2011; Rau et al., 2008). Between 1980 and 2006, life expectancy in the United States grew more slowly than in almost every other high-income country (Meslé and Vallin, 2006; Rau et al., 2008).

Although the U.S. health disadvantage has been ably documented in prior research, much of the focus has been on adults age 50 and older. This age group has received attention because of its higher burden of disease and because comparable international surveys were often only available for older adults. The National Research Council (2011) study that inspired the establishment of this panel was sponsored by the National Institute on Aging and focused on documenting and explaining differences in life expectancy at age 50, not the U.S. health disadvantage at younger ages. The impetus for the present study included a strong interest in extending the earlier analysis to those under age 50.

Part I of this report is devoted to documenting the nature and strength of the evidence regarding a health disadvantage of the U.S. population. It draws on prior work in discussing the health and survival of older adults, but it focuses on documenting cross-national differences in the health and life expectancy of children, adolescents, and young adults.

Because death is such a defining event and because national mortality and cause of death data tend to be widely available and of high quality, the panel chose to begin its examination by looking at mortality. Chapter 1 provides an initial look at cross-national mortality differences in high-income countries, focusing on Americans’ shorter life spans. The chapter begins by documenting the disparities in cause-specific mortality rates and then summarizes the existing literature on life expectancy differentials between the United States and other countries. So as not to duplicate the prior National Research Council (2011) study of mortality over age 50 and because of time constraints, the panel chose to focus on documenting differences between the United States and other high-income countries in life expectancy under age 50 and the causes of death responsible for years of life lost. The chapter features new analyses, commissioned by the panel, on cross-national life expectancy differentials before age 50. These analyses look at differences in life expectancy by sex, age group, and specific causes of death.

Chapter 2 moves beyond mortality and adopts a life-course perspective to examine health differences between the United States and other countries by age group. The chapter examines cross-national differences in the prevalence, severity, and mortality rates for specific diseases and injuries affecting each age group across the life course. As in Chapter 1, the panel’s primary focus was on individuals under age 50, especially children. We were particularly interested in adolescence, which is both an important life stage in its own right (Gore et al., 2011; Patton et al., 2009) and may offer



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