---
title: "U.S. Life Expectancy Now Ranks 38th and the Causes Vary Grimly by Age"
description: "A new analysis finds young Americans dying at rates that 60 countries have managed to beat before age 40"
author: "Nate Ledger"
published: 2026-09-23T22:02:20Z
modified: 2026-09-26T17:25:25Z
url: https://rews.cc/a/u-s-life-expectancy-now-ranks-38th-and-the-causes-vary-griml-ea63d9
language: en
tags: ["health", "economy", "politics", "drugs", "infrastructure", "us"]
publisher: "Rews (https://rews.cc)"
---

# U.S. Life Expectancy Now Ranks 38th and the Causes Vary Grimly by Age

*A new analysis finds young Americans dying at rates that 60 countries have managed to beat before age 40*

By Nate Ledger · September 23, 2026 · https://rews.cc/a/u-s-life-expectancy-now-ranks-38th-and-the-causes-vary-griml-ea63d9

## In brief

- VCU’s Steven H. Woolf analyzed U.S. life expectancy and mortality from 1999 through 2023 using CDC and OECD data
- The U.S. ranked 38th in life expectancy in 2023 among countries over 1 million people; only 13 ranked higher in 1980
- Mortality among 25- to 44-year-olds rose more than 70% from 2010 to 2021, driven by overdoses and early-onset diseases
- People in 60 countries now have a lower risk of dying before age 40 than Americans do
- Woolf cites systemic failures and says the U.S. lacks “not solutions but political will”

There are rankings a country wants to climb and rankings it wants to fall down, and “risk of dying before age 40” is very much the second kind. A new analysis by Steven H. Woolf of Virginia Commonwealth University tracks U.S. life expectancy and age-specific mortality from 1999 through 2023, drawing on data from the Centers for Disease Control, the OECD and other sources. The picture it assembles is bleak, and getting bleaker in a specific, measurable way: relative to everyone else.

In 1980, only 13 countries with populations over a million had higher life expectancy than the United States. That number has ratcheted up decade by decade, and as of 2023 data the U.S. ranks 38th. Falling behind a few rich peers happens. Falling behind 37 of them is a pattern, and the pattern is the finding.

What makes the study uncomfortable reading is that this is not one problem. It is a different problem at every age, which is worse. Young adults aged 25 to 44 suffered the steepest deterioration, with mortality rising more than 70 percent between 2010 and 2021 — driven primarily by drug overdoses and by early-onset diseases, including hypertensive disease, endocrine and metabolic disorders, and alcoholic liver disease. These are people dying of things that, in peer countries, mostly do not kill people in their thirties.

Among Americans aged 1 to 24, the rising causes of premature death include sudden unexplained infant deaths, car accidents, homicide and suicide. Add it all up and people in 60 countries now face a lower risk of dying before age 40 than Americans do. Sixty. The U.S. is being outlived not just by the usual Scandinavian suspects but by a list of countries long enough that the exception is the rule.

Middle-aged adults are succumbing at higher rates to many of the same diseases as young adults, plus nervous-system and genitourinary disorders. COVID-19 landed hardest here and in older age groups: it became the third leading cause of death for middle-aged Americans in 2020, then tripled in 2021 — a period when vaccines were already available. Older Americans suffered the highest COVID death rates of all.

The natural question is why, and Woolf’s answer has two layers. There are proximate causes everyone knows: the opioid epidemic, access to firearms, high-calorie diets. But he argues that fixating on those “obscures the larger story.” When mortality rises across this many causes of death at once, he writes, it calls for systemic explanations: a broken healthcare system, a sky-high poverty rate, and a lax regulatory environment that invites pollution and allows the sale of dangerous products. Federalism then concentrates the damage — people in the South, Appalachia and rural communities face even greater risk of premature death.

Which is to say the diagnosis points at things the country could, in principle, change. Woolf says so outright: “We know how to solve this. Other countries that have outperformed the United States for decades have demonstrated that better health outcomes are possible. What we lack in the United States is not solutions but political will.”

That is the grimmest line in the piece, and also the most mechanical one. Thirty-seven countries have run the same experiment — wealthy, industrialized, facing the same opioids and calories and cars — and produced better survival. The inputs differ mostly in policy. The gap between the U.S. and its peers is, on this account, a choice being made continuously, at scale, one budget and one regulation at a time. The mortality tables are just where it gets recorded.