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United States of America (USA) - Overview

The United States of America is the third largest country in the world, with coastlines on both the Atlantic Ocean and the Pacific Ocean and borders with Canada to the north and Mexico to the south. Due to its vast size, it has many diverse landscapes, climatic conditions, and cultural traditions. Geographically, the mainland (excluding Hawaii and Alaska) consists of a vast central plain, with mountains to the west and hills and low mountains in the east. Mainland USA is commonly referred to as the “the contiguous 48” or “the lower 48,” meaning the 48 States that lie between Canada and Mexico.

The capital of the USA, and seat of government, is Washington, D.C. (formally, the District of Columbia). Washington, D.C. is often simply called Washington and can therefore be confused with the state of Washington; for this reason, most people refer to the state of Washington as Washington State. Washington, D.C. is not a state on its own, nor is it part of a state; instead, it is a separate municipality nestled between the states of Virginia and Maryland.

The largest cities in the United States include New York City, Los Angeles, Chicago, Houston, and Philadelphia. In contrast to the crowded, bustling cities with their high-rise modern buildings, much of rural America has a fairly low population density; agriculture is still an important form of economic activity, and traditional social norms and values are still very strong.

The USA also holds several overseas territories. These include Puerto Rico, the US Virgin Islands, American Samoa, Guam, the Northern Mariana Islands, and the United States Minor Outlying Islands.

The United States has a federal structure, with its 50 states enjoying a high degree of autonomy and self-government. The United States has the largest economy in the world, controlled almost completely by the private sector.

America has for centuries been a country of high immigration, and the population includes a large number of different races and nationalities from around the world, many attracted by the freedom and opportunities offered by the United States. American culture has spread around the world through the influence of TV and cinema, contributing to a continuing inflow of foreign nationals chasing “The American Dream.”

While earlier European immigrants who came to America in the 19th and early 20th centuries tended to assimilate into the existing population, recent groups such as the many Hispanic groups have kept their own cultural and ethnic identities to a greater extent. There are major differences between regions of the United States in the racial and ethnic composition of their local populations, with the highest concentrations of recent immigrants, mainly from Mexico and other Latin America countries, living in California and the New York City area.

For more information regarding the demographic make-up of the US, visit the US Census Bureau's web site at www.census.gov.

Although rates of immigration to the United States from other western countries are relatively low these days, all of America's main cities and many of its towns have very cosmopolitan populations with foreign nationals from all over the world, some of whom are working in the United States on a temporary basis, others who are there permanently and seeking to become citizens. In some parts of rural America, however, the population is predominantly white, while other areas such as the southern states have particularly large African-Caribbean populations.

The Immigration Statistics Yearbook published by the State Department (www.dhs.gov/ximgtn/statistics/publications/yearbook.shtm) and the Immigration Statistics published by the Department of Homeland Security (www.dhs.gov/ximgtn/statistics) has more information about immigration rates.

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Expat Health Insurance Partners


Our award-winning expatriate business provides health benefits to more than 650,000 members worldwide. In addition, we have helped develop world-class health systems for governments, corporations and providers around the world. We want to be the global leader in delivering world-class health solutions, making quality health care more accessible and empowering people to live healthier lives.

AXA - Global Healthcare

As the global healthcare specialists for AXA, the world’s number one insurance brand, we can help you get fast access to expert medical care, whenever and wherever you need it. All our plans include evacuation and repatriation, a second medical opinion service and extra support from a dedicated case manager if you’re diagnosed with cancer. You’ll also have 24/7 support from our caring multilingual team - we’ll always remember you’re a person, not a case number.

Bupa Global

At Bupa we have been helping individuals and families live longer, healthier, happier lives for over 60 years. We are trusted by expats in 190 different countries and have links with healthcare organisations throughout the world. So whether you're moving abroad for a change of career or a change of scene, with our international private health insurance you will always be in safe hands.


Cigna has worked in international health insurance for more than 30 years. Today, Cigna has over 71 million customer relationships around the world. Looking after them is an international workforce of 31,000 people, plus a network of over 1 million hospitals, physicians, clinics and health and wellness specialists worldwide, meaning you have easy access to treatment.