Despite having the highest incarceration rate in the world, the US pays little attention to the poor health of its incarcerated population and the widespread harm it causes. To reduce the danger, we need to repeal the Medicaid exclusion for this population, prioritize health in correctional systems, upgrade quality standards of carceral health, coordinate care within and outside carceral settings, and dramatically reduce the level and consequences of incarceration.

Every year, 700 US women die from pregnancy or delivery complications and 50,000 more face serious health consequences. Maternal mortality rates are rising steadily, with Black women facing much higher risks. To alter these outcomes, we need ambitious national goals for improvement, community-based models of care, insurance coverage aligned with women’s needs, a broad commitment to tackling the racism that weakens maternity care, and research investments.

Antimicrobial resistance kills 35,000 Americans every year and countless more at risk, and threatens effective treatment of cancer, tuberculosis, HIV, malaria and other diseases. Lodging antibiotic stewardship in health systems, reducing consumer demand for antibiotics, taking a coordinated One Health approach to their use in humans, animals and agriculture, redesigning the antibiotic pipeline, and investing in more research are critical to curbing dangerous trends.

Chronic diseases are the leading cause of death and disability in the United States, accounting for 86% of the nation’s $2.7 trillion annual health care expenditures, yet we spend more to treat them than to prevent them. Strategies to reduce the burden include a national campaign to reduce obesity, policies that promote healthy eating, engagement across sectors and at the community levels, and investments in prevention.

In the US alone, some 33,000 people died from opioid overdoses in 2015, a staggering two million people are abusing prescription pain relievers, and the crisis has shown no signs of abating. Confronting the epidemic requires that we reduce overprescribing; reorient policy to treat addiction as a medical condition, not a crime; distribute lifesaving naloxone more broadly; guarantee access to treatment, and invest in research.

Care toward the end of life reflects the best and worst of the American health system: amazing medical advances delivered by dedicated clinicians, but often provided in the context of a fragmented health system, with its attendant high costs and poor coordination and communication among clinicians, patients, and families. New approaches are needed to honor patient preferences and meet their medical, social, and spiritual needs.