I believe they are implying that the US itself isn't in a healthy state. Economic disparity mostly, but also politically, socially, and likely physically. I think many would agree.

As in:

- Life expectancy at birth is lower than nearly all other high-income countries

- Preventable and treatable mortality rates are well above the OECD average

- Adult obesity rate is the highest among peer nations

- Infant mortality rate is worse than most developed countries

- Maternal mortality rate is dramatically higher than other wealthy nations

- Suicide rate exceeds the OECD average

- Drug overdose death rate is the highest in the developed world

- Prevalence of multiple chronic diseases is unusually high

- Physical inactivity rates exceed those of peer countries

- Healthcare spending per capita is the highest globally while outcomes lag peers