New life expectancy figures show Americans some way behind countries like Canada, the UK and Australia. Why?
Living in the world's richest country comes at a price, and it's measured in life years.
"We weren't surprised that we had lower life expectancies than other countries, but we were surprised by the fact that we were falling further behind," says Dr Ali Mokdad, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington.
Smoking alone is responsible for one out of every five deaths in the US, the professor says, yet the US has not been as tough as Australia in restricting tobacco advertising and public smoking.
Then there's the big issue - about one in three adults is classified as obese. That's about 10 times as many as in long-living countries like Japan, according to OECD figures.