On a global scale, it is commonly true that an individual’s wealth correlates directly with their health and life expectancy. This makes perfect sense; the wealthier an individual is, the more funds they have to spend on treatment, medicine, and various life-enriching procedures. However, according to a recent publication in The New England Journal of Medicine, this dynamic shifts when comparing the rich and poor in the US and Europe.
The research, conducted by Irene Papanicolas, a health services professor at the Brown School of Public Health, involved a sample of 73,000 individuals from both America and Europe, aged between 50 and 85. While the initial results aligned with prior studies indicating that wealthier individuals tend to live longer, the transcontinental comparison revealed an unexpected outcome.
The richest Americans had a lower life expectancy than their wealthiest European counterparts. They even fell short of that of the poorest individuals in certain European nations like Germany, France, and the Netherlands.
A Call to Arms for US Health
In a statement from her institution, Sara Machado, a researcher at Brown University and co-author of the study, argues that her findings present a humbling experience for the United States and serve as a call to action for policymakers who have the power to improve national health.
“If you look at other countries, they have better results, and that means we can learn from them and improve,” she says. “It’s not about spending more; it’s about addressing the factors we’re overlooking that could give us greater benefits than we think.”
What Is the US Doing Wrong?
According to the study, the richest 25% of individuals had a 40% lower mortality rate than those in the poorest quartile.
Furthermore, European participants died at approximately 40% lower rates than those in the United States throughout the study period.
This data offers additional insight into why, in recent years, life expectancy in the world’s most powerful country, where the planet’s greatest scientific and medical breakthroughs arise, has been declining.
Wealth Does Not Equal Health
Papanicolas acknowledges that “there are many differences we observed between the United States and Europe, but it’s not clear how they explain the health advantages of Europeans over Americans.”
The study found that many of the determinants associated with longer survival, such as having a college education, not smoking, or being married, are more concentrated among the wealthiest 25% of Americans, which would explain the large gap in life expectancy between rich and poor in that country. In Europe, factors such as education and smoking are more evenly distributed.
“Wealth can influence health by affecting access to education, job opportunities, healthcare, and social networks, all important predictors of health,” the researcher notes. “Possibly, the more generous social safety net in Europe also exerts a protective effect on the survival of those with fewer resources, and wealth status matters less overall,” she adds. “This finding tells us that, although wealth is linked to health everywhere, in Europe, especially in the north and west, less wealth is needed to achieve better life expectancy than in the United States.”
“If we want to improve health in the US, we need to understand better the underlying factors that contribute to these disparities, especially among similar socioeconomic groups, and why they translate into different health outcomes across countries,” Papanicolas says.
Beneito’s Final Thoughts
Miguel Ángel Martínez Beneito, lead author of the National Mortality Atlas in Spain, highlights that the most striking aspect of the work published is the transversality of mortality across all economic groups in the US.
“This means that this excess mortality goes beyond economic issues, because it seems that there are very wealthy people who do not have access to a healthcare system as comprehensive as Europe’s, or who are exposed to higher cumulative risk factors than Europeans,” he points out. “Now we must open lines of research to determine what factors explain the data, and how to improve access to a healthier life for all of American society.”
