We’re constantly told that America is the greatest country on Earth, hands down. Questioning that narrative invites eye-rolls and plenty of criticism. But question it, we must. If America is so great, why are so many young people dying? Between 2010 and 2021, as recent research from Virginia Commonwealth University shows, mortality among Americans ages 25 to 44 rose by 71.2 percent. People are meeting their maker during the very years they should be meeting a potential spouse.

The classic American playbook is incredibly simple, at least in theory. It encourages young adults to get an education, climb the career ladder, settle down, raise a family, and do their best not to get divorced. Mortality data suggest the script falls apart just as people try to follow it. America excels at adding extra months onto the end of an 80-year-old life with extraordinarily expensive ICU stays. At the very same time, it routinely fails to keep a 32-year-old alive long enough to see their kids enter middle school.

The human damage extends far beyond the coroner's office. A single premature death tears a family apart. Children grow up with empty seats at the dinner table. Parents bury adult children who were supposed to be choosing their senior care facilities. Men and women become widows before their first gray hairs appear. Communities lose plumbers, teachers, police officers, and neighbors who should have kept the local economy running for another 30 years. Public discussions often default to the fentanyl crisis when the issue of young mortality arises.

Illicit synthetic opioids certainly kill too many people, but drug overdoses tell only part of the story. Young Americans are dying from a bizarre cocktail of self-inflicted and biological disasters. Suicide rates remain high. Alcohol-related liver disease, fatal traffic wrecks, homicides, high blood pressure, and metabolic disorders are all claiming people in their 20s and 30s.

Diseases once reserved for world-weary retirees are making a triumphant comeback in people who still remember their high school gym class locker codes. Hypertension and fatty liver disease are moving down the demographic chart at an alarming rate. Young bodies are showing the structural wear and tear of 60-year-olds.

Modern political commentary loves to blame systemic failure for every national ailment. Institutional problems clearly exist, yet much of this crisis comes down to personal habits. Medical science can treat a gunshot wound and clear a blocked artery, but it can’t force a person to stop drinking a gallon of vodka a week. Technology cannot step in when someone decides to drive 90 miles an hour while sending memes on an icy interstate. Ultra-processed junk food, sedentary screen time, heavy drinking, and untreated mental illnesses represent personal choices that no government agency can micromanage away.

The U.S. spends trillions of dollars annually on healthcare, far more than any other wealthy nation. Yet the return on that astronomical investment is a declining life expectancy. European nations spend a fraction of what Americans shell out, yet their citizens routinely survive into their 80s and 90s without relying on advanced biological therapies. High-tech medical interventions are lousy substitutes for daily self-care and a respectable lifestyle.

Geography compounds the risk in ways that look almost arbitrary. A child born in one zip code can expect to live a decade longer than a child born 50 miles away. Local economics, regional food cultures, smoking habits, and access to trauma care create significant survival disparities across state lines. The differences reflect sobering realities about local employment, education and everyday habits.

Social isolation makes matters worse. High-speed internet access and infinite streaming content have arrived alongside a massive drop in face-to-face human connection.

Young adults have thousands of online followers but no one to pick them up from the hospital after a minor procedure. Chronic loneliness raises stress hormones and disrupts sleep. It accelerates inflammation and pushes people toward destructive vices like alcohol, hard drugs and self-harm. Traditional public health frameworks analyze each cause of death as an isolated event. One department handles addiction, another tracks heart disease, and a third studies traffic safety. That bureaucratic division misses the larger pattern.

When multiple completely different causes of death spike simultaneously within the exact same age group, the culture itself is creating something that physicians and strongly worded policies can’t fix. A genuinely healthy society ought to measure its basic success by whether an average citizen has the opportunity to age gracefully into grandparenthood. America is failing that test miserably, one premature obituary at a time. John Mac Ghlionn is a writer and researcher who explores culture, society and the impact of technology on daily life.