Poor Europeans live longer than rich Americans, study reveals stark contrast
Published in the
New England Journal of Medicine,
the study tracked nearly 74,000 individuals aged 50 to 85 across the US and 16 European countries from 2010 to 2022. Surprisingly, some of the poorest Europeans were found to outlive even the wealthiest Americans, revealing deep disparities tied to national healthcare systems and social structures.
Europe vs. US: Wealth doesn't guarantee longevity
Researchers divided Europe into three regions—northern and western, southern, and eastern—comparing survival rates to those in the United States.
The US had the highest overall death rate at 6.5 per 1,000 people, while northern and western Europe had a much lower rate of 2.9. Even more telling, wealthy Americans had lower survival rates than everyone in northern and western Europe and were only on par with the poorest in those regions.
This pattern persisted across multiple metrics. The poorest Americans died younger than their European counterparts, and the survival gap between America's rich and poor was the widest of any nation studied.
According to researchers, factors like income inequality, limited access to healthcare, and weaker social support structures in the US help explain this disturbing trend.
The role of welfare systems and social support
Experts say Europe's stronger welfare policies likely play a major role in these outcomes. Countries like the Netherlands, France, and Germany provide broader access to healthcare, affordable housing, and public support for aging populations.
Dr. Martin McKee, a professor of European public health, noted that robust social safety nets benefit not just the poor, but the middle class as well.
Europe's universal healthcare systems, along with preventive care programs, income support, elder care, and housing assistance, create a protective framework that sustains public health across all socioeconomic groups. These policies don't only improve outcomes for those at the bottom—they raise the baseline for everyone.
In contrast, the US approach—heavily reliant on employer-based insurance, private healthcare, and minimal government intervention—excludes millions and creates gaps even among those with stable incomes.
The study controlled for major risk factors such as gender, education, smoking habits, and chronic illnesses, which strengthens its conclusion that national policy—not just personal behavior—plays a pivotal role in longevity. However, it did not account for the influence of racial disparities or the ultra-wealthy 1%, which researchers say could further widen the inequality picture. Still, the core message remains stark: a society's collective investment in healthcare and social support directly impacts how long and well its people live.
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