Several recent studies have documented a slowdown in rates of improvement in mortality in the United States (Case and Deaton 2017; Crimmins et al. 2011; Institute of Medicine and National Research Council 2013; Kochanek et al. 2016; Squires and Blumenthal 2016). Middle-aged white women have actually experienced rising mortality over much of the past several decades (Astone et al. 2015; Case and Deaton 2015; Kochanek 2016). The relatively slow declines in US mortality occur against a background in which US mortality was already high by standards of other OECD countries (Crimmins et al. 2011; Institute of Medicine and National Research Council 2013; Ho 2013; Ho and Preston 2010; Palloni and Yonker 2016). In this paper, we describe recent patterns of change in US adult death rates by age in comparison to those of other OECD countries. This age-pattern of change has received relatively little attention in previous accounts.