Evidence indicates that while health-care spending in the United States is the highest in the world, people in the United States experience the worst health outcomes of any high-income nation overall. Americans are more likely to die younger, and from avoidable causes, than residents of peer countries. The U.S health-care system is characterized by fragmented organization and financing, inadequate access to care, rising health-care costs and inefficient use of resources, high utilization of medical technology, inconsistent quality and pervasive inequity, and limited public health infrastructure. The overall emphasis is on providing care during illness rather than developing and maintaining health. 

Nursing and public health are working to change this by educating a workforce dedicated to developing and supporting health for individuals, families, communities, and populations, by concentrating on physical, mental, and spiritual health and the environments where people live, work and play.