Difficulty accessing healthcare” is argued to be as much about cost opacity, insurance networks, and fear of financial ruin as about distance or wait times.
• Several anecdotes describe people avoiding urgent care — and even dying — because of expected bills, despite having insurance.
• There is debate over US poverty: some argue official statistics understate the impact of large welfare spending; others say spending levels are irrelevant if outcomes (e.g., places like Gary, Indiana) remain poor.

Behavior, Environment, and “Social Causes”

• Many point to poor diet, ultra-processed food (major share of calorie intake), car dependence, and low physical activity as central.
• Obesity is highlighted as a key driver of chronic disease and reduced life expectancy, especially among younger adults.
• Traffic fatalities, overdoses (especially synthetic opioids), and homicides are seen as major contributors, particularly for ages 15–49.
• Alcohol is debated: US drinking culture is criticized, but others note per-capita consumption is lower than in much of Europe, where life expectancy is higher.

Regional and Demographic Variation

• Thread repeatedly emphasizes huge state- and county-level gaps (≈10-year differences) and argues national averages hide crucial spatial inequality.
• Some argue multicultural demographics require disaggregation by race/ethnicity and region; others counter that using demographics to “explain away” poor outcomes is morally troubling and risks racist framing.
• Climate and walkability are discussed: some blame southern heat for inactivity; others counter that northern states with harsh winters still manage higher fitness, pointing instead to culture, urban design, and diet.

Obesity, Doctors, and Culture

• Several report doctors downplaying or over-attributing problems to weight, suggesting inconsistent clinical handling.
• There’s disagreement whether doctors avoid discussing obesity due to “body shaming” fears or, conversely, focus on it too bluntly.
• Some propose sugar/fast-food taxes, better urban design, and stronger social safety nets; others emphasize individual lifestyle changes (cooking, walking, everyday activity).