Among OECD (Organization for Economic Co-operation and Development) member nations, the infant mortality rates in the United States and New Zealand are the highest among the 21 most highly industrialized nations, with 5.9 and 5.7 deaths per 100,000 births, respectively. In the case of the United States, the cause—according to a 2016 paper in the Journal of Economic Policy—is a higher mortality among lower socioeconomic groups, and this issue cannot be resolved by simply increasing access to healthcare resources. Rather, the authors conclude, the solution is a targeted program of home nurse visits.
The Affordable Care Act provides some opportunities for home nurse visits, which could lower infant mortality over time.
Life expectancy in the United States is similar to infant mortality in terms of its position relative to peer nations. Over the preceding two years, it has decreased further, and, according to research, this decrease is driven by higher mortality levels among youth, largely as a result of drug overdoses. Further, a pre-ACA (2009) paper by the National Bureau of Economic Research found that "the more recent increase in obesity in the United States suggests that a high disease incidence cannot be laid entirely at the feet of the health care system." These two issues—higher rates, compared to peer nations, of obesity and drug abuse in the United States—may be effectively addressed through health education programming. According to scholarly research published in 2014, the ACA may help, through its indirect mechanisms, to improve health education, but its effectiveness in doing so is neither certain nor guaranteed.