Constitutional Right to Bear Arms without Restrictions: We’re Number 1

The United States is one of just three countries in the world that have the right to bear arms as a constitutional protection. The other two are Mexico and Guatemala. Further, the United States is the only country with a right to keep and bear arms with no constitutional restrictions. At one time, six other countries (Bolivia, Costa Rica, Colombia, Honduras, Nicaragua, and Liberia) had a constitutional right to bear arms, but they have all repealed those guarantees.

Source: Zachary Elkins, “Rewrite the Second Amendment,” New York Times, April 4, 2013, https://www.nytimes.com/2013/04/05/opinion/rewrite-the-second-amendment.html?ref=opinion

Violent Cities: St. Louis is Number 7 and Baltimore is Number 16

Of the twenty most dangerous cities in the world in 2023, as measured by murder rate, the top six are all in Mexico. Celaya, Mexico, tops the list, with a murder rate of 109.39 per 100,000 residents. The seventh most dangerous city is St. Louis, Missouri, which has a murder rate of 87.43. Baltimore ranks sixteenth, with a murder rate of 56.45. All the other most dangerous cities are in Mexico, Venezuela, Brazil, Jamaica, or South Africa. These rankings do not include situations of war or conflict. For the OECD member countries, the average murder rate is 4.50 per 100,000. No European or Asian city ranks in the top fifty of the world’s deadliest cities.

Source: “Ranking of the Most Dangerous Cities in the World in 2023, by Murder Rate per 100,000 Inhabitants,” Statista, https://www.statista.com/statistics/243797/ranking-of-the-most-dangerous-cities-in-the-world-by-murder-rate-per-capita/

Violence Against Women: We’re Number 2

When looking at violence against women, we find that the United States is one of the worst countries in the twenty-seven OECD countries that have reported such information. These data look at the percentage of women who have experienced physical and/or sexual violence by an intimate partner in 2020. Only women in Turkey experienced a higher percentage of violence than women in the United States.

Source: “Violence Against Women,” OECD, https://www.oecd.org/gender/vaw.htm

Death Penalty: 144 Countries Have Abolished or Abandoned It; We’re Among 55 Who Still Have It

Amnesty International reports that altogether, 108 countries had completely abolished the death penalty by the end of 2021; a total of 144 countries have abolished it in practice (that is, no executions in the past ten years). Fifty-five countries, including the United States, retain the death penalty. At the end of 2021, there are, however, some 28,670 persons who have been sentenced to death. Iraq has the highest number, around 8,000; the United States has 2,382 persons on death row.

Source: “Death Penalty 2021: Facts and Figure,” Amnesty International, May 24, 2022, https://www.amnesty.org/en/latest/news/2022/05/death-penalty-2021-facts-and-figures/.

Incarceration Rate: We’re Number 1

The Prison Policy Initiative looked at the US incarceration rates and compared them to the founding NATO countries. Again, the United States can claim Number One status. The incarceration rate in the United States is 664 prisoners per 100,000 population. Next highest among NATO countries is the United Kingdom with 129 per 100,000, followed by Portugal (111 prisoners) and Canada (104).

Source: www.prisonpolicy.org/global/2021.html

Life Expectancy: We’re Number 27

Life expectancy in the United States has seen a “historic decline” since 2015, the biggest decrease in a century, partly due to the opioid crisis and party due to the COVID pandemic. In 2019, before the pandemic, life expectancy in the United States was 78.85 years; in 2020, in decreased to 76.98 years, and in 2021 decreased again to 76.44 years. Altogether, there was a net loss of life expectancy of 2.41 years. Hit the hardest during the pandemic were Hispanic, Black, Native American, and Asian populations. But in 2021, the largest decreases occurred in non-Hispanic white population.

Jessica Y. Ho found that “life expectancy in the United States lags well behind that of other high-income countries,” dropping from near the middle in the 1980s to near the bottom in the mid-2000s. Her study found that American men lived 5.18 years lower and American women lived 5.82 years lower than their peers in the world’s high-income countries. Young Americans, ages 25-29, have experienced death rates three times their counterparts.

In their study of early deaths in America, titled “Missing Americans,” Jacob Bor and his colleagues note that 1 million US deaths in 2020 and another 1.1 million US deaths in 2021 “would have been averted if the United States had the mortality rates of other wealthy nations.” They note that the number of excess US deaths relative to its peers is “unprecedented in modern times.”

In 2006, a report called the Eight Americas study examined the health inequities in the United States by separating out and analyzing eight distinct groups based on race, urbanicity, geography, income per capita, and homicide rates. In a November 2024 study, the Eight Americas groups were expanded to ten. The authors of the new study found the disparities “truly alarming,” with over a twenty-year gap in life expectancy between the highest group (Asian Americans, who lived an average of 84 years) and the lowest (American Indian and Alaska Native persons, who lived an average of 63.6 years). One of the lead authors, Christopher J.L. Murray, stated that "These disparities reflect the unequal and unjust distribution of resources and opportunities that have profound consequences on well-being and longevity, especially in marginalized populations."

What countries do better in life expectancy? First is Japan, with a life expectancy of 84.45 years; in second place is Switzerland (83.85); then South Korea (83.53), Australia (83.30), and Spain (83.18). The United States comes in 27th with an average life expectancy of 76.33.

Sources: Claire Klobucista, “US Life Expectancy Is in Decline. Why Aren’t Other Countries Suffering the Same Problem?” Council on Foreign Relations (September 8, 2022), https://www.cfr.org/in-brief/us-life-expectancy-decline-why-arent-other-countries-suffering-same-problem#:~:text=U.S.%20life%20expectancy%20was%20slightly,States%20have%20higher%20life%20expectancie. Ryan K. Masters, Laudan Y. Aron, and Steven H. Woolf, “Changes in Life Expectancy Between 2019 and 2021 in the United States and 21 Peer Countries,” MedRxiv, June 1, 2021, https://www.medrxiv.org/content/10.1101/2022.04.05.22273393v4. Jessica Y. Ho, “Causes of America’s Lagging Life Expectancy: An International Comparative Perspective,” Journals of Gerontology: SOCIAL SCIENCES, 2022 77 (S2), https://academic.oup.com/psychsocgerontology/article/77/Supplement_2/S117/6533432. Jacob Bor, Andrew Stokes, Julia Raifman, Atheendar Venkataramani, Mary T. Bassett, David Himmelstein, and Steffie Woolhandler, “Missing Americans: Early Death in the United States—1933-2021,” PNAS Nexus 2 (6) (June 2023), https://doi.org/10.1093/pnasnexus/pgad173. Laura Dwyer-Lindgren, Mathew M. Bauman, Zuochen Li, Yikaterina O. Kelly, Chris Schmidt, Chloe Searchinger, et al., “Ten Americas: A Systematic Analysis of Life Expectancy Disparities in the USA,” The Lancet, November 21, 2024, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01495-8/fulltext. The ten Americas are defined as: “America 1—Asian individuals; America 2—Latino individuals in other counties; America 3—White (majority), Asian, and American Indian or Alaska Native (AIAN) individuals in other counties; America 4—White individuals in non-metropolitan and low-income Northlands; America 5—Latino individuals in the Southwest; America 6—Black individuals in other counties; America 7—Black individuals in highly segregated metropolitan areas; America 8—White individuals in low-income Appalachia and Lower Mississippi Valley; America 9—Black individuals in the non-metropolitan and low-income South; and America 10—AIAN individuals in the West.” Murray quoted in Sara Moniuszko, “Life Expectancy Gap in US Widens to 20 Years Due to ‘Truly Alarming’ Health Disparities, Researchers Say,” CBS News, November 21, 2024, https://www.cbsnews.com/news/life-expectancy-gap-20-years/. “Life Expectancy at Birth, Total Years,” World Bank, https://data.worldbank.org/indicator/SP.DYN.LE00.IN).

Best Healthcare Systems: We’re Number 30

In 2021, CEOWorld magazine published The Healthcare Index which looked at the overall quality of healthcare, ranking countries according to their health infrastructure, healthcare professionals, costs, availability, and government readiness (such as imposing penalties on risks such as tobacco use and obesity). Altogether, eighty-nine countries were ranked. The Index measured health infrastructure, professionals, cost, medicine availability, and government readiness to support healthcare.

The study determined that South Korea had the highest level of quality healthcare, scoring 78.72 (out of 100) in its Index. Second was Taiwan (77.70), Denmark (74.11), Austria (71.32), Japan (70.73), Australia (67.99), and France (65.38).

The United States came in 30th, with an overall quality healthcare score of 45.62.

Source: Sophie Ireland, “Revealed: Countries with the Best Healthcare Systems,” CEO World, April 27, 2021, https://ceoworld.biz/2021/04/27/revealed-countries-with-the-best-health-care-systems-2021/

The United States can rightly boast of having some of the finest hospitals, doctors, and specialty care facilities in the world; but at the same time, many rural hospitals in America have been forced to close, leading to a crisis in rural healthcare access. In 2021, Newsweek magazine and Statista compiled a list of the best specialized hospitals in the world. American hospitals garnered high marks in each of the specializations of cardiology, oncology, endocrinology, neurology, gastroenterology, and orthopedics. In the field of cardiology, for example, eight of the top ten hospitals were in the United States; American hospitals also ranked high in the other specialized fields of medicine.

At the other end of the spectrum are rural hospitals, many of which are in critical financial straits; and without federal or state assistance many will have closed their doors. The Center for Healthcare Quality and Payment Reform, a national healthcare policy organization, noted that more than 100 rural hospitals had closed over the past decade, 200 more are at immediate risk of closure, and that more than 600 additional rural hospitals (30 percent of all rural hospitals) are in precarious financial conditions. This is the dilemma for millions of Americans who live in rural areas: even if they have insurance to pay for medical care, their communities cannot provide the healthcare they need. These hospitals lose money delivering services to patients, and, especially in states withdrawing patients from Medicaid eligibility, the financial difficulties become even more challenging.

Another major concern, no matter where in the country, is the growing shortage of physicians. In October 2023, Jesse M. Ehrenfeld, president of the American Medical Association, warned that “there is an insidious crisis going on in medicine today that is having a profound impact on our ability to care for patients, and yet isn’t receiving the attention it deserves. This crisis is physician burnout.” Physicians everywhere, in every part of the country and every medical specialty, Ehrenfeld noted, “continue to carry tremendous burdens that have us frustrated, burned out, abandoning hope. . . and in increasingly worrying numbers, turning our backs on the profession we’ve dedicated our lives to.” The American Association of Medical Colleges has projected a national physician shortfall over the next decade of at least 37,000, perhaps even 100,000. Covid burnout, the administrative and bureaucratic health care system drowning physicians in paperwork, the attack on science undermining the trust in physicians, the government intrusion into health care decision and aggressive efforts to criminalize health care, the widening healthcare disparities suffered by marginalize communities, the increases in gun violence and drug overdoses, and the shrinking Medicare reimbursement that has pushed many small, independent medical practices to the brink of financial collapse—all these have contributed to the loss of doctors and the consequent repercussions for millions of patients.

Ehrenfeld noted that some 83 million Americans do not have sufficient access to primary care physicians; 90 percent of counties in the US do not have access to pediatric ophthalmologists, 80 percent of counties do not have infectious disease specialists, and “more than 30 percent of Black Americans live in cardiac deserts.”

Sources: “World’s Best Specialized Hospitals,” Newsweek, n.d., https://www.newsweek.com/worlds-best-specialized-hospitals-2021. Cardiology, hospitals and world ranking: Cleveland Clinic, Ohio (1); Mayo Clinic-Rochester, Minnesota (2); Brigham and Women’s Hospital, Massachusetts (3); Massachusetts General Hospital, Massachusetts (4); Mount Sinai Hospital, New York (5); The Johns Hopkins Hospital, Maryland (6); Cedars-Sinai Medical Center, California (7), New York-Presbyterian Hospital-Columbia and Cornell (8).Oncology, hospitals and world ranking: MD Anderson Cancer Center, Texas (1); Memorial Sloan Kettering Cancer Center, New York (2); Dana-Farber Cancer Institute, Massachusetts (3); Mayo Clinic-Rochester, Minnesota (4); The Johns Hopkins Hospital, Maryland (8). Endocrinology, hospitals and world ranking: Mayo Clinic-Rochester, Minnesota (1); Cleveland Clinic, Ohio (2); Massachusetts General Hospital, Massachusetts (3); Johns Hopkins Hospital, Maryland (5); Brigham and Women’s Hospital, Massachusetts (10). Neurology, hospitals and world ranking: Mayo Clinic-Rochester, Minnesota (1); Massachusetts General Hospital, Massachusetts (5); Cleveland Clinic, Ohio (7); The Johns Hopkins Hospital, Maryland (9). Gastroenterology, hospitals and world ranking: Mayo Clinic-Rochester, Minnesota (1); Mount Sinai Hospital, New York (2); Massachusetts General Hospital, Massachusetts (4); The Johns Hopkins Hospital, Maryland (9). Orthopedics, hospitals and world ranking: Hospital for Special Surgery, New York (1); Mayo Clinic-Rochester, Minnesota (2); The Johns Hopkins Hospital, Maryland (7); and Massachusetts General Hospital, Massachusetts (8).

“The Crisis in Rural Healthcare,” Saving Rural Hospitals, n.d., http://ruralhospitals.chqpr.org;Press Release, “AMA President Sounds Alarm on National Physician Shortage,” American Medical Association, October 25, 2023, https://www.ama-assn.org/press-center/press-releases/ama-president-sounds-alarm-national-physician-shortage.

Higher Education: We’re Number 1, but . . .

Higher education presents a different and mixed story. The elite American universities, both private and public, are the envy of the world. In a 2014 survey conducted by US News, American institutions of higher education dominated, with sixteen of the top twenty universities worldwide found in the United States; 134 American institutions were among the 500 top universities worldwide.

Altogether, there are nearly 4,000 degree-granting colleges and universities in the United States. The top 100 private schools enroll only about 500,000 students; the remaining 10.5 million students attend the other state-supported and private institutions. Included among them are hundreds of weaker institutions: those relying heavily on tuition, having little endowment, and increasingly dependent on a diminishing supply of both US and international students.

Many such institutions are hanging on by a thread, admitting 80, 90 or even 100 percent of the students who apply. In a 2022 study, the American Enterprise Institute found that in 355 colleges accepted between 80-90 percent of its applicants; 303 colleges accepted 90-99 percent; and 226 colleges accepted 100 percent of its applicants. These are the bottom-tier schools that rarely crack the top 200 in the US News rankings. The Pew Research Center found that 57.4 percent of colleges admitted at least 70 percent of its applicants in 2023; just 0.4 percent of schools (the most elite schools) accepted less than 10 percent of its applicants. The fate of these schools is compounded by the harsh reality of a declining American student population. In the 2011 academic year, 24.8 million undergraduates were enrolled in American colleges and universities; in 2023, enrollment had dropped to 20.3 million. Between 2026 and 2031, the number of high school graduates is expected to drop by 9 percent, translating into a loss of 280,000 American students enrolled in four-year colleges. In addition there have been cuts in state funding, the drying up of private support, and increased competition from other schools.

Many more schools are predicted to fold or merge. A headline in the April 26, 2024, Washington Post declared that “Colleges Are Now Closing at a Pace of One a Week.” In 2023, the rate of college closings was a little more than two a week, according to the State Higher Education Executive Officers Association. The educational consulting firm EAB predicted that by 2030 some “449 colleges are expected to see a 25 percent decline in enrollment and 182 colleges are expected to see a 50 percent decline.” Schools received federal emergency relief funds during the pandemic years, but those funds—a lifeline for many institutions--have mostly dried up. In addition, student enrollment has not rebounded in all sectors, and many institutions face significant enrollment pressures.

Compounding these demographic and financial difficulties was a growing sense that college simply wasn’t worth the time and effort. In a recent Wall Street Journal poll, conducted with the independent research institute NORC of the University of Chicago, some 56 percent of Americans didn’t think college was “worth the cost”; that figure was up by 16 percent since the same question was asked ten years ago.

Seth Bodnar, president of the University of Montana, noted the skepticism among many on whether a college education was worth the time and money, and he was particularly worried about those who encourage young people to forgo high education. “Our competitors are certainly not advising their youth, ‘Don’t get an education.’ They’re playing a long game, and they’re playing to win.”

Indeed, the United States is the outlier among OECD countries when it comes to higher education goals and aspirations. On average, notes journalist Paul Tough, OECD countries “have increased their college-attainment rate among young adults by more than 20 percentage points since 2000, and eleven of those countries now have better-educated labor forces than we do.” It is not just Japan, South Korea and Britain, but also smaller countries like the Netherlands, Ireland, and Switzerland.

Sources: “Best Global Universities Rankings,” US News, October 2014, http://www.usnews.com/education/best-global-universities/rankings; George F. Will, “Colleges Hide the Truth About Tuition,” Washington Post, August 30, 2023, https://www.washingtonpost.com/opinions/2023/08/30/high-college-tuition-marketing-tool/; Preston Cooper, “After Decades of Competitive Admissions, Getting into College Has Finally Become Easier,” AEIdeas, September 11, 2024, https://www.aei.org/education/after-decades-of-competitive-admissions-getting-into-college-has-finally-become-easier/; Jon Marcus, “It’s Becoming Easier to Get Into Many Colleges,” Washington Post, November 18, 2024, https://www.washingtonpost.com/education/2024/11/18/college-acceptance-rates-easier-to-get-in/; Drew Desilver, “A Majority of US Colleges Admit Most Students Who Apply,” Pew Research Center, April 9, 2019, https://www.pewresearch.org/short-reads/2019/04/09/a-majority-of-u-s-colleges-admit-most-students-who-apply/; “Undergraduate Enrollment in US Universities, Statista, n.d., https://www.statista.com/statistics/235406/undergraduate-enrollment-in-us-universities/; Jeffrey J. Selingo, “Despite Strong Economy, Worrying Signs for Higher Education,” Washington Post, August 3, 2018, https://www.washingtonpost.com/news/grade-point/wp/2018/08/03/despite-strong-economy-worrying-financial-signs-for-higher-education/?noredirect=on; Preston Cooper, “After Decades of Competitive Admissions, Getting into College Has Finally Become Easier,” AEIdeas, September 11, 2024, https://www.aei.org/education/after-decades-of-competitive-admissions-getting-into-college-has-finally-become-easier/; Jon Marcus, “It’s Becoming Easier to Get Into Many Colleges,” Washington Post, November 18, 2024, https://www.washingtonpost.com/education/2024/11/18/college-acceptance-rates-easier-to-get-in/; Jon Marcus, “Colleges Are Now Closing at a Pace of One a Week. What Happens to the Students?” Washington Post, April 26, 2024, https://www.washingtonpost.com/education/2024/04/26/college-closures-student-impact/; EAB report cited in Olivia Sanchez, “Experts Predicted Dozens of Colleges Would Close in 2023—and They Were Right,” Hechinger Report, January 12, 2024, https://hechingerreport.org/experts-predicted-dozens-of-colleges-would-close-in-2023-and-they-were-right/; Josh Moody, “A Harbinger for 2023? Presentation College to Close,” Inside Higher Ed, January 18, 2023, https://www.insidehighered.com/news/2023/01/19/more-colleges-will-likely-face-closure-2023-experts-say; Douglas Belkin, “Americans Are Losing Faith in college education. WSJ-NORC Poll Finds,” Wall Street Journal, March 31, 2023, https://www.wsj.com/articles/americans-are-losing-faith-in-college-education-wsj-norc-poll-finds-3a836ce1.

In June 2023, the US Supreme Court ruled that Harvard College and the University of North Carolina had violated the equal protection clause of the US Constitution through their affirmative action admissions programs. For the six conservatives in the majority, Chief Justice Roberts wrote that the student “must be treated based on his or her experiences as an individual — not on the basis of race. Many universities have for too long done just the opposite. And in doing so, they have concluded, wrongly, that the touchstone of an individual’s identity is not challenges bested, skills built, or lessons learned but the color of their skin. Our constitutional history does not tolerate that choice.”

In a blistering dissent, Justice Sonia Sotomayor, joined by Justices Elena Kagan and Ketanji Brown Jackson, wrote, “The devastating impact of this decision cannot be overstated. The majority’s vision of race neutrality will entrench racial segregation in higher education because racial inequality will persist so long as it is ignored.”

The immediate partisan and ideological reactions were predictable. President Biden declared “I strongly—strongly disagree with the Court’s decision. . . I believe our colleges are stronger when they are racially diverse. Our nation is strong because . . . we are tapping into the full range of talent in this nation.” On the campaign trail, Donald Trump calling it “a great day for America.”

Now with Donald Trump in the White House, Diversity, Equity, and Inclusion (DEI) programs are also under attack at colleges and universities, with critics arguing that such programs lead to reverse discrimination, violate free speech, and are simply attempts promote affirmative action by another name. The University of Michigan, a leading voice in promoting DEI programs, has spent a quarter billion dollars over the past decade on such efforts, only to find students, faculty, administrators, and alumni, of all political stripes frustrated with the implementation, educational and societal ramifications, even the fundamental premises of diversity, equity, and inclusion.

Sources: Students for Fair Admissions v. President and Fellows of Harvard College, https://www.supremecourt.gov/opinions/22pdf/20-1199_hgdj.pdf; “Remarks by President Biden on the Supreme Court’s Decision on Affirmative Action,” The White House, June 29, 2023, https://www.whitehouse.gov/briefing-room/speeches-remarks/2023/06/29/remarks-by-president-biden-on-the-supreme-courts-decision-on-affirmative-action/; Neil Vigdor and Jonathan Weisman, “The GOP Presidential Field Is Hailing the Dismantling of Affirmative Action,” New York Times, June 29, 2023, https://www.nytimes.com/2023/06/29/us/politics/affirmative-action-republican-reactions.html; Nicholas Confessore, “The University of Michigan Doubled Down on DEI. What Went Wrong?” New York Times, October 16, 2024, https://www.nytimes.com/2024/10/16/magazine/dei-university-michigan.html.

International Student Scores (TIMSS): We’re Number 27, 22, and 15

In early December 2024, the results of the 2023 TIMSS (Trends in International Mathematics and Science Study) international assessments in mathematics and science were published. Every four years, fourth and eighth grade students in sixty-four countries are tested and evaluated. Once again, the scores of American students were not impressive. In mathematics, American fourth graders ranked 27th (Singapore, Taiwan, South Korea, Hong Kong, and Japan topped the list); eighth graders did slightly better, ranking 22nd (Singapore, Taiwan, South Korea, Hong Kong, and Japan scored highest in this list). In science, American fourth graders and eighth graders ranked 15th (Singapore, South Korea, Taiwan, Turkey, and England topped the list of fourth graders; Singapore, Taiwan, South Korea, Hong Kong, and Japan were at the top of the eighth grader achievements).

Source: “TIMSS International Results in Mathematics and Science,” IEA (International Association for the Evaluation of Educational Achievement), in partnership with the TIMSS and PIRLS International Study Center at Boston College, and the United Arab Emirates Ministry of Education, https://timss2023.org/results/ (accessed December 4, 2024). Fifty-eight countries participated in the mathematics and science achievement assessments for fourth graders; forty-four countries participated in the mathematics and science achievement assessments for eighth graders.

International Student Scores (PISA): We’re Number 22

When it comes to competing with students from around the world, American fourth and eighth graders are simply not measuring up. Every three years, the OECD conducts the Programme for International Student Assessment (PISA), a global educational examination involving around 600,000 15-year-old students from around the world. Students take a two-hour test in mathematics, science, and reading. Over sixty-five countries, representing 90 percent of the world’s economies, participate in the PISA program. The 2022 results are the latest; PISA was postponed during the pandemic years. The World Population Review noted that “Since a high ranking on PISA corresponds to economic success, researchers have concluded that PISA is one of the indicators of whether school systems are preparing students for the 21st-century global knowledge economy.”

Students in the United States ranked 22nd overall in the 2022 PISA testing. American students ranked 11th in science but ranked 28th in mathematics. The “bleak” math scores were offset by improved scores in reading and science. About 66 percent of US students performed at least at the basic level of math, while 80 percent scored at the basic levels in science and reading. China scored the highest. The World Population Review noted, however, that these scores from China should be taken with a “pinch of salt.” The Chinese scores were based on students living in Beijing, Shanghai, and two adjacent provinces, rather than testing throughout the country. Yet, the level of income in these testing regions was well below the OECD average.

In addition, students in the United Kingdom, New Zealand, Netherlands, Denmark, Germany, Belgium, Australia, Switzerland, Norway, and the Czech Republic all scored higher than students in the United States. Students in France, Portugal, and Austria scored slightly below the American students.

Sources: “PISA Scores by Country, 2022”, OECD, https://www.oecd.org/publication/pisa-2022-results/; “PISA Scores by Country, 2018,” World Population Review, https://worldpopulationreview.com/country-rankings/pisa-scores-by-country Data from OECD 2019 PISA report; Sarah Mervosh, “Math Scores Dropped Globally, but the US Still Trails Other Countries,” New York Times, December 5, 2023, https://www.nytimes.com/2023/12/05/us/math-scores-pandemic-pisa.html.

Homeless: We’re Number 1 in Total Number of Homeless; We’re Number 7 per Capita

The most recent estimate of American total population in 339 million. While the United States has the largest homeless population among OECD countries (580,000), it ranks 7th in per capita (1,707 per 100,000 persons). The United Kingdom, with a total population of 67.7 million has the second largest number of homeless person (365,000) in the OECD, but ranks 1st in homeless persons per capita (5,399 per 100,000).

Source: World Population Review data, https://worldpopulationreview.com/country-rankings/homelessness-by-country

Social Spending: We’re Number 16 (Public Social Spending) and 2 (Total Net Spending)

How does the United States compare with other OECD countries in terms of social spending? There are two terms involved here: “Public Social Spending” means social spending with financial flows controlled by general government (different levels of government and social security funds), such as social insurance and social assistance payments. “Total Net Social Spending” takes into account public and private social expenditures, and also include the effect of direct taxes (income tax and social security contributions), indirect taxation of consumption on cash benefits as well as tax breaks for social purposes.

In comparison with other OECD countries, the United States is tucked into the middle, ranking 16th in public social spending as a percentage of GDP. But when looking at total net social spending, which includes private social expenditures and indirect taxes and tax breaks, the US ranks as 2nd among OECD countries. The average public social spending for OECD countries is 21.1 percent of GDP, while the average total net social spending is 20.9 percent of GDP.

Source: A complete list of data sets on US public social spending is available at www.oecd.org/social/expenditure.htm.

Opioid Addiction: We’re Number 1

Opioid use became widespread and rampant in America. The United States consumes 80 percent of the world’s supply of OxyContin and Hydrocodone. Much of it ended up in the most economically depressed areas of America.

When compared to the countries of the European Union, the deaths attributed to drug overdoses in the United States is astounding. In 2020, for the entire European Union, with a population of 440 million, there were 5,800 total overdose deaths. By contrast, in America, with a population of a little over 330 million, there were 68,000 deaths. That number jumped to 80,000 in 2021, and 107,000 deaths in 2022 in America.

Source: David Wallace-Wells, “Why Is America Such a Deadly Place?” New York Times, August 9, 2023, https://www.nytimes.com/2023/08/09/opinion/mortality-rate-pandemic.html

Food Sustainability: We’re Number 30

In an analysis conducted by the Economist, the United States ranked 30th in food sustainability and food wasted. The countries with the best performance were Sweden, Japan, Canada, Finland, and Austria. In the individual categories of sustainability, the United States ranked this way: in Food Loss (score 77), it was 8th out of 78 countries; in Sustainable Agriculture (score 55), it was 75th out of 78; in Nutritional Challenges (score 64), it was States was 47th out of 78.

Source: Economist Impact, n.d., https://impact.economist.com/projects/foodsustainability/interactive-world-map/

Food Waste: We’re Number 3 in Total Waste; We’re Number 8 in Waste Per Person

The USDA estimates that between 30 and 40 percent of all food is wasted in the United States. Food is wasted at all levels of its life cycle. Starting with the agricultural production in the fields (crop pests, poor irrigation, and disease), post-harvest handling and storage, processing, distribution (inefficient transportation), consumption, and the food end of life. About 16 percent of the waste comes from farms, 2 percent from manufacturers, 39 percent from businesses, and 43 percent from households. Food is the largest component of municipal landfills, and decomposing food releases methane, a powerful greenhouse gas. The United States spends approximately $218 billion (1.3 percent of GDP) each year to grow, handle, deliver, and dispose of uneaten food.

In 2015, the USDA along with the Environmental Protection Agency (EPA) set a goal to cut the US food waste by 50 percent by the year 2030. There was, however, no base line for food loss. The EPA admits that “the US still has a long way to go to meet the 2030 goal.”

The picture throughout the world is hardly better, and the US sits somewhere in the middle when it comes to alleviating the problem. It is estimated that one-third of all food globally is lost or wasted each year. The average North American household wastes about 130 pounds of food annually; the global average is nearly 35 pounds higher.

Sources: “Food Waste,” US Department of Agriculture, n.d., https://www.usda.gov/foodwaste/faqs; “Fighting Food Waste,” National Conference of State Legislatures, October 24, 2022, https://www.ncsl.org/agriculture-and-rural-development/fighting-food-waste#:~:text=The%20federal%20Bill%20Emerson%20Good,of%20which%20include%20greater%20protections; “Closing the Food Waste Gap,” Boston Consulting Group, n.d., https://www.bcg.com/featured-insights/closing-the-gap/food-waste; “Food Waste by Country, 2023,” World Population Review, n.d., https://worldpopulationreview.com/country-rankings/food-waste-by-country.

Hunger and Food Insecurity: We’re Number 24

The US Department of Agriculture states that about 56 percent of food insecure persons have participated in one or more of the federal government’s nutritional programs—SNAP (food stamps); special Supplemental Nutrition Program for Women, Infants, and Children (WIC), or the National School Lunch Program. Still, for many, this was not enough.

Whatever the cause—lay-offs from work, unexpected bills, marital discord, accidents and doctor bills—many Americans have to weigh the terrible decision of feeding their families or paying their bills. The lengthy pandemic unscored the uncertain circumstances facing many workers and communities. Food insecurity is certainly not confined to families with children. In fact, the biggest increase in food insecurity from 2020 to 2021 came from elderly women living alone.

In the federal bipartisan budget agreement in 2022, funds were set aside to feed hungry children during the summer break from school. It was anticipated that this $2.5 billion program would serve 21 million students, coming from families whose income was below the poverty level. The US Department of Agriculture called the summer nutrition program a “giant step forward” in meeting the needs of families when school is not in session. Yet, when the deadline for accepting the program came in January 2024, Republican governors in fifteen states rejected the funds, impacting an estimated 8 million children. “I don’t believe in welfare,” said Nebraska governor Jim Pillen. Iowa governor Kim Reynolds said she saw no need in adding this federal benefit to food-insecure children “when childhood obesity has become an epidemic.”

Along with Iowa and Nebraska, the other states declining to participate were Alabama, Alaska, Florida, Georgia, Idaho, Louisiana, Mississippi, Oklahoma, South Carolina, South Dakota, Texas, Vermont, and Wyoming. The three states with the highest level of food insecurity (Mississippi, Alabama, and Texas) refused these new funds. In addition, Florida, Georgia, South Carolina, and Wyoming were among the seven states that did not fully extend Medicaid coverage to low-income individuals.

The United States has miles to go, when compared with other OECD countries: the US ranked 24th, with 8.8 percent of its population experiencing moderate to severe food insecurity, far behind countries like the United Kingdom (3.5 percent), Germany (3.5 percent), and Japan (3.8 percent).

Sources: Alisha Coleman-Jensen, Matthew P. Rabbitt, Christian A. Gregory, and Anita Singh, “Household Food Security in 2021,” Economic Research Service, US Department of Agriculture, September 2022, https://www.ers.usda.gov/webdocs/publications/104656/err-309_summary.pdf?v=1779.1; Annie Gowan, “Republican Governors in 15 States Reject Summer Food Money for Kids,” Washington Post, January 10, 2024, https://www.washingtonpost.com/nation/2024/01/10/republican-governors-summer-lunch-program/; “Status of State Medicaid Expansion Decisions,” KFF, December 1, 2023, https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/; “Prevalence of Moderate to Severe Food Insecurity in the Population-OECD Countries,” The World Bank, https://data.worldbank.org/indicator/SN.ITK.MSFI.ZS?end=2020&locations=OE&most_recent_value_desc=false&start=2017

Abortion and Reproductive Rights: We’re Hopelessly Divided

Thirteen states had already crafted anti-abortion statutes, dubbed “trigger laws,” just waiting for the Supreme Court to make the anticipated decision in Dobbs v. Jackson Women’s Health Center (2022). The unprecedented leak of the majority opinion certainly gave anti-abortion advocates the green light they needed. As of the end of May, 2023, fourteen states have banned abortions outright: Alabama (no exceptions for rape or incest), Arkansas (no exceptions for rape or incest), Idaho (nearly all instances), Kentucky (no exceptions for rape or incest), Louisiana (no exceptions for rape or incest), Mississippi (except for rape, but not incest), Missouri (except for rape, but not incest), North Dakota (except for rape or incest), Oklahoma (no exceptions for rape or incest), South Dakota (no exceptions for rape or incest), Tennessee (no exceptions for rape or incest), Texas (no exceptions for rape or incest), West Virginia (except for rape or incest), and Wisconsin (no exceptions for rape or incest, being challenged). Georgia has a six-week ban in effect.

The Texas law was dubbed the “vigilante law,” which established a $10,000 court award, letting individual citizens sue anyone who helps a woman obtain an abortion after the six-week mark—that included suing the doctor who performed the abortion down to the person who drove the patient to the clinic. The Supreme Court declined to temporarily block the Texas vigilante law. Other states have now embraced this idea: the Washington Post noted that at least thirty-five copycat laws have been introduced throughout America, not only for abortions but for a wide variety of polarizing issues—like book banning, gun control, and transgender athletics.

In six states—Indiana, Iowa, Montana, Ohio, South Carolina, and Wyoming—bans imposed by state legislatures have been block by state courts. In five states—Nebraska, Arizona, Florida, Utah, and North Carolina—abortions are banned during the gestational period, from 12 to 20 weeks. In twenty-five states, abortions remain legal, and in twenty of those states, new legal or constitutional protections have been created. In 2024 ballot measures, five states added to their abortion rights protections and in two states, Arizona and Missouri, previous abortions bans had been lifted. At the same time, voters in three states (South Dakota, Nebraska, and Florida) rejected measures to enshrine abortion rights in their laws and constitutions.

Thanks to Dobbs, there is no national law regulating abortions. Congress is gridlocked on this issue: not enough votes to make this a national protection; not enough votes to severely restrict abortion access. Women living in abortion-restricted states have the difficult choice: carry the fetus to birth or leave the state, hoping to receive the care they need in states that offer abortion services. In 2023, over 171,000 women traveled from states that restricted abortions to states that permitted the procedure. More than 14,000 Texas women crossed over into New Mexico; 37,300 traveled from mostly southern and midwestern states to Illinois; and 12,000 traveled from Georgia or South Carolina to North Carolina. Amy Hagstrom Miller, founder of Whole Woman’s Health, stated that “we’re having people travel hundreds or thousands of miles for a procedure that typically takes less than 10 minutes and can be done in a doctor’s office setting. Nobody does that for any other medical procedure.” An embolden 2025 Republican majority in the House of Representatives continues to talk about a nationwide law to regulate and restrict abortions.

In 2015, the Pew Research Center found that in over 96 percent of the 146 nations surveyed women were allowed to terminate their pregnancies in order to save their lives. Only six countries did not allow women to receive abortions under any circumstances (and since that 2015 report, Ireland, one of the six, has completely reversed its policy).

How Did They Do It? How Ireland, a predominantly Catholic country, repeal its pro-life amendments and allowed abortions nationwide.

Fifty countries (26 percent) only allow abortions to save the life of the mother; eighty-two countries (42 percent) allow abortions when the mother’s life is at risk as well as for at least one other specific reason (rape, incest, fetal impairment, or social or economic reasons). Fifty-eight countries (30 percent) allow abortions on request for any reason, although many of these countries set a certain point in the pregnancy, such as twenty weeks, as the cutoff point for an abortion. In September 2023, the Mexican Supreme Court decriminalized abortion nationwide, making abortions legal in all of the country’s thirty-two states; previously the procedure had been available in only twelve states. In a brief announcement accompanying the ruling, the Supreme Court stated that penalizing women who sought abortions was “unconstitutional” and “violates the human rights of women.”

In March 2024, France became the first country to protect the right to have an abortion explicitly protected in its constitution. The vote in the French Parliament was overwhelmingly in favor of the abortion rights protection. In 1975, France had decriminalized abortion, permitting the procedure for any reason through the fourteenth week of pregnancy, and now that protection was enshrined in its constitution. As the Washington Post noted, French “activist and politicians have been transparent that this is, above all, a response to what has been happening in the United States” since the overturning of Roe.

Sources: Kimberly Kindy and Alice Crites, “Texas Abortion Law Created a Vigilante Loophole: Both Parties Are Rushing to Take Advantage,” Washington Post, February 2, 2022, https://www.washingtonpost.com/politics/2022/02/22/texas-abortion-law-vigilante-loophole-supreme-court/; “Tracking the States Where Abortion is Now Banned,” New York Times, May 26, 2023, https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html; Allison McCann and Amy Schoenfeld Walker, “How Ballot Measures Will Change Abortion Access,” New York Times, November 6, 2024, https://www.nytimes.com/interactive/2024/11/06/us/elections/abortion-ballot-results-laws-election.html; Molly Cook Escobar, Amy Schoenfeld Walker, Allison McCann, Scott Reinhard, and Helmuth Rosales, “171,000 Traveled for Abortions Last Year. See Where They Went,” New York Times, June 13, 2024, https://www.nytimes.com/interactive/2024/06/13/us/abortion-state-laws-ban-travel.html; Angelina E. Theodorou and Aleksandra Sandstrom, “How Abortion is Regulated Around the World,” Pew Research Center, October 6, 2015, https://www.pewresearch.org/short-reads/2015/10/06/how-abortion-is-regulated-around-the-world/; Simon Romero and Emiliano Rodríguez Mega, “Mexico’s Supreme Court Decriminalizes Abortion Nationwide,” New York Times, September 6, 2023, https://www.nytimes.com/2023/09/06/world/americas/mexico-abortion-decriminalize-supreme-court.html; Karla Adam, “France Becomes First Country to Explicitly Enshrine Abortion Rights in Constitution,” Washington Post, March 4, 2024, https://www.washingtonpost.com/world/2024/03/04/france-abortion-constitution/?utm_source=alert&utm_medium=email&utm_campaign=wp_news_alert_revere&location=alert.

Child Well-Being: We’re Number 36

In 1988, the United Nations Children’s Fund (UNICEF) created a research center to support its advocacy of children worldwide. Its Office of Research-Innocenti, based in Florence, Italy, has compiled annual Report Cards on the status of children and their well-being in advanced countries.

For the Sixteenth Report Card (2020), out of thirty-eight countries examined, the United States came in thirty-sixth, ahead of only Bulgaria and Chile. Using data from the OECD, the World Bank, Global Burden of Disease Study, World Health Organization, PISA, and other data measurements, the Report Card focuses on three overall dimensions: mental well-being (both positive and negative aspects of a child’s mental well-being—life satisfaction and suicide rates); physical health (rates of overweight and child mortality); and skills (academic proficiency and social skills, such as making friends easily).

Source: “Worlds of Influence: Understand What Shapes Child Well-Being in Rich Countries,” Innocenti Report Card 16, UNICEF, 2020; written by Anna Gromada, Gwyther Rees, and Yekaterina Chzhen, https://www.unicef-irc.org/publications/pdf/Report-Card-16-Worlds-of-Influence-child-wellbeing.pdf.

Highest Infant and Maternal Mortality Rates: We’re Number 1

The Commonwealth Fund, using data from the Centers for Disease Control and Prevention and the OECD, reports that “the United States has the highest maternal mortality rate among developed countries.” Further, there is an overrepresentation of obstetrician-gynecologists in the maternity workforce, a shortage of midwives, and the US lacks comprehensive post-partum support.

Women in the United States experience more late maternal deaths than women in other high-income countries. In the US, 52 percent of all maternal deaths come after delivery or postpartum while 17 percent of deaths occur on the day of delivery. Roosa Tikkanen and her colleagues at the Commonwealth Fund note during the first week of postpartum that “severe bleeding, high blood pressure, and infection are the most common contributors to maternal deaths, while cardiomyopathy is the leading cause of late deaths.”

As in many cases of health and welfare, there is a racial component to maternal mortality. Research conducted by Marian F. MacDorman and her colleagues concludes that Black women are more than three times as likely to die during pregnancy or postpartum than white women. Linda Villarosa, in Under the Skin, makes a sweeping and powerful assessment of the systematic assault on Black American’s bodies, the racial disparities, the neglect, the inbred biases, and the social racisms that African Americans endure, no matter their social or economic status.

Sources: Roosa Tikkanen, Munira Z. Gunja, Molly Fitzgerald, and Laurie Zephyrin, “Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries,” Commonwealth Fund, Issue Brief, November 18, 2020, https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries; Marian F. MacDorman, et al., “Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016,2017,” American Journal of Public Health, September 2021, https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2021.306375; Linda Villarosa, Under the Skin: The Hidden Toll of Racism on Health in America (New York: Anchor, 2023).

Childcare and Early Childhood Education: We’re Number 28

As part of the “Build Back Better” plan the Biden administration described the childcare provisions as “the largest investment in childcare in the nation’s history,” a $425 billion package including universal and free kindergarten, expanded child tax credits, and a wage boost for caregivers. But the effort was stalled in Congress. Senate Minority Leader Mitch McConnell (Republican-Kentucky) berated the childcare provisions as a “toddler takeover.” The Democrats, McConnell insisted in a floor speech, “want to ram though a radical, reckless, multi-trillion-dollar taxing and spending spree between now and Christmas. And a huge part of their bill would completely upend childcare and pre-K as they exist for families across America.” The legislation was stalled and ultimately died.

In April 2023, President Joe Biden tried again, bypassing Congress and signing an executive order directing federal agencies to make childcare cheaper and more accessible. Biden noted that “almost every federal agency will collectively take over fifty actions to provide more peace of mind for families and dignity for care workers.” Biden emphasized that this executive order, limited to the action of the federal agencies, wouldn’t require any new spending. “It’s about making sure taxpayers get the best value for the investments they’ve already made.” Executive agencies would lower co-pays for services, ensure that Medicare and Medicaid dollars could go further, improve care for veterans and Native Americans. This executive order was certainly helpful, but these provisions are a far cry from his earlier, unrealized commitment for $225 billion to cover childcare for low-income parents and another $200 billion for universal preschool education. Despite the efforts of the Biden administration and the signing of the executive order, a comprehensive federal childcare program is still not a reality.

During the pandemic, Congress set aside $24 billion in stimulus money for childcare. It helped keep many childcare facilities afloat. Yet during the first two years of the pandemic one-tenth (20,000) of all childcare centers folded. When the federal money ran out in September 2023, the Century Fund estimated that 70,000 childcare programs would close, affecting 3.2 million children, and causing a $10.6 billion loss to the US economy.

For single parents in the United States, the childcare costs as a percentage of their net income are the highest among all the OECD countries. For single parents in the United States, up to 50 percent of their income goes to childcare; for New Zealand single mothers it is 14 percent, for mothers in the United Kingdom, it is 8 percent; for German single parents, the percentage of childcare costs is 1 percent.

Sources: Floor statement of Senate Republican Leader Mitch McConnell, December 7, 2021, https://www.republicanleader.senate.gov/newsroom/remarks/democrats-toddler-takeover-huge-childcare-inflation-and-discrimination-against-religion; Michael D. Shear, “Biden Signs Executive Order That Aims to Make Childcare Cheaper,” New York Times, April 18, 2023, https://www.nytimes.com/2023/04/18/us/politics/biden-executive-order-child-care.html; Abha Bhattarai, “Childcare is About to Get More Expensive, As Federal Funds Dry Up,” Washington Post, September 5, 2023, https://www.washingtonpost.com/business/2023/09/05/child-care-cliff-day-care/.