Though it hosts the best medical research in the world and spends more money on healthcare than any other country, a new study shows that the U.S. is falling behind other countries when it comes to actual health outcomes.

The study shows that traffic injuries, self-harm, cirrhosis, and drug addiction are rising as causes of premature death, along with Alzheimer’s, Parkinson’s, and kidney cancer. Years of life lost due to drug addiction are rising particularly fast, up 448% from 1990 to 2010.

“The United States has spent a good amount of time and money on finding successful solutions for cardiovascular diseases and even some cancers, but like a lot of countries, it has yet to make that same kind of effort with these leading causes of disability,” said Dr. Alan Lopez, co-author of the study and chair of Global Health and Burden of Disease Measurement at the University of Melbourne in Australia. “That’s a real problem with a population as large as the US has, and there are few good options for dealing with a massive amount of health loss.”

Though the U.S. has lowered disease burden rates for all childhood diseases and lowered mortality rates for all people since 1990, it is not improving at the same rate as other industrialized countries. Of the study’s 34 peer countries, the U.S.’ death rate ranking has fallen from 18th to 27th in the past two decades, and its life expectancy at birth ranking has fallen from 20th to 27th. It’s healthy life expectancy ranking has fallen from 14th to 26th.

The top five risk factors in 2010 for U.S. deaths were all attributable to personal health factors: dietary risks, smoking, high blood pressure, high body mass index, and physical inactivity. The study’s authors believe that poor diet choices and little physical activity are the factors holding Americans back from better health outcomes.

“If the US can make progress with dietary risk factors, physical activity, and obesity, it will see massive reductions in death and disability,” said Dr. Ali Mokdad, head of the U.S. County Health Performance team for Institute for Health Metrics and Evaluation. “Unhealthy diets and a lack of physical activity in the US cause more health loss than smoking, alcohol, or drug use.”

The study, called “The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors,” is the first comprehensive analysis of U.S. disease burden in over 15 years. It was published this week in the Journal of the American Medical Association. The study covers death and disability estimates for 291 diseases and injuries, and 67 risk factors. Its findings were presented today at a Lets’s Move campaign event hosted by U.S. First Lady Michelle Obama.

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