Americans lead shorter and less healthy lives than people in other high-income countries Is this US health disadvantage specific to some US populations  diseases  or particular age groups? And what explains these variations in the length and quality of life between Americans and other high-income countries? Mauricio Avendano and Ichiro Kawachi review the evidence and find the American health disadvantage begins at birth and extends across the life-course  and it is particularly marked for American women and for regions in the US South and Midwest