Why Wealthy Americans Are Dying Earlier than Wealthy Europeans and What This Means For You?

While many are aware that individuals with higher incomes tend to live longer, recent research reveals a startling reality. While researchers, including Sara Machado, Ph.D., a researcher and research scientist at the Center for Health System Sustainability at Brown University, had expected to find disparities between rich and poor across the countries they studied, they were surprised to find what the data told them about the differences between patients in the U.S. and Europe.

"The plot twist is that even the wealthiest quartile of Americans does not have better outcomes than most of northern and Western Europeans," Machado said. "That was unexpected and counters a lot of the narrative that we're used to."

Below, we examine key findings from this research and why your retirement planning might be more important for your longevity than you realize.

Key Takeaways

Even the wealthiest Americans have higher mortality rates than their European peers; the wealthiest 25% of people in northern and western Europe had mortality rates about 35% lower than the wealthiest quartile in the U.S.
Across all wealth levels, Americans are more likely to die sooner than Europeans; individuals in continental Europe died at rates about 40% lower than participants in the U.S. during the study period.

America's Premium Price for Shorter Lives

In broad strokes, much was already known about the differences between the U.S. and Europe in health outcomes, including a growing gap in life expectancy. Reasons typically given for the differences between the U.S. and Europe include the following:

Americans’ sedentary lifestyles and poor diet lead to higher rates of obesity and chronic diseases.
Disparities in health insurance coverage as millions of Americans remain uninsured (8.2% of the population) or underinsured.
An inefficient healthcare system that pays far more for worse outcomes, about $13,432 per person as of 2023 or about 81% more than U.S. peer countries.
European healthcare systems are also known for emphasizing primary care and prevention, while the U.S. system is more fragmented, profit-driven, and focused on pricier forms of specialized care.

What the New Research Tells Us

The study from Machado and her colleagues takes this picture and fills in far more detail. Since 2010, they have tracked over 73,000 adults aged 50 to 85 from the U.S. and 16 European countries. Individuals in the wealthiest 25% of the population across both regions were 40% less likely to die during the study period than those in the poorest quarter. But if you’re going to be wealthy, it’s better for your health if you’re European: the wealthiest 25% of people in northern and western Europe had mortality rates about 35% lower than participants in the wealthiest quartile in the U.S.

Most surprising, however, was that the wealthiest individuals in the U.S. had health outcomes comparable to those found in the poorest populations of Western Europe. Other notable findings from the study:

Individuals in continental Europe died at rates about 40% lower than participants in the U.S. during the study period; in southern Europe.
In both regions, greater wealth is associated with lower mortality; however, the health gap between rich and poor is significantly wider in the U.S. than in Europe.

A Collective Problem, But There Are Still Things You Can Do

These findings reveal that even the wealthiest Americans are not immune to the systemic disadvantages affecting U.S. health outcomes. They also challenge a common narrative that wealth shields you against poor health outcomes.

However, Machado's research isn't just telling you to give up if you're not wealthy already or because wider societal forces are at play. "There is a lot of it that is a collective issue," Machado said. "But I would say to individuals that you really need to think about your retirement—about when you're going to retire, how you're going to retire, and how you can be happy as a person that has retired."

Put another way, building savings when you can is a health issue as much as a financial one.

Bottom Line

Despite far higher per-capita healthcare spending, the U.S. faces a wider gap in life expectancy between the rich and poor, and even between the wealthiest Americans and all but the poorest in much of Europe. While you can't change this societal picture on your own, there are financial ways to improve your own health prospects as you grow older.