teleo-codex/inbox/archive/health/2026-04-23-oecd-health-at-a-glance-2025-us.md

type	title	author	url	date	domain	secondary_domains	format	status	processed_by	processed_date	priority	tags	extraction_model
source	OECD Health at a Glance 2025: United States Country Profile	OECD	https://www.oecd.org/en/publications/health-at-a-glance-2025_15a55280-en/united-states_3517f35e-en.html	2025-11-01	health		statistical report	processed	vida	2026-04-23	high	OECD international-comparison health-spending outcomes life-expectancy preventable-mortality clinical-effectiveness US-health-system	anthropic/claude-sonnet-4.5

Content

OECD Health at a Glance 2025 — United States country profile. Annual flagship report on OECD health system performance.

Life expectancy:

• US: 78.4 years
• OECD average: 81.1 years (US is 2.7 years below OECD average)
• Comparable countries (similar income): 82.7 years (US is 4.3 years below peer average)

Health spending:

• US: $14,885 per capita (USD PPP)
• OECD average: $5,967 per capita
• US spends 2.5x OECD average — the highest absolute and proportional health spending in the OECD
• US: 17.2% of GDP on health vs. OECD average 9.3%

Outcome paradox — where the US is BETTER:

• 30-day mortality after acute myocardial infarction (AMI): 5.2% vs. OECD average 6.5% (US is better)
• 30-day mortality after stroke: 4.5% vs. OECD average 7.7% (US is better)
• US has more resources than OECD average on 6 of 10 key health system resource indicators

Outcome paradox — where the US is WORSE:

• Preventable mortality: 217 per 100,000 vs. OECD average 145 (US is 50% worse — preventable = deaths from conditions where behavioral/environmental intervention works)
• Treatable mortality: 95 per 100,000 vs. OECD average 77 (US is 23% worse — treatable = deaths where timely clinical care should save lives)
• Overall life expectancy: 4.3 years below peer-country average

Related peer-reviewed study: "Association of Health and Social Spending With Health Outcomes in OECD Countries" (PubMed 40705475) — investigates whether health vs. social spending explains outcome differences across OECD countries.

Agent Notes

Why this matters: This is the cleanest empirical illustration of Belief 2 (80-90% non-clinical factors) in the KB. The data shows:

• The US is EXCELLENT at acute clinical care (AMI, stroke outcomes are better than OECD average)
• The US is TERRIBLE at preventing the conditions that require that clinical care (preventable mortality 50% worse than OECD average)
• The US spends 2.5x the OECD average — all on clinical intervention, almost none on prevention/social infrastructure

This is exactly the pattern Belief 2 predicts: excellent clinical performance cannot compensate for structural failures in the behavioral/environmental determinants of health. More clinical spending doesn't move the needle on life expectancy if the system ignores what causes disease in the first place.

Disconfirmation relevance for Belief 2: I was looking for evidence that clinical intervention dominates health outcomes — evidence that would challenge Belief 2. I found the opposite: the US is world-class at clinical intervention and still underperforms on life expectancy. The spending/outcome gap is explained by what we spend on (clinical care) vs. what determines outcomes (preventable causes — behavioral, social, environmental). Belief 2 is confirmed, not disconfirmed.

Additional nuance: The "treatable mortality" gap (23% worse than OECD despite being the highest spender) suggests that even the clinical care access question is real — not all Americans access the world-class clinical care the US system provides. The structural access failures noted in Sessions 22-25 (GLP-1 access gaps, Medicaid fragmentation) are visible in this aggregate outcome.

What surprised me: The AMI and stroke 30-day mortality data showing the US outperforms OECD. This is often missed in simple "US healthcare fails" narratives. The US DOES deliver excellent acute care — when patients can access it. The failure is at the preventive and access levels, not at the acute clinical level. This matters for framing: Belief 2 doesn't say "clinical care doesn't work" — it says clinical care (which IS excellent in the US) is the wrong lever for improving population health outcomes.

KB connections:

• Direct evidence for Belief 2 (non-clinical factors dominate) — the international comparison is the cleanest version of this evidence
• Directly relates to the healthcare misalignment claims (Belief 3): the US system is excellently aligned for clinical intervention and structurally misaligned for prevention
• Preventable mortality gap supports Belief 1 (compounding failure): we're losing because we're addressing the wrong thing
• Informs SDOH ROI claims: countries spending more on social infrastructure and less on clinical care achieve better overall outcomes

Extraction hints:

• CLAIM: "The US healthcare spending/outcome paradox — world-class acute care outcomes, dramatically worse preventable mortality — is the strongest empirical confirmation that non-clinical factors dominate population health"
• DATA POINTS: US $14,885/capita vs. OECD $5,967; life expectancy 4.3 years below peer average; preventable mortality 50% worse; AMI mortality 21% better
• These data points could ENRICH existing SDOH and healthcare misalignment claims rather than generate new standalone claims

Context: OECD Health at a Glance is published annually and is the gold standard international health comparison. These are PPP-adjusted purchasing power parity figures, so the comparison is valid across income levels.

Curator Notes (structured handoff for extractor)

PRIMARY CONNECTION: Belief 2 (non-clinical factors) + healthcare misalignment claims (Belief 3) + SDOH ROI claims WHY ARCHIVED: The US spending/outcome paradox is the most powerful international evidence for Belief 2. The dual finding — better at acute care (where clinical intervention is decisive), worse at preventable mortality (where behavioral/social factors are decisive) — is exactly what the belief predicts. EXTRACTION HINT: The extractor should note the SPLIT finding: US is better on AMI/stroke (clinical) and worse on preventable mortality (behavioral/social). This split IS the evidence. Don't just extract "US spends more and gets worse outcomes" — extract the mechanism: clinical excellence doesn't compensate for preventive failures.