The Japanese have the best prospects for a long and active life, while the United States -- which spends most on health -- lags behind because of miserable standards among its poor, who fare worse than many Africans, the World Health Organization (WHO) says.
CBS News Correspondent Pamela McCall reports that Americans can expect good health for only 70 years. Speaking in London, the WHO's Dr. Christopher Murray says the U.S. lags well behind.
"That's not terribly good compared to the other high income countries ahead of them. In Japan for example, life expectancy is nearly 75."
The WHO said Japan's traditional low fat diet and low lung disease rates have been key factors in its top position, but it appears to be losing ground.
Second-placed Australia, at 73 years, ``is on its way up,'' Murray said, having reduced smoking, campaigned effectively against the spread of the AIDS virus and cut road accidents.
France came in third, followed by Sweden, Spain and Italy.
Murray says the biggest reason for bad health in the U.S. is inequality in care...with a huge gap in standards between rich and poor. He says some areas of the United States are as bad off as impoverished African nations.
"Until the United States is able to bring up the level of health of those at the bottom, as a country they're not going to do very well," said Murray.
The country with the worst healthy life expectancy is the war-ravaged nation of Sierra Leone. They can only expect a good healthy life for 25 years.
"Healthy life expectancy in some African countries is dropping back to levels we haven't seen in advanced countries since medieval times,'' said Chris Murray, director of the U.N. agency's global program on evidence for health policy. AIDS has cut five years or more from African life expectancy in the past decade, he said.
Overall, the WHO said global life expectancy averaged 64.5 years in 1999, six years more than two decades ago. But its study focused on healthy life expectancy rather than the number of years spent alive.
``There's been a real concern that (people) are spending those extra years of life in bed disabled,'' Murray said. But ``the countries at the top of the list are getting a double bonus -- they're living longer and they're spending more of their time in good health.''