The United States is on track to fall behind many other nations in health progress, with its life expectancy expected to see only modest growth by 2050, according to a new analysis from the Institute for Health Metrics and Evaluation (IHME). The report, published in The Lancet, suggests that the U.S. will face challenges in improving life expectancy and healthy life expectancy (HALE) as the nation’s health struggles to keep pace with global advancements.
The study forecasts that U.S. life expectancy (LE) will rise only slightly, from 78.3 years in 2022 to 79.9 years by 2035 and 80.4 years by 2050. While this increase represents some progress, it is not enough to prevent a dramatic decline in the U.S.’s global health ranking. By 2050, the U.S. is expected to fall from 49th place in 2022 to 66th in the world.
This slowdown in life expectancy improvements, despite progress in reducing mortality from diseases like heart disease, stroke, and cancer, is largely attributed to the rising prevalence of obesity. As the U.S. faces an obesity crisis, with an estimated 260 million people affected by 2050, the forecasted improvements in life expectancy could be significantly undercut.
The forecast for healthy life expectancy, which accounts for years lived in good health, shows a similarly concerning trend. The U.S. is expected to see a drop in HALE rankings from 80th in 2022 to 108th by 2050. This decline is particularly pronounced for women, whose health is falling behind faster than men’s. Women’s HALE in the U.S. is projected to decline in 20 states by 2050, with only a few states seeing stability in female health outcomes.
The global ranking for female life expectancy in the U.S. is expected to plummet to 74th in 2050, a significant drop from 19th in 1990. Meanwhile, male life expectancy is forecasted to rank 65th globally by 2050, a decline from 35th in 1990.
Beyond obesity, the U.S. faces alarming increases in mortality rates from drug-related causes, including opioid addiction and other substance use disorders. From 1990 to 2021, drug-related deaths in the U.S. soared by 878%, and the death rate is expected to climb another 34% by 2050. The U.S. is projected to have the highest drug-related mortality rate in the world by that time.
“Despite efforts to combat the opioid crisis, the epidemic continues to affect millions, and more must be done to address this growing public health challenge,” said Professor Ali Mokdad, lead author of the study.
While the future health outlook is bleak without major interventions, IHME researchers have outlined pathways that could prevent millions of deaths by addressing key risk factors. If obesity, high blood sugar, and high blood pressure were eliminated by 2050, up to 12.4 million deaths could be prevented.
The study also highlights the potential benefits of reducing smoking, a risk factor that could save 2.1 million lives by 2050. Despite these potential gains, the U.S. is still on track to fall behind countries like Canada in health outcomes, suggesting that tackling risk factors alone will not be enough to catch up with global health leaders.
IHME urges policymakers, health professionals, and the public to take immediate action to prevent further declines in health outcomes. “The U.S. must shift its approach to health if it hopes to reverse these concerning trends,” said Dr. Stein Emil Vollset, co-senior author of the study. “Access to high-quality health care, preventive services, and addressing health disparities at the community level are critical to reversing this course.”
The study also stresses the need for universal health coverage to ensure that all Americans have access to the care they need to stay healthy, reduce chronic disease risks, and improve life expectancy. Additionally, increasing public health education and addressing social determinants of health, such as income and education, will be essential to improving the nation’s overall health.
The IHME report serves as a wake-up call for the U.S. to address its escalating health challenges. As the nation grapples with rising obesity rates, drug-related deaths, and health disparities, the forecasted decline in life expectancy and healthy life expectancy rankings underscores the need for comprehensive health system reform. It is clear that the time for action is now, before these trends become irreversible.
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