A new study led by Brown University researchers reveals that even the wealthiest Americans live shorter lives compared to their European peers, highlighting systemic issues and economic inequalities that undermine U.S. health outcomes.
A recent study led by Brown University’s School of Public Health reveals that wealth does not buy longevity in America to the extent it does in Europe. Over a 10-year period, Americans from all wealth levels have a higher likelihood of dying compared to their European counterparts, according to the study published in the New England Journal of Medicine.
The researchers analyzed data from over 73,000 adults, aged 50 to 85, in the United States and different regions of Europe in 2010 to understand how wealth affects mortality.
The findings showed that, while wealthier individuals tend to live longer, the disparity between the health outcomes of the wealthy and the poor is much more pronounced in the United States than in Europe.
“The findings are a stark reminder that even the wealthiest Americans are not shielded from the systemic issues in the U.S. contributing to lower life expectancy, such as economic inequality or risk factors like stress, diet or environmental hazards,” study author Irene Papanicolas, a professor of health services, policy and practice at Brown, said in a news release.
The study highlighted that the mortality rates among the wealthiest Americans are comparable to those of the poorest Europeans. In countries like Germany, France and the Netherlands, even the least affluent citizens often have better survival rates than America’s wealthiest individuals.
Life expectancy in the United States has been on the decline, which this study attributes to a range of systemic issues including weaker social safety nets and health disparities.
Papanicolas, who directs the School of Public Health’s Center for Health System Sustainability, emphasized the need to look beyond health care systems to understand these differences fully.
“If we want to improve health in the U.S., we need to better understand the underlying factors that contribute to these differences — particularly amongst similar socioeconomic groups — and why they translate to different health outcomes across nations,” added Papanicolas.
The study found that the wealthiest quartile faced a death rate 40% lower than the poorest quartile in their country. Meanwhile, individuals in Continental Europe experienced death rates roughly 40% lower than U.S. participants, and those in Southern Europe had approximately 30% lower rates. Eastern European participants also had lower death rates, though the difference was smaller at 13% to 20%.
“We found that where you stand in your country’s wealth distribution matters for your longevity, and where you stand in your country compared to where others stand in theirs matters, too,” added study author Sara Machado, a research scientist at Brown’s Center for Health System Sustainability.
Systemic cultural and behavioral factors like diet, smoking habits and social mobility were also found to impact these disparities. Higher smoking rates and living in rural areas, linked to poorer health, are more common in the United States compared to Europe.
Another aspect discussed in the study was the “survivor effect.” In the United States, poorer individuals with worse health outcomes tend to die earlier, creating a misleading decline in wealth inequality over time because the population that ages is both healthier and wealthier.
“Our previous work has shown that while wealth inequality narrows after 65 across the U.S. and Europe, in the U.S. it narrows because the poorest Americans die sooner and in greater proportion,” Papanicolas added.
The study concluded with a call to action for U.S. policymakers. The researchers advocate for comprehensive policies targeting broader social determinants of health to bridge the wealth-mortality gap more effectively.
“If you look at other countries, there are better outcomes, and that means we can learn from them and improve,” Machado concluded. “It’s not necessarily about spending more, but about addressing the factors we’re overlooking, which could deliver far greater benefits than we realize.”
Source: Brown University