Wealth and Mortality in the United States and Europe
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- Thu, 3 Apr 2025
A new study published in the New England Journal of Medicine reveals that Americans across all wealth levels face higher mortality rates than their European counterparts over a 10-year period. The research, led by experts at Brown University’s School of Public Health, compared data from more than 73,000 adults aged 50 to 85 in the U.S. and various regions of Europe.
The findings highlight a significant disparity: while wealthier individuals tend to live longer than those with fewer financial resources, this effect is particularly pronounced in the U.S., where the gap between rich and poor is much wider than in Europe. Even among the wealthiest Americans, life expectancy falls short compared to Europe’s affluent populations. In some cases, wealthy Americans have survival rates similar to the poorest individuals in Western European nations like Germany, France, and the Netherlands.
These findings highlight the fact that even the wealthiest Americans are not immune to systemic issues that contribute to lower life expectancy, such as economic inequality and risk factors like stress, diet, and environmental hazards. There is a need to better understand these disparities to improve health outcomes across socioeconomic groups.
According to the study, individuals in the wealthiest quartile had a 40% lower mortality rate than those in the poorest quartile. Continental Europeans had a mortality rate approximately 40% lower than their American counterparts. Southern Europeans had a death rate about 30% lower than Americans. Even in Eastern Europe, where health outcomes are generally poorer, mortality rates were still 13% to 20% lower than in the U.S.
Study researchers found that both an individual’s wealth and their country’s overall wealth distribution impact longevity. Hence, fixing health outcomes isn’t just about addressing the most vulnerable—those in the top quartile of wealth are affected, too.
The study suggests that weaker social safety nets and systemic disparities in the U.S. contribute to poorer survival rates across all wealth groups. While these issues disproportionately affect the poorest residents, even the wealthiest Americans remain more vulnerable than their European counterparts.
Other contributing factors include cultural and behavioural influences such as smoking rates, dietary habits, and social mobility. The study also identified a “survivor effect” in the U.S., where poorer individuals with worse health outcomes die earlier, creating the illusion that wealth inequality decreases over time. In reality, this narrowing is largely due to the early deaths of lower-income Americans.
The findings provide a sobering perspective on U.S. health outcomes and serve as a call to action for policymakers. Other countries have better outcomes, which means one can learn from them and improve. It’s not necessarily about spending more—it’s about addressing the factors that have been overlooked, which could yield far greater benefits than is currently realised.
Source: Brown University
Image Credit: iStock
References:
Machado S et al. (2025) Association between Wealth and Mortality in the United States and Europe. NEJM. 392:1310-1319.
