Wealthy Americans die sooner than most Europeans, large study finds
A Brown University study of more than 73,000 older adults found that America's richest quartile has no mortality advantage over the poorest in several European countries, with the US gap persisting across the income scale.
America's wealthiest older adults do not live longer than their counterparts in several European countries, according to a Brown University study that challenges the assumption that money alone buys better health. The research, published last year in the New England Journal of Medicine, found that the richest quartile of Americans has no mortality advantage over the poorest quartile in France, Germany and the Netherlands.
The study tracked more than 73,000 adults aged 50 to 85 in the United States and 16 European countries. Researchers drew on the US Health and Retirement Study and Europe's Survey of Health, Ageing and Retirement in Europe, known as SHARE, and followed participants for about a decade beginning in 2010. Lead researchers Sara Machado and Irene Papanicolas of Brown University analyzed how wealth related to death rates across the two regions.
The gap in longevity was large. Wealthy adults in northern and western Europe had mortality rates roughly 35 percent lower than the richest Americans. Adults across continental Europe overall had death rates about 40 percent lower than Americans, and southern Europe showed rates around 30 percent lower. Wealth still mattered within each country, the researchers found, but the American position stood out even at the top of the income ladder.
The findings arrive as the United States posts gains on several economic measures. Median household income reached $87,460 in 2025, a record since the government began tracking the figure in 1967. US life expectancy also rose to 79 years in 2024, another record. Those numbers have not closed the gap with peer nations, which average a life expectancy of 82.7 years, about 3.7 years longer than the American figure.
Health spending helps explain part of the divide. Americans spent roughly $14,775 per person on health care in 2024, about $7,000 more than the average for comparable wealthy countries. Coverage is also less secure. About 26.7 million Americans were uninsured for all of 2025, and enrollment in Affordable Care Act marketplace plans fell by about 2.6 million in early 2026. In the United States, insurance is tied more closely to employment, leaving many people exposed when they change jobs or lose work.
The study points to specific causes of death where the American record diverges. Firearm deaths, alcohol-related deaths and suicides occur at higher rates in the United States, and cardiovascular mortality is also higher. Heart disease and cancer remain the leading causes of death in both regions, but smoking and rural living are more common in the United States, factors that contribute to poorer outcomes.
The researchers acknowledged that important questions remain open. The reasons for the gap among people of similar socioeconomic standing are still unclear, and the recent improvement in American life expectancy is partly tied to the end of the pandemic and a decline in overdose deaths. Those gains may not reflect a lasting change in the underlying drivers of the gap, and the study leaves the explanation for the transatlantic difference unresolved.
Source: fortune.com
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