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Urbanization
About 82% of Americans live in urban areas, including suburbs;[180] about half of those reside in cities with populations over 50,000.[431] In 2022, 333 incorporated municipalities had populations over 100,000, nine cities had more than one million residents, and four cities—New York City, Los Angeles, Chicago, and Houston—had populations exceeding two million.[432] Many U.S. metropolitan populations are growing rapidly, particularly in the South and West.[433] Health Main articles: Healthcare in the United States, Healthcare reform in the United States, and Health insurance in the United States  The Texas Medical Center in Houston is the largest medical complex in the world.[435][436] In 2018, it employed 120,000 people and treated 10 million patients.[437] According to the Centers for Disease Control and Prevention (CDC), average American life expectancy at birth was 78.4 years in 2023 (75.8 years for men and 81.1 years for women). This was a gain of 0.9 year from 77.5 years in 2022, and the CDC noted that the new average was largely driven by "decreases in mortality due to COVID-19, heart disease, unintentional injuries, cancer and diabetes".[438] Starting in 1998, life expectancy in the U.S. fell behind that of other wealthy industrialized countries, and Americans' "health disadvantage" gap has been increasing ever since.[439] The U.S. has one of the highest suicide rates among high-income countries.[440] Approximately one-third of the U.S. adult population is obese and another third is overweight.[441] The U.S. healthcare system far outspends that of any other country, measured both in per capita spending and as a percentage of GDP, but attains worse healthcare outcomes when compared to peer countries for reasons that are debated.[442] The United States is the only developed country without a system of universal healthcare, and a significant proportion of the population that does not carry health insurance.[443] Government-funded healthcare coverage for the poor (Medicaid) and for those age 65 and older (Medicare) is available to Americans who meet the programs' income or age qualifications. In 2010, former President Obama passed the Patient Protection and Affordable Care Act.[y][444] Abortion in the United States is not federally protected, and is illegal or restricted in 17 states.[445]
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