Research Article
Lindsay GB, Merrill R, Thacker
Abstract
Purpose: Identify the extent Americans are aware of the United States’ declining health rankings compared with 16 Western democracies, and assess people's explanation for the U.S. decline. Methods: Participants in a national survey ranked U.S. life expectancy against that of 16 referent countries. Participants indicated whether the U.S. health ranking had risen, fallen or stayed the same since 1985. After being subsequently informed U.S. life expectancy was the lowest of the 16 countries and the U.S. ranking has steadily declined, participants identified which factor best explained the US health disadvantage. Results: Most participants (55.3%) believed U.S. life expectancy was “at or near the top” or “above the middle.” They also believed U.S. health rankings have risen or stayed the same since 1985. The misperception of superior U.S. health was most highly correlated with political orientation, with Liberals tending to give the U.S. lower health ranking. Most participants attributed the poor ranking to lifestyle and healthcare-related factors. Social determinants of health and environmental factors were infrequently identified as reasons for the poorer ranking. Conclusion: Americans have a highly inflated perception of the country’s health rankings compared with other Western democracies