A new survey on American health finds some U.S. cities, like New York and San Francisco, have among the highest life expectancies in the world.
Other areas -- mostly in the south -- are compared to third world countries.
"In our least healthy counties we look like Bangladesh," said Dr. Lee Goldman, and Dean, Columbia University Medical Center
Experts say it is a problem of excess. Americans in the poorest parts of the country are consuming too much food, salt, and tobacco -- and as a consequence, men in these areas tend to die in their mid-sixties.
"It turns out that we spend the most on healthcare, but our outcomes as measured by life expectancy are mediocre," said Dr. Christopher Murray of the University of Washington.
While the rates of physical activity are up in two-thirds of the country, exercise can't erase the effects of bad diet.
Obesity rates continue to climb, and doctors say we need to focus on eating healthier foods -- like fruit, vegetables and whole grains.
"There are health benefits from the makeup of diet that are above and beyond the total calories that you take in," Dr. Murray said.
The U.S. ranks best in the world for stroke care and treatment of certain cancers.
But even though people are living longer, they're doing so with chronic conditions like diabetes, Alzheimer's and depression.
"People who used to die suddenly in their 50's or 60's are now living longer with a whole variety of chronic diseases that we didn't worry about so much before," Dr. Goldman said.
And men are closing the life expectancy gap on women. In 1985, men died an average of seven years younger than women.
Now that number stands at four-and-a-half -- but not because men are healthier. It's because more women are obese, and smoke.
To find health numbers for your community, visit www.healthmetricsandevaluation.org/tools/data-visualization/us-health-map.