1. Peterson-Kaiser Health System Tracker What do we know about social determinants of health in the U.S. and comparable countries?

2. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from OECD (2016), "Health expenditure and financing: Health expenditure indicators", OECD Health Statistics (database). doi: http://dx.doi.org/10.1787/data-00349-en (Accessed on 08 February 2016); and OECD (2016), Social spending (indicator). doi: 10.1787/7497563b-en (Accessed on 08 February 2016) Note: Social spending includes cash assistance. Total net social spending data unavailable for Switzerland.http://dx.doi.org/10.1787/data-00349-en The U.S. is an outlier for health spending, but when combined with other social services, spending is similar to other countries Total health consumption as percent of GDP, 2011 Total social spending (including health and other social services) as percent of GDP, 2011

3. Peterson-Kaiser Health System Tracker Source: Data on median age from the CIA World Fact Book, available at https://www.cia.gov/library/publications/the-world-factbook/fields/2177.html; data on the percent of population over age 65 from the World Bank, available at http://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.https://www.cia.gov/library/publications/the-world-factbook/fields/2177.htmlhttp://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS Though the U.S. population is aging, it has a younger average age and smaller elderly population than comparable countries Median age, 2015 estimatesPercent of population over age 65, 2014

4. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from OECD (2016), Life expectancy at birth (indicator). doi: 10.1787/27e0fc9d-en (Accessed on 12 January 2016). Note: Data for Canada are from 2011. The U.S. has the shortest life expectancy among comparable countries Life expectancy at birth in years, 2013

5. Peterson-Kaiser Health System Tracker Source: Data by race are from the Centers for Disease Control, available at: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf (Accessed on 12 January 2016); comparable country data are from OECD (2016), Life expectancy at birth (indicator). doi: 10.1787/27e0fc9d-en (Accessed on 12 January 2016).http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf In the U.S., both blacks and whites have shorter average life expectancies than the average of comparable countries Life expectancy at birth in years, 2006 and 2013

6. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation Analysis of data from The World Bank, World Development Indicators (database). Available at http://data.worldbank.org/indicator/SI.POV.GINI/countries?cid=DEC_SS_WBGDataEmail_EXT&display=default (Accessed on December 16, 2015). Note: Data for Japan are unavailable. The U.S. has a higher degree of income inequality than comparably wealthy countries Gini coefficient, 2010

7. Peterson-Kaiser Health System Tracker Source: OECD (2015), Perceived health status by income level, 2013 (or nearest year), in Health at a Glance 2015, OECD Publishing, Paris. DOI: http://dx.doi.org/10.1787/health_glance-2015-graph33-enhttp://dx.doi.org/10.1787/health_glance-2015-graph33-en Americans with lower incomes are less likely to report being in good health than those with high incomes Percent of population age 15+ reporting good health, by income quintile, 2013

8. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2014 U.S. Census data, available here https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf; and data from OECD (2015), “OECD Health Data: Social Protection”, OECD Health Statistics (database). (Accessed on September 16, 2015). Note: Data for Japan were unavailable for 2013, so data from the previous year are shown. https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf The U.S. has the lowest insured rate of comparable countries Percent of total population covered by private and/or public health insurance in 2013 (comparable countries) or 2014 (United States)

9. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of National Health Interview Survey. Report available here: http://kff.org/uninsured/fact-sheet/key-facts- about-the-uninsured-population/ Uninsured adults are much more likely to go without needed medical care due to costs Barriers to health care among nonelderly adults by insurance status, 2014

10. Peterson-Kaiser Health System Tracker Source: World Lung Foundation and the American Cancer Society. The Tobacco Atlas. Available at: http://www.tobaccoatlas.org/topic/cigarette-use- globally/ (Accessed on January 5, 2016).http://www.tobaccoatlas.org/topic/cigarette-use- globally/ Per capita cigarette consumption is lower in the United States than in comparably wealthy countries Number of cigarettes smoked per capita per year, age 15+, 2014

11. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 22, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads The U.S. has higher than average disease burden from lung cancer Lung, tracheal, and bronchus cancer age-standardized disability adjusted life years (DALY) rate per 100,000 population, 2013

12. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from OECD (2016), "Non-medical determinants of health", OECD Health Statistics (database). DOI: http://dx.doi.org/10.1787/data-00546-en (Accessed on 21 January 2016). Note: Comparable countries here include Australia, Canada, Germany, Japan, and the United Kingdom. Data for Australia are for 2011 and data for Canada are for 2013.http://dx.doi.org/10.1787/data-00546-en The U.S. has the highest prevalence of obesity among comparable countries Prevalence of obesity, BMI ≥ 30, age-standardized estimates, 2012 or nearest year

13. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the World Health Organization. Available at: http://apps.who.int/gho/data/view.main.2463?lang=en (Accessed on November 22, 2015). Note: Data not available for Switzerland. http://apps.who.int/gho/data/view.main.2463?lang=en More adults in the U.S. have a sedentary lifestyle than in most comparable countries Prevalence of insufficient physical activity among adults aged 18+ years, age-standardized estimate, 2010

14. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads The U.S. has a higher than average disease burden caused by cardiovascular diseases Age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013

15. Peterson-Kaiser Health System Tracker Source: Data by race are from CDC/National Center for Health Statistics, “Health, United States, 2014: With Special Feature on Adults Aged 55–64,” available at http://www.cdc.gov/nchs/hus.htm; comparable country data are from OECD (2016), "Non-medical determinants of health", OECD Health Statistics (database). DOI: http://dx.doi.org/10.1787/data-00546-en (Accessed on 21 January 2016). Note: Comparable countries here include Australia, Canada, Germany, Japan, and the United Kingdom. Data for Australia are for 2011 and data for Canada are for 2013.http://www.cdc.gov/nchs/hus.htmhttp://dx.doi.org/10.1787/data-00546-en In the U.S., whites, blacks, and Hispanics all have higher prevalence of obesity than the average of comparable countries Prevalence of obesity for adults age 20+ by race/ethnicity and gender, age-adjusted, 2012

16. Peterson-Kaiser Health System Tracker Source: Data by poverty level are from CDC/National Center for Health Statistics, “Health, United States, 2014: With Special Feature on Adults Aged 55– 64,” available at http://www.cdc.gov/nchs/hus.htm; comparable country data are from OECD (2016), "Non-medical determinants of health", OECD Health Statistics (database). DOI: http://dx.doi.org/10.1787/data-00546-en (Accessed on 21 January 2016). Note: Comparable countries here include Australia, Canada, Germany, Japan, and the United Kingdom. Data for Australia are for 2011 and data for Canada are for 2013.http://www.cdc.gov/nchs/hus.htmhttp://dx.doi.org/10.1787/data-00546-en Income level may contribute to the higher prevalence of obesity in the United States than in similar countries Prevalence of obesity for adults age 20+ by poverty level in the U.S. and on average in comparable countries, age-adjusted, 2012

17. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from OECD (2015), "OECD Health Data: Non-Medical Determinants of Health", OECD Health Statistics (database). doi: 10.1787/data-00546-en (Accessed September 29, 2015). Note: Data for Austria were unavailable for 2012, so data from the previous year are shown. The U.S. has consistently had lower average alcohol consumption than most comparable countries Liters per capita, age 15+, 1980-2012

18. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads Disease burden from alcohol use disorders is higher than average in the U.S. Age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013

19. Peterson-Kaiser Health System Tracker The U.S. has higher than average disease burden caused by liver conditions due to alcohol use Liver cancer due to alcohol use, age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013 Liver cirrhosis due to alcohol use, age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013 Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). Note: “Average” is the simple average of the comparable countries shown above. Comparable countries are defined as those with above median GDP and above median GDP per capita in at least one of the past ten years. http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads

20. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the WHO Global Health Observatory Data Repository. Available at: http://apps.who.int/gho/data/node.main.162?lang=en (Accessed on November 23, 2015). http://apps.who.int/gho/data/node.main.162?lang=en The U.S. has the highest environmental burden of disease compared to other high-income countries Total environment attributable DALYs per 100,000 capita, 2004

21. Peterson-Kaiser Health System Tracker Source: CDC (2013). Available at: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf Poisonings, car accidents, and falls are the leading causes of accidental death in the United States Mortality rate per 100,000 population, by cause of death, 2013

22. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads Accidental poisonings lead to more than twice the years of disability in the U.S. than in comparable countries Age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013

23. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of 2013 OECD data: OECD Health Statistics (database). doi: 10.1787/data-00540-en (Accessed on December 15, 2015). Notes: Where data were unavailable (United Kingdom in 2000 and Australia for 2005), the previous year’s data were used. Data for Switzerland omitted. Break in series for Austria in 2002, Canada and France in 2000, and the United Kingdom in 2001. Relative to comparable countries, the U.S. has higher rates of death from accidental poisonings, such as drug overdoses Standardized mortality rate for accidental poisonings per 100,000 population, 2000-2010

24. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads Disease burden from drug abuse disorders is higher in the U.S. than in comparable countries Age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013

25. Peterson-Kaiser Health System Tracker 56 percent of people in the U.S. report having a personal connection to prescription painkiller abuse Source: Kaiser Family Foundation. Kaiser Health Tracking Poll: November 2015. Available at: http://kff.org/health-reform/poll-finding/kaiser-health- tracking-poll-november-2015/ Percent of nationally representative sample who say they personally know anyone who has…

26. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads The U.S. has the highest disease burden from motor vehicle road injuries Age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013

27. Peterson-Kaiser Health System Tracker Source: Kaiser Family Foundation analysis of data from the University of Washington Institute for Health Metrics and Evaluation. Available at: http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads (Accessed on November 23, 2015). http://ghdx.healthdata.org/global-burden-disease-study-2013-gbd-2013-data-downloads The U.S. has the highest rate of years of life lost to disability and premature death due to firearm assaults Age-standardized Disability adjusted life years (DALY) rate per 100,000 population, 2013