INTRODUCTION – Recent increases in mortality are at the forefront of the public health debate in the United States. This paper takes a comparative international perspective and documents the poor relative performance of life expectancy in the United States. We characterize its age and cause of death profiles over time and estimate its welfare implications. We show that this poor performance is not recent, not restricted to very particular causes of death, but mostly driven by adults and older ages. We calculate that recent welfare gains could have been 19%–28% higher had the United States been able to reproduce the life expectancy performance of the average member of the Organization for Economic Cooperation and Development.