A groundbreaking study shows that wealthy Americans’ survival rates are on par with the poorest residents of northern and western Europe—and even eastern Europeans overall. Meanwhile, poor Europeans often outlive rich Americans, exposing a stark health and wealth divide. Published in the New England Journal of Medicine, this research uncovers how even the richest in the U.S. struggle with lower life expectancy compared to many Europeans.
Wealth and Health: A Global Comparison
Health and longevity are deeply tied to income, with wealth typically unlocking better education, high-paying jobs, nutritious diets, and top-tier healthcare. Yet, the study reveals that even the poorest citizens in countries like the Netherlands and France outlive affluent Americans. Analyzing nearly 74,000 people aged 50-85 from 2010 to 2022 across the U.S. and 16 European nations, researchers divided Europe into three regions: northern and western Europe (Austria, Belgium, Denmark, France, Germany, Netherlands, Sweden, Switzerland), southern Europe (Italy, Portugal, Spain), and eastern Europe (Czech Republic, Estonia, Hungary, Poland, Slovenia).
The U.S. recorded a death rate of 6.5 per 1,000 during the study period—far higher than northern and western Europe’s 2.9, southern Europe’s 4.9, and eastern Europe’s 5.8. These findings highlight a troubling trend: America’s wealthiest citizens lag behind in survival rates, matching only the poorest in some European regions.
The U.S. Health Gap: Rich vs. Poor
While wealth boosts survival everywhere, the health disparity between America’s richest and poorest is wider than in any European country studied. Poor Americans face the lowest survival rates globally, dying younger than their European counterparts. Surprisingly, even wealthy Americans fare worse than many Europeans, with survival rates trailing rich southern Europeans and all residents of northern and western Europe—regardless of income.
“The wealthiest Americans aren’t immune to systemic U.S. health challenges driving down life expectancy,” said Irene Papanicolas, a Brown University health economist who led the study. Despite higher average incomes in the U.S. and western Europe, wealth alone doesn’t guarantee longevity. Relative wealth—how rich someone is compared to their peers—matters more, especially in the U.S., where extreme income inequality, weak social safety nets, and limited healthcare access amplify mortality risks.
Why Poor Europeans Outlive Rich Americans
The study pinpoints America’s “weaker social structures” as a key factor. Northern and western Europe’s robust welfare systems likely explain why even their poorest citizens live longer. Dr. Martin McKee, a European public health expert from the London School of Hygiene and Tropical Medicine, told Healthbeyondyears, “A strong welfare state benefits everyone, including the middle class.” This social infrastructure contrasts sharply with the U.S., where healthcare disparities and inadequate support widen the mortality gap between rich and poor.
“Improving health outcomes isn’t just about helping the vulnerable—even the top 25% of wealthy Americans are affected,” noted Sara Machado, a study co-author from Brown University. The research adjusted for variables like gender, education, smoking, and chronic illnesses (e.g., cancer, diabetes), isolating wealth’s direct impact on survival.
Hidden Factors and Future Insights
While the study grouped participants into four wealth tiers, McKee suggests this may understate the extremes. “The real issue lies with the top 1-2% of wealth holders, not just the top 25%,” he said, hinting that disparities could be even starker. Unmeasured factors like race and ethnicity may also influence outcomes, warranting further research.
Lessons from Europe: Boosting U.S. Life Expectancy
The study offers a clear takeaway: the U.S. can learn from Europe to improve longevity across all income levels. Countries with better health outcomes demonstrate the power of universal healthcare, strong welfare programs, and narrower wealth gaps. “Other nations show us what’s possible—we can adopt their strategies to enhance American well-being,” Machado said.Bridging the Health-Wealth Divide
This eye-opening research underscores a critical truth: wealth doesn’t guarantee a longer life in the U.S. as it does in Europe. With poor Europeans outliving rich Americans and even the wealthiest U.S. citizens trailing behind, it’s time to address systemic flaws. By strengthening social infrastructure and healthcare access, the U.S. could close the survival gap and boost life expectancy for all.
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