April 03, 2025
Wealthy Americans have a survival rate comparable to the poorest individuals in Northern and Western Europe, as well as to Eastern Europeans overall.
A new study reveals that poor Europeans can expect to live as long as, or even longer than, wealthy Americans.
Health and longevity are often linked to wealth, which provides better access to education, stable jobs, nutritious food, and quality healthcare. However, research published in the New England Journal of Medicine shows that even the poorest individuals in countries like the Netherlands and France tend to outlive affluent Americans.
The study analyzed data from nearly 74,000 people across the U.S. and 16 European nations, all aged 50 to 85 in 2010, tracking their survival through 2022.
The study divided Europeans into three regions: northern and western Europe (Austria, Belgium, Denmark, France, Germany, the Netherlands, Sweden, and Switzerland), southern Europe (Italy, Portugal, and Spain), and eastern Europe (Czech Republic, Estonia, Hungary, Poland, and Slovenia).
During the study period, the U.S. had a death rate of 6.5 per 1,000 people, significantly higher than Europe’s rates—2.9 in northern and western Europe, 4.9 in southern Europe, and 5.8 in eastern Europe.
The Link Between Health and Wealth
While wealth and survival rates were connected in every country, the U.S. showed the widest gap between the richest and poorest individuals. The study found that the lowest-income Americans had the poorest survival rates, dying younger than their European counterparts.
Even wealthy Americans fared worse than many Europeans. Their survival rates were lower than those of wealthy individuals in southern Europe and lagged behind people of all income levels in northern and western Europe. In fact, wealthy Americans had survival rates similar to the poorest individuals in northern and western Europe and comparable to eastern Europeans overall.
“The findings are a stark reminder that even the wealthiest Americans are not immune to the systemic issues affecting life expectancy in the U.S.,” said Irene Papanicolas, a health economist at Brown University, which led the study.
While Americans and Western Europeans generally have higher incomes than people in other regions, the study highlights that health outcomes are influenced by more than just financial wealth.
What matters most is how wealthy someone is relative to their fellow citizens. The U.S. has one of the widest wealth gaps among developed nations, along with weaker social support systems and limited access to healthcare. These factors contribute to the significant mortality gap between rich and poor Americans.
As a result, the poorest Americans have lower survival rates than their European counterparts, while even the wealthiest in the U.S. do not experience the same longevity benefits seen in many European nations, the researchers noted.
“Improving health outcomes isn’t just a concern for the most vulnerable— even those in the top wealth quartile are affected,” said Sara Machado, a researcher at Brown University and one of the study’s authors.
The Role of Social Infrastructure
While the study did not compare individual European countries, the stronger health outcomes for poorer individuals in northern and western Europe likely reflect the impact of robust welfare programs, according to Dr. Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine and former president of the European Public Health Association (EUPHA).
“This is strong evidence that a well-functioning welfare state benefits everyone, including those who see themselves as at least middle class,” McKee told Euronews Health. He was not directly involved in the study.
Researchers accounted for various factors across all countries, including gender, marital status, education level, urban or rural residence, smoking habits, and pre-existing health conditions such as cancer or diabetes.
This analysis helped researchers isolate the direct connection between wealth and survival over time. However, other unmeasured factors, such as race and ethnicity, could also influence outcomes.
Additionally, the study divided participants into just four wealth groups, which may obscure more extreme disparities between the richest and poorest individuals, according to Dr. Martin McKee.
“The real concern in both Europe and the U.S. is the growing concentration of wealth among the top 1 to 2 percent, not just the top 25 percent,” McKee said, suggesting that the study may underestimate the full extent of the issue.
Despite these limitations, the study’s authors believe the U.S. can take inspiration from European countries to improve life expectancy and overall well-being.
(Source)