Between 1983 and 1999, men's life expectancy decreased in more than 50 U.S. counties, according to a recent study by [Majid] Ezzati, associate professor of international health at the Harvard School of Public Health (HSPH), and colleagues. For women, the news was even worse: life expectancy decreased in more than 900 counties-more than a quarter of the total. This means 4 percent of American men and 19 percent of American women can expect their lives to be shorter than or, at best, the same length as those of people in their home counties two decades ago. The United States no longer boasts anywhere near the world's longest life expectancy. It doesn't even make the top 40. In this and many other ways, the richest nation on earth is not the healthiest. Poor health is not distributed evenly across the population, but concentrated among the disadvantaged. But in the United States, the gap between the rich and the poor is far wider than in most other developed democracies, and it is getting wider. That is true both before and after taxes: the United States also does less than most other rich democracies to redistribute income from the rich to the poor. Living in a society with wide disparities-in health, in wealth, in education-is worse for all the society's members, even the well off. People at the top of the U.S. income spectrum live a very long time," says Cabot professor of public policy and epidemiology Lisa Berkman, "but people at the top in some other countries live a lot longer."