Original Investigation

A Global Analysis of Within-Country Health Inequalities

JAMA Health Forum 10.1001/jamahealthforum.2025.3611

October 17, 2025 at 11:00 AM EDT

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How do health inequalities in the US compare with health inequalities in other countries, and what changes health inequalities across countries or over time?In this repeated cross-sectional study involving an index of health inequality comparable across 181 countries and territories, on average, health inequalities were found to have decreased between 1960 and 2021. In the US, health inequality also decreased but less than in other high-income nations: it ranked 19th in 1960 but 77th in 2021 among 181 countries and territories, and 55th among 59 high-income countries.In this study, infant mortality and life expectancy dominate factors associated with health inequality, and future improvements in countries with high infant mortality have potential to meaningfully improve health inequality.

Corresponding Author: Eran Bendavid, MD, Department of Medicine, Stanford University, 615 Crothers Way, Stanford CA 94305 (ebd@stanford.edu).

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