Not so long ago, the United States was on a trajectory to reach an average life expectancy of 80. Then, progress toward that milestone stalled before lurching into reverse. That was happening even before the coronavirus pandemic, a health cataclysm that accelerated the backward march of Americans’ life spans.

It is a distinctly American story told in lives hobbled by chronic illness, in lives lost too soon.

The Washington Post spent the past year examining the nation’s crisis of premature death, analyzing county-level death records from the past five decades. The analysis concentrated on people in the prime of life — 35 to 64 years — because the scale of loss is so profound: These ages have the greatest number of excess deaths compared with peer nations.

To tell the story, The Post spoke with scores of clinicians, patients and researchers, and reported from 10 states, Europe and South America. Customized data analyses were performed by a health-care analytics company and by a federal health agency. Health statistics from peer nations were used to inform conclusions about the comparative state of Americans’ well-being.

The portrait that emerged shows a nation beset with chronic illness and saddled with a fractured health-care system that, compared with its peers, costs more, delivers less and fails at the fundamental mission of helping people maintain their health:

ncG1vNJzZmivp6x7uK3SoaCnn6Sku7G70q1lnKedZLWmrcutn2hqYGeAcH2PaGdrZ6SWuKat1pqwrGWlqHqttcWeZJ6woJqwta3NnLBmm6KewKq%2Fjg%3D%3D