Americans die younger than their peers in the industrialized world and not all due to the health system.
The authors offered a range of possible explanations for Americans' worse health and mortality, including social inequality. They also described criticisms including limited availability of contraception for teenagers, community designs that discourage physical activity such as walking, air pollution and access to firearms, as well as individual behaviors such as high calorie consumption., to suggest that even affluent Americans were worse off compared with their peers in other countries
The U.S. health-care system wasn't spared criticism, with authors describing it as fragmented, lacking sufficient primary-care physicians and posing financial barriers to millions of Americans who lack insurance or are unable to afford out-of-pocket medical costs.

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