than national resources. It is also true that these contextual factors are not randomly distributed in the population; rather, they are more likely to affect the health of people of lower social status and those who are less likely to have lifetime access to health care. Finally, the panel did not undertake any analysis of the cost-effectiveness of public interventions designed to change personal health 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.