Women in the United States face significantly poorer health outcomes compared to their peers in other high-income countries, according to a new report from the Commonwealth Fund. The U.S. ranks lowest among developed nations in terms of life expectancy, health status, access to care, and care affordability for women.
American women live, on average, two years less than those in other high-income nations. The Commonwealth Fund’s 2023 International Health Policy Survey, alongside data from the CDC and the OECD, reveals that U.S. women have a life expectancy of 80 years at birth, compared to 87 years in South Korea and Japan, 86 years in Switzerland and France, and 85 years in Sweden and Australia.
The U.S. also experiences a high rate of avoidable deaths, with 279 per 100,000 women, significantly higher than other nations like South Korea, which has 81 avoidable deaths per 100,000 women. American women are more likely to die from cardiovascular disease but show average rates for breast and cervical cancer mortality.
A major factor contributing to these outcomes is inadequate healthcare coverage and access. The U.S. is unique among developed countries in having an uninsured rate for women of 14%. In contrast, countries like Australia, Germany, and the U.K. provide public insurance, while nations such as Canada and France rely on private insurance. This lack of coverage leads to poorer access to care; while 87% of American women have a usual source of care, this rate is higher in countries like the Netherlands and New Zealand, where virtually all women have access to a regular healthcare provider.
Cost is a significant barrier to care in the U.S., with around half of American women skipping needed care due to expenses. This problem is less severe in peer nations. For example, only 15% of women in the Netherlands and 18% in the U.K. report avoiding care due to cost. Mental healthcare access is similarly impacted, with 27% of American women reporting cost-related barriers, a stark contrast to only 4% in Germany.
The Commonwealth Fund report highlights that universal healthcare coverage and policies to cap out-of-pocket costs are common in other developed nations. Efforts to improve U.S. women’s health may require enhancing aspects of the Affordable Care Act, such as increasing marketplace subsidies and closing Medicaid coverage gaps. However, ongoing legal challenges, including those related to preventive services and reproductive rights, could complicate these efforts.
Overall, the U.S. faces significant challenges in improving women’s health outcomes, necessitating systemic reforms to address coverage gaps and affordability issues.
