Comparing wealth and survival rates in the U.S. with those in Europe, researchers found that over a 10-year period, Americans at all wealth levels were more likely to die than Europeans.
The findings were detailed in a new study in the New England Journal of Medicine by a team led by researchers at Brown University’s School of Public Health (“Association between Wealth and Mortality in the United Sates and Europe“).
The analysis compared data from more than 73,000 adults in the United States and various parts of Europe, aged 50 to 85 in 2010, to determine how wealth affects a person’s chances of dying. The results revealed that people with more wealth tend to live longer than those with less wealth, particularly in the United States, where the gap between rich and poor is much wider than in Europe.
The comparison data also showed that at every level of wealth in the United States, mortality rates were higher than in the regions of Europe the researchers studied. The richest Americans have a shorter life expectancy on average than the richest Europeans. In some cases, the richest Americans have survival rates on par with the poorest Europeans in western parts of Europe, such as Germany, France and the Netherlands.
Life expectancy in the United States has been declining in recent years, said study author Irene Papanicolas, a professor of health services, policy and practice at Brown. The study provides a more detailed picture of life expectancy across demographic groups in the United States compared to different parts of Europe.
The findings are a stark reminder that even the wealthiest Americans are not immune to the systemic problems in the United States that contribute to lower life expectancy, such as economic inequality or risk factors such as stress, diet or environmental hazards.
According to the study, people in the richest quartile had a 40% lower mortality rate than people in the poorest quartile. People in continental Europe died at rates about 40% lower than U.S. participants throughout the study. Participants from southern Europe had estimated mortality rates about 30% lower than U.S. participants during the study, while participants from eastern Europe had estimated mortality rates 13% to 20% lower.
The study, which analyzed data from the U.S. Health and Retirement Study and the European Health, Aging, and Retirement Survey, highlights how weaker social safety nets and structural inequalities in the U.S. may contribute to poorer survival rates across wealth groups. These deficiencies disproportionately affect the poorest residents, but ultimately leave even wealthiest Americans more vulnerable than Europeans, the researchers argued.
The study noted how systemic cultural and behavioral factors, such as diet, smoking, and social mobility, may also play a role. For example, smoking rates and living in rural areas—both linked to poorer health—were more common in the US.
The researchers also highlighted a “survivor effect” in the US, where the poorest people with worse health outcomes were more likely to die earlier, leaving behind a population that is healthier and wealthier as age groups move forward. This creates the illusion that wealth inequality is decreasing over time, when in fact it is partly due to the premature deaths of the poorest Americans.
The researchers said the findings provide a sobering picture of health outcomes in the US and a call to action for policymakers to address the growing mortality-wealth gap with policies that have a broader focus beyond health system deficiencies.
