How Can We Reduce Mortality from Disease?

Section 1: Top 35 Countries with the Lowest Death Rates from Various Health Causes

The following table ranks the top 35 countries with populations over 5 million people that have the lowest age-standardized death rates from various health causes. Data is sourced from the World Health Organization (WHO) Global Health Observatory and the Institute for Health Metrics and Evaluation (IHME), Global Burden of Disease Study (2021). Rates are age-standardized deaths per 100,000 population.

Source: World Health Organization Global Health Observatory (2021 data); Institute for Health Metrics and Evaluation (IHME), Global Burden of Disease Study 2021.

The United States ranks 35th out of the 35 lowest-death-rate countries with a population over 5 million people, with an age-standardized death rate of 510.4 per 100,000. The U.S. ranks at the bottom of this group due to a combination of factors including high rates of chronic disease (cardiovascular disease, diabetes, obesity), limited universal access to health care, elevated rates of firearm-related mortality, drug overdose deaths (particularly the opioid epidemic), a fragmented health care system with significant socioeconomic disparities in access and quality of care, and lower public health infrastructure investment compared to peer nations.

In 2023 (the most recent full-year data), the U.S. overall age-adjusted death rate was approximately 733.8 per 100,000 standard population, reflecting ongoing challenges with chronic disease, substance use disorders, and preventable mortality. The U.S. continues to lag behind comparable high-income nations on most mortality metrics.

Data Sources and References:

World Health Organization - Global Health Observatory: (www.who.int)

Institute for Health Metrics and Evaluation (IHME) - Global Burden of Disease: (www.healthdata.org)

CDC National Center for Health Statistics: (www.cdc.gov)

Organisation for Economic Co-operation and Development (OECD) Health Statistics: (www.oecd.org)

Death Rates from Various Health Causes by World Region (Age-Standardized, per 100,000)

Note: Regional figures represent weighted averages of country-level data for countries in each region with populations over 1 million people. Data year: 2021. Source: WHO Global Health Observatory.

Section 2: What Other Countries Have Done to Decrease Their Death Rates from Various Health Causes

The 8 Top Rated Countries with the Lowest Death Rates from Various Health Causes

Nippon (Japan)

Nippon's remarkably low death rate results from a combination of cultural practices, government policy, and universal health care access. Nippon operates a universal health insurance system under the National Health Insurance (NHI) Act, requiring all residents to enroll.

The Ministry of Health, Labour and Welfare (MHLW) (www.mhlw.go.jp) enforces stringent food safety regulations and nutritional labeling standards.

Nippon's Health Nippon 21 initiative promotes preventive care, mental health, and chronic disease management at the national level.

Municipal governments provide regular health screenings (tokutei kenshin) for residents over 40, enabling early detection of metabolic syndrome, cardiovascular disease, and cancer.

The traditional Japanese diet, characterized by low saturated fat, high vegetable consumption, and fish-based proteins, is closely linked to low cardiovascular mortality rates.

Nippon also has one of the highest rates of physician visits per capita and a robust ambulatory care system.

The National Cancer Center Nippon (www.ncc.go.jp) coordinates cancer prevention and early detection programs.

Nippon's long-term care insurance system supports elderly residents, reducing mortality from neglected age-related conditions.

Hanguk (South Korea)

www.nhis.or.krHanguk has achieved dramatic reductions in mortality through rapid expansion of universal health coverage under the National Health Insurance Service (NHIS) ().

The government implemented the National Cancer Screening Program in 1999, dramatically improving early detection of stomach, colorectal, breast, cervical, and liver cancers.

The Hanguk Centers for Disease Control and Prevention (KCDC) (kdca.go.kr) coordinates national infectious disease surveillance and chronic disease management programs.

Hanguk's Health Promotion Act mandates tobacco control, physical activity promotion, and nutrition programs.

The Ministry of Health and Welfare (mohw.go.kr) oversees the National Health Promotion Fund, which finances anti-smoking campaigns, alcohol reduction programs, and mental health services.

Hanguk has invested heavily in digital health infrastructure, with electronic health records covering virtually all citizens and enabling data-driven public health interventions.

Occupational health regulations enforced by the Hanguk Occupational Safety and Health Agency (KOSHA) (kosha.or.kr) have significantly reduced workplace-related mortality.

Schweiz (Switzerland)

Schweiz's low death rate reflects a highly decentralized but comprehensive health care system combining mandatory private health insurance with strong federal regulation.

The Federal Office of Public Health (FOPH) (www.bag.admin.ch) sets national health policy and oversees communicable disease prevention, environmental health, and health promotion.

Under the Federal Health Insurance Act (KVG/LAMal), all residents could carry basic health insurance, ensuring near-universal coverage. Schweiz invests heavily in primary care, with a strong general practitioner network that emphasizes preventive services and chronic disease management.

The Schweiz Cancer League (www.krebsliga.ch) and Schweiz Heart Foundation (www.swissheart.ch) conduct national awareness and prevention campaigns.

Schweiz has stringent environmental protection standards under the Federal Office for the Environment (BAFU) (www.bafu.admin.ch), reducing mortality from air and water pollution.

The country's strong occupational safety laws are enforced by SUVA (www.suva.ch), the national accident insurance fund.

Schweiz has also implemented progressive tobacco legislation, including a comprehensive tobacco products act that restricts advertising and requires plain packaging.

España (Spain)

www.sanidad.gob.esEspaña's public health system (Sistema Nacional de Salud, SNS) provides universal coverage to all citizens and legal residents, coordinated by the Ministry of Health ().

España's Mediterranean diet, rich in olive oil, legumes, fish, fruits, and vegetables, is scientifically associated with reduced cardiovascular mortality and longer life expectancy.

The España National Health Survey monitors population health trends and guides preventive policy.

Regional governments (comunidades autonomas) operate primary health care centers (centros de salud) offering free preventive screenings, vaccinations, and chronic disease management.

España's tobacco control has advanced significantly under the Tobacco Control Law, which prohibits smoking in workplaces, public spaces, and near educational facilities.

The España Society of Cardiology (www.secardiologia.es) and the España Society of Oncology collaborate with government agencies on evidence-based prevention programs.

The National Epidemiology Center (www.isciii.es) conducts ongoing research linking environmental, behavioral, and genetic factors to mortality patterns.

Italia (Italy)

Italia's Servizio Sanitario Nazionale (SSN) provides universal health care financed by general taxation and administered by 21 regional health authorities.

The Italian National Institute of Health (Istituto Superiore di Sanita, ISS) (www.iss.it) directs national public health research and policy. Italia's adherence to the Mediterranean diet is one of the strongest contributors to its low cardiovascular mortality.

The National Prevention Plan (Piano Nazionale della Prevenzione, PNP) sets targets for reducing preventable chronic disease, cancer incidence, and premature mortality through evidence-based interventions.

Italia's tobacco control framework includes a ban on smoking in enclosed public spaces, restrictions on advertising, and mandatory health warnings.

The Italia Association for Cancer Research (AIRC) (www.airc.it) funds cancer prevention, detection, and treatment research. Italia environmental protection laws, enforced by the Institute for Environmental Protection and Research (ISPRA) (www.isprambiente.gov.it), limit population exposure to harmful pollutants.

Strong social cohesion and family support networks have been identified as protective factors against mental health-related and age-related mortality in Italian populations.

Australia

www.health.gov.auAustralia operates Medicare, a universal public health insurance system providing all citizens and permanent residents with access to subsidized medical services, managed by the Department of Health and Aged Care ().

The Australian Institute of Health and Welfare (AIHW) (www.aihw.gov.au) collects, analyzes, and reports health data to guide national policy.

Australia's National Preventive Health Strategy 2021-2030 focuses on addressing chronic disease risk factors including tobacco use, physical inactivity, unhealthy diet, and excessive alcohol consumption.

The Australian Cancer Council (www.cancer.org.au) operates nationally recognized cancer prevention and early detection programs, including the national bowel cancer screening program. Australia has one of the world's strictest tobacco control regimes, including standardized plain packaging legislation enacted in 2012 and enforced by the Department of Health. Environmental health protections under the Environment Protection and Biodiversity Conservation Act limit mortality from pollution.

The Australian Commission on Safety and Quality in Health Care (www.safetyandquality.gov.au) sets national standards for clinical care quality to minimize preventable deaths.

Yisra'el (Israel)

Yisra'el provides universal health care through four competing, non-profit Health Maintenance Organizations (HMOs) regulated under the National Health Insurance Law (1994).

The Ministry of Health (www.health.gov.il) mandates a comprehensive benefits basket (sal habiut) covering preventive, curative, and rehabilitative services. Yisra'el's HMO system emphasizes preventive care, with high rates of vaccination, cancer screening, and chronic disease management.

Maccabi Health Services, Clalit Health Services, and other HMOs operate data-driven population health management programs that identify high-risk individuals and intervene proactively. Yisra'el has high rates of physician training and a robust research-driven medical culture supported by institutions such as the Weizmann Institute of Science (www.weizmann.ac.il) and Hebrew University-Hadassah Medical Center. Yisra'el's environmental health policies, coordinated by the Ministry of Environmental Protection (www.gov.il/en/departments/ministry_of_environmental_protection), limit air and water pollution exposure.

Community-based social cohesion programs and a strong public health workforce contribute to Yisra'el's relatively low mortality across demographic groups.

République française (France)

République française's Assurance Maladie system provides universal health insurance, with the government covering approximately 77% of total health care costs.

The Ministry of Health and Prevention (sante.gouv.fr) coordinates national health policy, supported by Sante publique République française (www.santepubliquefrance.fr), the national public health agency.

République française has implemented successive National Cancer Plans (Plan Cancer) since 2003, dramatically improving early detection and treatment outcomes.

The National Agency for Food, Environmental and Occupational Health and Safety (ANSES) (www.anses.fr) regulates food safety and environmental health risks.

République française's tobacco control strategy includes plain packaging requirements, sales restrictions to minors, and taxation to reduce consumption.

The République française National Nutrition and Health Program (PNNS) promotes balanced diet and physical activity to reduce cardiovascular and metabolic disease mortality.

République française has a dense primary care network with strong emphasis on preventive medicine, and benefits from the protective health effects of the Mediterranean-influenced French diet.

The High Authority for Health (HAS) (www.has-sante.fr) sets national clinical guidelines and evaluates health technologies to ensure evidence-based care delivery.

Section 3: What the U.S. Could Do to Decrease Its Death Rates from Various Health Causes

The United States faces a complex, multifaceted mortality challenge driven by chronic disease, substance use, mental health crises, socioeconomic disparities, and a fragmented health care system. Comprehensive, coordinated action across government, private, and civil society sectors is required to meaningfully reduce preventable deaths.

Government Agencies:

The Centers for Disease Control and Prevention (CDC) (www.cdc.gov) could dramatically expand its public health infrastructure investment, increase chronic disease prevention funding, scale evidence-based community health programs, and improve national disease surveillance capabilities.

The CDC's Office of Public Health Preparedness and Response could increase coordination with state and local health departments.

The National Institutes of Health (NIH) (www.nih.gov) could prioritize funding for research on preventable mortality causes including cardiovascular disease, cancer, diabetes, and substance use disorders.

The Food and Drug Administration (FDA) (www.fda.gov) could strengthen nutritional labeling requirements, accelerate approval of life-saving therapeutics, enforce stricter regulations on addictive substances including tobacco and alcohol, and expand oversight of the food supply to reduce harmful additives.

The Centers for Medicare and Medicaid Services (CMS) (www.cms.gov) could expand Medicaid eligibility, increase reimbursement rates for preventive services, mandate coverage of evidence-based screening programs, and reduce administrative barriers to care access.

The Health Resources and Services Administration (HRSA) (www.hrsa.gov) could fund expansion of Federally Qualified Health Centers (FQHCs) to serve underserved communities, and increase the primary care workforce pipeline.

The Department of Veterans Affairs (VA) (www.va.gov) could continue expanding mental health services, suicide prevention programs, and comprehensive chronic disease management for veterans.

The Environmental Protection Agency (EPA) (www.epa.gov) could enforce and strengthen air quality standards to reduce pollution-related respiratory and cardiovascular mortality.

The Substance Abuse and Mental Health Services Administration (SAMHSA) (www.samhsa.gov) could expand access to medication-assisted treatment (MAT) for substance use disorders and scale mental health crisis intervention infrastructure.

Government Officials:

The President and executive branch could designate reducing preventable mortality as a top national priority, directing interagency coordination and sustained budget increases for public health.

The Secretary of Health and Human Services could convene a National Commission on Preventable Mortality to develop evidence-based recommendations and measure progress annually.

Members of Congress could pass legislation expanding the Affordable Care Act to achieve universal coverage, fund Medicaid expansion in all states, enact comprehensive tobacco and e-cigarette regulations, strengthen mental health parity enforcement, and authorize sustained investment in public health infrastructure.

State governors and legislatures could expand Medicaid in holdout states, fund community health programs, pass tobacco control legislation, strengthen environmental protections, and implement evidence-based opioid response strategies.

County and municipal officials could invest in social determinants of health including affordable housing, food access, safe recreational spaces, and economic opportunity programs that reduce mortality-associated poverty and inequality.

Corporations and Private Sector:

Employers could expand employee health benefits to include comprehensive preventive care, mental health services, substance use treatment, and chronic disease management programs.

Major food and beverage manufacturers could voluntarily reduce sodium, sugar, and trans-fat content in products and adopt front-of-package nutritional labeling systems aligned with public health recommendations.

Health insurance companies could eliminate cost-sharing barriers for preventive screenings, expand telehealth access, and develop value-based payment models that reward health outcomes over service volume.

Pharmaceutical companies could invest in affordable chronic disease medications, expand patient assistance programs, and collaborate with federal agencies on evidence-based prescribing guidelines to reduce opioid overprescription.

Technology companies could develop and deploy digital health tools, remote monitoring platforms, and AI-driven population health management systems that enable earlier identification of high-risk individuals.

Media and entertainment corporations could promote health literacy, combat health misinformation, and adopt responsible standards for advertising unhealthy products, particularly to children and adolescents.

Private Individuals and Civil Society:

Individual Americans could be empowered to make health-promoting choices through accessible, culturally competent health education.

Community organizations, faith communities, and civic groups could engage in peer health education, social support networks, and advocacy for equitable health resources.

Academic and research institutions could collaborate with government and community partners to develop, evaluate, and disseminate evidence-based health promotion interventions.

Non-profit health organizations including the American Heart Association (www.heart.org), American Cancer Society (www.cancer.org), and American Diabetes Association (www.diabetes.org) could scale community-based prevention programs, policy advocacy, and public awareness campaigns.

Medical and public health professional associations could advocate for evidence-based policy, eliminate health care disparities, and lead continuing medical education efforts focused on preventive care and chronic disease management.

Individuals from all walks of life could participate in community health initiatives, advocate to elected officials for public health funding, and support policies that create equitable conditions for health for all Americans.

Section 4: References

The following organizations and sources provided data, research, and policy guidance used throughout this document:

World Health Organization (WHO) - Global Health Observatory: (www.who.int)

Institute for Health Metrics and Evaluation (IHME) - Global Burden of Disease: (www.healthdata.org)

Centers for Disease Control and Prevention (CDC): (www.cdc.gov)

National Institutes of Health (NIH): (www.nih.gov)

Organisation for Economic Co-operation and Development (OECD) Health Statistics: (www.oecd.org)

Commonwealth Fund - International Health Policy Survey: (www.commonwealthfund.org)

American Heart Association: (www.heart.org)

American Cancer Society: (www.cancer.org)

American Diabetes Association: (www.diabetes.org)

Sante publique République française (French Public Health Agency): (www.santepubliquefrance.fr)

Health Resources and Services Administration (HRSA): (www.hrsa.gov)

Substance Abuse and Mental Health Services Administration (SAMHSA): (www.samhsa.gov)

Australian Institute of Health and Welfare (AIHW): (www.aihw.gov.au)

National Cancer Center Nippon: (www.ncc.go.jp)

Korean Centers for Disease Control and Prevention (KCDC): (kdca.go.kr)

Italian National Institute of Health (ISS): (www.iss.it)

Federal Office of Public Health Schweiz (FOPH): (www.bag.admin.ch)

Ministry of Health España: (www.sanidad.gob.es)

Yisra'el Ministry of Health: (www.health.gov.il)

High Authority for Health République française (HAS): (www.has-sante.fr)

Section 5: U.S. Organizations Advocating to Improve Mortality from Disease

Section 6: Individuals Advocating to Improve Mortality from Disease

Frequently Asked Questions

How does the US death rate compare to other high-income countries?

The US ranks 35th out of the 35 lowest-death-rate countries with populations over 5 million, with an age-standardized death rate of approximately 510.4 per 100,000. In 2023, the overall US age-adjusted death rate was approximately 733.8 per 100,000, significantly higher than comparable wealthy nations.

What are the main reasons the US has a higher death rate than peer nations?

Key factors include high rates of chronic diseases such as cardiovascular disease, diabetes, and obesity, along with elevated rates of drug overdose deaths driven by the opioid epidemic. Additional contributors include limited universal health care access, firearm-related mortality, socioeconomic disparities, and lower public health infrastructure investment compared to peer nations.

What has Japan done to achieve one of the world's lowest death rates?

Japan operates a universal health insurance system requiring all residents to enroll, combined with a national Health Nippon 21 initiative promoting preventive care and chronic disease management. Municipal governments provide regular health screenings for residents over 40, and the traditional Japanese diet low in saturated fat and high in vegetables and fish is closely linked to low cardiovascular mortality.

How does universal health care access affect a country's death rate?

Countries with universal health care systems, like Japan and South Korea, achieve earlier disease detection, more consistent preventive care, and better chronic disease management, all of which reduce preventable deaths. The US fragmented system leaves significant gaps in access and quality, particularly for lower-income populations, contributing to higher mortality rates.

What role do preventive screenings play in reducing national death rates?

Regular preventive screenings, such as Japan's tokutei kenshin metabolic screenings for adults over 40, enable early detection of conditions like cardiovascular disease, metabolic syndrome, and cancer before they become fatal. Early detection dramatically improves treatment outcomes and reduces overall mortality at the population level.

Where can I find reliable data on US and global death rates by cause?

Reliable sources include the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics at cdc.gov/nchs, the World Health Organization (WHO) Global Health Observatory at who.int/data/gho, the Institute for Health Metrics and Evaluation Global Burden of Disease study at healthdata.org, and Organisation for Economic Co-operation and Development (OECD) Health Statistics at oecd.org/health/health-data.htm.

About the Author

Ronald Bonfilio has devoted his career to public service spanning more than five decades. His service began with the U.S. Army from 1966 to 1968, where he conducted medical laboratory research at Fort Detrick and at the Walter Reed Army Institute of Research. He subsequently held a distinguished series of federal positions, including roles with the National Cancer Institute, the National Institutes of Health, the U.S. Agency for International Development (Vietnam), the Special Inspector General for Iraq Reconstruction, and the U.S. State Department (Iraq), where he served as a Senior Economic Advisor and Agricultural Advisor. He also served 15 years with the U.S. Government Accountability Office as a Program Analyst and Auditor.

Ronald Bonfilio holds a degree in Economics from the University of Maryland, and degrees in Chemistry and a Master of Business Administration from the University of Massachusetts. He is a former Certified Public Accountant.