It's well-established that, on the whole, Americans die younger than people in most other high-income countries. For instance, an analysis from 2022 found that the average life expectancy of someone born in Switzerland or Spain in 2019 was 84 years. Meanwhile, the average US life expectancy was 78.8, lower than nearly all other high-income countries, including Canada's, which was 82.3 years. And this was before the pandemic, which only made things worse for the US.
Perhaps some Americans may think that this lower overall life-expectancy doesn't really apply to them if they're middle- or upper-class. After all, wealth inequality and health disparities are huge problems in the US. Those with more money simply have better access to health care and better health outcomes. Well-off Americans live longer, with lifespans on par with their peers in high-income countries, some may think.
It is true that money buys you a longer life in the US. In fact, the link between wealth and mortality may be stronger in the US than in any other high-income country. But, if you think American wealth will put life expectancy in league with Switzerland, you're dead wrong, according to a study in the latest issue of the New England Journal of Medicine.
A stark finding
The study, led by researchers at Brown University, found that the wealthiest Americans lived shorter lives than the wealthiest Europeans. In fact, wealthy Northern and Western Europeans had death rates 35 percent lower than the wealthiest Americans, whose lifespans were more like the poorest in Northern and Western Europe—which includes countries such as France, the Netherlands, and Switzerland.
"The findings are a stark reminder that even the wealthiest Americans are not shielded from the systemic issues in the US contributing to lower life expectancy, such as economic inequality or risk factors like stress, diet or environmental hazards," lead study author Irene Papanicolas, a professor of health services, policy and practice at Brown, said in a news release.
The study looked at health and wealth data of more than 73,000 adults across the US and Europe who were 50 to 85 years old in 2010. There were more than 19,000 from the US, nearly 27,000 from Northern and Western Europe, nearly 19,000 from Eastern Europe, and nearly 9,000 from Southern Europe. For each region, participants were divided into wealth quartiles, with the first being the poorest and the fourth being the richest. The researchers then followed participants until 2022, tracking deaths.
The US had the largest gap in survival between the poorest and wealthiest quartiles compared to European countries. America's poorest quartile also had the lowest survival rate of all groups, including the poorest quartiles in all three European regions.
While less access to health care and weaker social structures can explain the gap between the wealthy and poor in the US, it doesn't explain the differences between the wealthy in the US and the wealthy in Europe, the researchers note. There may be other systemic factors at play that make Americans uniquely short-lived, such as diet, environment, behaviors, and cultural and social differences.
"If we want to improve health in the US, 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," Papanicolas said.
