New data reveals a surprising story about American health—especially as we age

A new study published in JAMA looked at the healthspan-lifespan connection—how long people live in relation to how many healthy years they actually have—among men and women across 183 World Health Organization (WHO) member states. The researchers looked at data from 2000 to 2019, just before the COVID-19 pandemic swept the globe and undoubtedly skewed the numbers.^[]

When it came to Americans, the findings weren’t so promising: People living in the United States had the largest healthspan-lifespan gap at 12.4 years, meaning they spent more time suffering from disease or disability.  The authors note that even though people are living longer, their healthy years are limited.

As they explain, “Gains in life expectancy across global populations are recognized as a societal achievement. Increased lifespan, however, does not necessarily mean a longer healthy life. In considering quality of life, healthy longevity is increasingly underscored. To this end, characterizing healthspan—years lived in good health—would be valuable.”

America is the sickest we have ever been.

BOLD CHANGES are warranted.

Our food is filled with inflammatory garbage like antibiotics, pesticides, seed oils, modified-Gluten and is super ultra-processed.

73% of Americans are either overweight or obese.

50% of American…

— Jesse Morse, MD (@DrJesseMorse) November 24, 2024

How do other countries compare?

More so, Americans were found to have been most affected by noncommunicable diseases, given the number of years they lived with disease per every 100,000 people.  America’s large healthspan-lifespan gap was closely followed by that of Australia (12.1 years), New Zealand (11.8 years), and the United Kingdom (11.3 years).

In Rwanda, Malawi, Burundi, Uganda, and Ethiopia, people also saw greater increases in healthspan. The lowest healthspan-lifespan gaps (between 6.5 to 7 years) were found in Lesotho, Central African Republic, Somalia, Kiribati, and Micronesia, the authors note.

People are living longer, but they’re not living healthier lives, especially in America. Why, and how, can healthspan be increased, especially when it comes to noncommunicable diseases?

The key health factors at play

Mir Ali, MD, a board-certified general surgeon, bariatric surgeon, and Medical Director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, says that there are a lot of factors at play in America: “More sedentary lifestyle, lack of education, and easy access to ultra-processed foods all contribute to a general decline in health.” 

Dr. Ali says that patients should be encouraged to make the following changes:

• Eat less processed foods

• Eat more protein and vegetables 

• Get regular exercise

• Increase nutritional education at an earlier age and reinforce it throughout childhood

Beyond sticking to a healthy lifestyle, Dr. Ali says, patients need to think about attaining—and maintaining!—a healthy weight. “This is not easy to achieve. The recent surge in weight loss medications has helped, but if people do not make sustainable lifelong changes, then the benefits are only temporary,” he says.

Should docs use food and exercise as medicine?

Diving deeper into nutrition barriers, Jen Scheinman, MS, RDN, CDN, a New York-based registered dietitian and owner of Next Jen Health (nextjenhealth.com), adds that healthy living can be inaccessible to many people. “I do think that, at the foundation, there is a systemic issue that makes it hard for people to live their healthiest lives,” she says. “One significant issue is the ease of access to inexpensive, unhealthy foods that are loaded with sugar, fat, and sodium. These options are often more convenient and cheaper, while whole foods like fruits, vegetables, and whole grains tend to be more expensive and time-consuming to prepare, especially for busy individuals.”

She says that she’s also concerned that the American healthcare system “often prioritizes medication over lifestyle interventions. Instead of referring patients to dietitians, health coaches, or personal trainers who can help them make meaningful changes, many providers rely on prescriptions to manage chronic conditions,” which can, for some patients, lead to quick fixes rather than sustainable solutions. 

But it’s not just about eating or working out, Scheinman says. Community plays an important role in health. “You can’t overestimate the power of community and relationships in boosting health and longevity, and I think this is something desperately missing from American life. Creating supportive environments—whether it’s cooking meals with family, joining a walking group, or workplace wellness programs—can make healthy living feel less like a chore and more like a lifestyle,”  she says. 

Stress is taking a toll on Americans

Beyond community, patients also need to consider their stress levels and working life, says Michelle Routhenstein, MS, RD, CDCES, CDN, Preventive Cardiology Dietitian and Certified Diabetes Educator at EntirelyNourished.com. “Work-life balance, stress management, and burnout are not prioritized in many professional environments,” she says.

“The constant pressure to perform, combined with a lack of emphasis on mental well-being and mindfulness, contributes to chronic stress, which can lead to poor nutrition choices and exacerbate physical health issues like obesity, heart disease, and metabolic disorders.”

Routhenstein says that employers need to start “promoting health within busy work environments, encourag[ing] daily physical activity, and cultivat[ing] a culture that values work-life balance while supporting a health-focused model of being.” She says that health should be part of the work environment.