When one looks at the things that increase risks for significant health problems, obesity (not smoking) tops the list. And who has a higher rate of obesity, children and adults, than other Western countries? You guessed it -- USA. Americans also tend to be more sedentary, which puts the double whammy on the obese individual's health. And our higher infant mortality rate? I'm guessing here, but I think it is less likely to be due to lack of available prenatal care so much as it is due to the unhealthy habits of mothers passing their problems to their babies in-utero. The fast food diets, obseity, diabetes and the substance abuse issues rampant in America also affect expecting mothers. I think available medical care is a plus in US -- our own people's lifestyle choices have a lot to do with our poorer health, mediocre longevity and higher health care costs. (That, and Americans' insistence -- promoted by our medical industries -- upon reaching for prescription drugs to deal with life and minor health issues rather than some more natural remedies).