ports large numbers of automobiles, low taxes on gasoline, and dispersed residences and workplaces that encourage driving; a climate and soil in part of the country that are conducive to growing tobacco; and a productive agricultural sector that produces inexpensive foods. From a cross-national perspective, the United States is often noted for high income inequality and weak social safety nets, labor policies, and child support policies.

Some of the relevant context is political. The panel undertook no analysis of the cost-effectiveness of public interventions designed to change personal health-related behaviors; therefore, recommendations as to what might be undertaken in this regard are not appropriate. It is clear, however, that failures to prevent unhealthy behaviors are costing Americans years of life compared with their counterparts in other wealthy countries.

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