It's really easy to get a license in the US and cops focus on looking for speeders over other forms of dangerous driving.

It's mostly not that people in the US drive worse, it's that people in the US drive more. Similar risk multiplied by more miles leads to more fatalities.

Sadly that isn't the case: The actual fatalities and accidents per billion km driven is higher in the US than many other industrialized countries, so it's not about more km/miles being driven in the US: https://en.wikipedia.org/wiki/List_of_countries_by_traffic-r...

In terms of fatalities per billion km the US is between Belgium and New Zealand. Not really up there with Somalia.

And the ranking there is kind of misleading because the types of countries that collect fatalities per unit distance at all are the ones that tend to do really well on it. We don't have the data for Russia or China but guesstimating based on accidents per 100k vehicles, it's bad.

Whereas e.g. Germany does really well. But fatalities per unit distance for the US isn't even twice the number in Germany, whereas in terms of fatalities per 100k population, the US is 335% of Germany. Consistent with the bulk of the difference being explained in terms of more miles traveled.

Are they also reluctant to wear seat belts?

Seat belt usage is about the same: https://en.wikipedia.org/wiki/Seat_belt_use_rates_by_country

I'd be curious to know what exactly makes the difference so pronounced.

My pet theory is that people don't know how dangerous their actions are _and_ feel entitled to break laws they deem useless. About 4 times out of 5 when somebody nearly hits me blowing through a stop sign and crosswalk they'll stop and apologize profusely, indicating they probably didn't intend to put me in harm's way. That's not a huge dataset though (at most a few times per week), and it doesn't say anything about tailgating or other forms of dangerous driving.

Several things will need to change for that number to be lower. Licenses needs to be much more difficult to obtain, and a lot easier to lose. There are things allowed on American roads that could cost you your license in countries with lower numbers. Cars should have higher safety standards.

Basically a lot of people wouldn't be able to drive anymore.