Some of Europe's Poorest Live Longer Than America's Wealthiest. Study Explains Why

New research highlights a striking contrast in mortality rates between the US and Europe, revealing that even the wealthiest Americans are at a higher risk of dying early compared to their European counterparts, and in some cases, even when compared to the poorest in Europe. While higher income generally correlates with lower mortality risk in both regions, the disparity between the richest and poorest populations is notably greater in the US. The study suggests that this difference may stem from better access to healthcare, social welfare, and stronger social structures in Europe, which are less prevalent in the US.

"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," said Papanicolas, who directs the School of Public Health's Centre for Health System Sustainability. "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."

According to the study, individuals in the wealthiest quartile had a death rate that was 40% lower than for individuals in the poorest quartile. Individuals in continental Europe died at rates approximately 40% lower than participants in the U.S. throughout the study period. Participants from Southern Europe had estimated death rates around 30% lower than U.S. participants over the study period, while participants from Eastern Europe had estimated death rates 13% to 20% lower.

"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," said study author Sara Machado, a research scientist at Brown's Centre for Health System Sustainability. "Fixing health outcomes is not just a challenge for the most vulnerable - even those in the top quartile of wealth are affected."

The study, which analysed data from the US Health and Retirement Study and Europe's Survey of Health, Ageing and Retirement, underscores how weaker social safety nets and structural disparities in the US may contribute to poorer survival rates across all wealth groups. These shortcomings disproportionately affect the poorest residents but ultimately leave even the wealthiest Americans more vulnerable than their European counterparts, the researchers argued.