r/science Professor | Medicine 1d ago

Health Even the richest Americans face shorter lifespans than their European counterparts. Over a 10-year period, Americans across all wealth levels were more likely to die than Europeans. People with more wealth still lived longer, especially in the US, where the gap between rich and poor is much larger.

https://www.brown.edu/news/2025-04-02/wealth-mortality-gap
7.0k Upvotes

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u/nimwue-waves 1d ago

I am surprised nobody mentioned social quality and sense of community as a major factor. I think the American attitude of rugged individualism and isolationism is leading to more loneliness with few or no deep and meaningful friendships and community connections across every income level. Poor social quality significantly deteriorates health and lifespan.

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u/Curious_Charge9431 22h ago

The loneliness problem in America is huge.

The problem is not one of attitude, Americans are social creatures just like anyone else. In fact, one of the main stereotypes for Americans is their willingness to engage with strangers.

The problem is one of infrastructure: the country is stupidly car centric. There is no commons for people to meet in. There's work, there's shopping, they's single family homes, and everyone is stuck in traffic in their own cars which they are driving from parking lot to parking lot.

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u/nimwue-waves 22h ago

Yes, I agree. I think our infrastructure and work-life balance is atrocious and drives most of the isolation issues.

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u/SpeckTech314 1d ago

Im curious how it will play out for younger generations. Most have an online community even if they are isolated in real life.

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u/risingthermal 1d ago

I suspect social media overall has an isolating effect. The ability to curate and filter how one comes across online prevents more authentic connection, and leads to identity resembling a brand rather than a personhood. But I am old and perhaps this has changed.

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u/mhornberger 23h ago edited 23h ago

I suspect social media overall has an isolating effect.

Unless it has the opposite. Try being an LGBT or atheist youth in a rural area in the 1970s. There was no one to talk to. Social media let you connect with others like you, to find community, support, affirmation. Talking to someone online is still talking to someone.

All the people I know who sweepingly consider social media isolating either grew up in cities, or were already part of a dominant majority, so they never felt isolated without it.

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u/setsewerd 21h ago edited 20h ago

Not disagreeing, but worth pointing out that you're technically saying people who were already more isolated/lonely than the average person found social media helpful, but for the dominant majority it wouldn't be as much the case. I.e. LGBT people have a more difficult social baseline (especially a few decades ago) so a subpar social experience is often an improvement.

To add to your point though, I'm in the dominant social majority but had pretty bad social skills when I was young in the early 2000s (possibly some undiagnosed neurodivergence), and the Internet overall was definitely helpful for finding that affirmation among people who felt similarly alienated.

As I got older though and found my people IRL, I started to recognize that social media wasn't enough to address that loneliness compared to in person. And often was doing more harm than good (especially with Instagram, Facebook, and Snapchat in my case).

Reddit is the last platform I use regularly, because aside from knowledge and entertainment it offers a lot of interesting discussion, so maybe this point should be platform specific.

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u/SpeckTech314 1d ago

I think it’s also possible that there’s an equalizing effect. People who would normally find themselves isolated without social media, e.g. TikTok, discord, Skype, etc. could see an increase in quality of life vs people with strong communities IRL having social media degrade what they already have.

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u/SkutchWuddl 1d ago

I'd guess esoteric social characteristics have a lot less of an impact than the material condition of public access to Healthcare services.

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u/nimwue-waves 1d ago

When you're wealthy, you have access to all of the best health care. I knew a millionaire who flew to Europe multiple times to get the most innovative treatment for his cancer. So that would not be a major factor for wealthy Americans. But he was lonely and didn't treat his family or friends very well.

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u/SkutchWuddl 23h ago

Having to fly to Europe is still a barrier to receiving healthcare that people in Europe don't have, a material condition, regardless of weather or not someone can afford it.

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u/Isord 7h ago

I don't know why they used flying to Europe as an example tbh. The US has some of the best healthcare in the world available if you are rich enough. It's extremely unlikely that access to healthcare explains the gap in life expectancy for wealthy Americans vs Wealthy Europeans.

I'd imagine sedentary lifestyle and loneliness to play bigger roles. You can be as rich as sin and still not get enough exercise. It's more normal in Europe for even very wealthy people to commute via transit and walking.

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u/Isord 7h ago

I don't know why they used flying to Europe as an example tbh. The US has some of the best healthcare in the world available if you are rich enough. It's extremely unlikely that access to healthcare explains the gap in life expectancy for wealthy Americans vs Wealthy Europeans.

I'd imagine sedentary lifestyle and loneliness to play bigger roles. You can be as rich as sin and still not get enough exercise. It's more normal in Europe for even very wealthy people to commute via transit and walking.

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u/Memory_Less 17h ago

Agreed. I think it is the implied point aka the ‘sacred’ elephant in the room.

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u/kfractal 1d ago

i'm going to bust out some high level science and just claim this is a correlation with stress.

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u/Compy222 1d ago

Or just dramatically less walking/moving

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u/Fumquat 1d ago

Nutrition as well.

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u/ImFamousYoghurt 1d ago

Lower standards for meat etc.

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u/Thestohrohyah 1d ago

I remember when I visited the US and got a burger.

It tasted sweet...

Like yes, I know the sugar and salt marinade technique, but that is used on cuts, not minced meat. It honestly felt wrong.

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u/midnightauro 1d ago

That’s not normal, yuck! Our ground meat does not just normally have sugar in it.

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u/JohnBrownsBobbleHead 1d ago

More Ivermectin, Vitamin A, Codliver Oil, Beef Tallow, and Smecklers Powder

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u/delirium_red 1d ago

Less public health initiatives, access to preventative medicine and affordable medicines, and environmental regulations as well (exposure to pollution).

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u/SleepIllustrious8233 1d ago

Don’t make fun

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u/HarmoniousJ 1d ago

You forgot colloidal silver and a healthy, hearty breath in at a pump of leaded gasoline.

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u/MaleficentSoul 1d ago

the amount of additives in the food around the US that isn't allowed in other countries is astronomical. Wealthier families can afford better food.

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u/Masseyrati80 1d ago

I'm under the impression it's common for Americans to ingest much less fiber than they should.

No country is perfect, but I have been lead to believe it has considerable health benefits, both on the physical and mental side, as it has a lot to do with your gut microbiome, and some countrie's average diets contain a lot more fiber-rich things like root vegetables and whole grain.

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u/sydmanly 9h ago

SAD - standard American diet

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u/Swimming-Mom 1d ago

This! It’s walking and nutrition and less loneliness.

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u/luckydrzew 1d ago

Or, you know, access to medicine.

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u/mtcwby 1d ago

That's typically not an issue among wealthier Americans.

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u/jimmyharbrah 1d ago

True. But you have to wonder if just being acculturated to a society that simply doesn’t go to the doctor or “toughs it out” because going to the doctor is so costly doesn’t have some affect on wealthy people’s going to the doctor. In short, even though they surely love having poor people suffer without healthcare while they have all the access they want, perhaps wealthy people are negatively affected by our horrible healthcare system. It would be fitting

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u/Trust-Issues-5116 1d ago

doesn’t go to the doctor or “toughs it out”

This is hilarious coming form European, where going to a doctor with throat pain will lead to "take camomile tea and come back in a week if it doesn't stop"

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u/DerSchreiner2 1d ago

But you might have the week on paid sick leave (depending on the country)

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u/Cease-the-means 1d ago edited 1d ago

In the Netherlands you can declare yourself sick and are not even legally required to explain to your boss why you are sick for 3 weeks. At that point the company has to contact you via a company doctor, because your boss is not considered an independent or qualified judge of whether you should return to work. If the doctor agrees that you shouldn't be working, you can take up to a year on 70% pay.

Nobody really seems to be abusing this system though,maybe because it's just easier to use some of your 21 minimum paid holidays.

This is just one example of the kind of strong employment and tenancy rights that people have in Europe. Personally I'm fine with paying more tax and earning less than in the US to live in such a country.

Despite all these 'socialist' policies (the government has actually been conservative neoliberale for a long time), the per worker productivity rate in NL is higher than in the UK or US who have the Anglo Saxon 'work hard play hard' mentality. It's almost as if treating employees like livestock doesn't actually bring the best out of them.

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u/Spaghett8 1d ago edited 1d ago

Poor-avg Americans no. But wealthy Americans have access to the most advanced medical care in the world.

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u/maporita 1d ago

Even rich Americans might avoid preventative checkups and tests, particularly young people, if they have to pay out of pocket. Public health systems recognize that the best bang for the buck is catching disease early.

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u/Danny_III 1d ago

Rich Americans are either on their parent's insurance or if they're older than 26 have their own insurance because they're employed. OOP costs even with premiums are significantly less than the taxes for healthcare in countries with universal systems

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u/sajberhippien 1d ago

True, but it is worth considering that worse healthcare for the broad masses can end up negatively affecting the ruling class as well, e.g. through infectious diseases spreading more.

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u/VirtualMoneyLover 21h ago

have access to the most advanced medical care

How about loneliness and community? Does entourage count as community?

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u/SnowceanJay 1d ago

Also, less access to healthcare.

Socialized healthcare does wonders in Europe.

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u/HelenEk7 1d ago

That shouldn't make a difference for the wealthiest Americans though?

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u/VirtualMoneyLover 21h ago

It sure not, but people general tend to sniff their own fart a lot. So just because you are successful in X, you think you are good at medicine too. Then you die...

I also assume they still do eat American and not super healthy, so those 2 alone can make the difference. Throw in over working and stress instead of quitting and you have your explanation.

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u/IamJaegar 1d ago

Not “or”, but “and”.

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u/Hessian_Rodriguez 1d ago

There is also the factor that the average American drives 2 to 3 times more miles than a European annually. Americans die at 2.5 times the rate of Europeans from car deaths.

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u/Dagur 1d ago

I definitely think it's car related. Not just accidents but pollution (air and noise) and the amount of time spent sitting in them.

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u/picklestheyellowcat 1d ago

It's more likely correlated with weight and obesity.

It's a miracle Americans live as long as they do given the obesity issues.

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u/max5015 1d ago

Probably also the healthcare system is not as good in the US as it is in Europe. Our for profit industry does not exactly do it's best to keep you healthy instead ot focuses on covering the symptoms.

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u/UsurpistMonk 1d ago

That’s only relevant for the poorest 50%. The top ~25% get better health care than anywhere in Europe.

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u/max5015 1d ago edited 1d ago

Is there a source for that claim? Do they see exclusive doctors or are these people just able to go to other countries to get better healthcare?

Neither would surprise me cause those bastards seem to live forever

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u/Bay1Bri 1d ago

You make claims without a source them demand sources for others.

Also, the best medical facilities are in the US. Wealthy people travel to the US for healthcare, not the other way around. The quantity of our medical care isn't the problem, access to it for poor people is the problem. This doesn't even touch on the average wait times.

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u/UsurpistMonk 1d ago edited 1d ago

They’re able to pay for the care necessary. On top of that a lot of the very best specialists will be out of network for almost every insurance because dealing with insurance companies is a pain in the ass. So you shell out 20k to see the specialist and then you deal with your insurance to get the 20k back. You don’t actually pay the rates, but you have to front the cash. If you can’t do that then you’re SOL for that doctor

On the other side, look at what kind of insurance teachers in New York State get. You can look up the coverage and costs. To be fair they get amazing coverage, but it’s better than any nationalized program in the world. And cheaper for the teachers.

Statistics can be misleading when distributions aren’t normal.

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u/itskelena 1d ago

Top 25% of whom? Earners? Top 25% of earners won’t be able to shell out 20k for a specialist visit. According to Wikipedia top 25% is people earning over 100k before tax.

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u/semideclared 1d ago

Why is that

Is it a lack of Visits to the Doctor?

  • Physician office visits in 2019 was 1.0 billion for the US
    • Number of visits per 100 persons: 320.7
    • Percent of visits made to primary care physicians: 50.3%
      • Primary care office Visits 521.47 Million
      • Surgical specialty 214.8 Million
  • 46.4% of Office visits, by patient age 24 - 64
    • 480 Million Office Visits
    • U.S. population aged 25 to 64 totaling around 172.2 million people
      • On Average 2.8 Doctors visits a year
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u/hulatoborn37 1d ago

Weight and obesity also correlated with stress. Chicken or egg?

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u/dariznelli 1d ago

They are far more correlated with bad diet and lack of exercise. Let's not sugar coat the main problems in the US. Pun intended.

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u/dnyank1 1d ago

bad diet and lack of exercise

alright, root cause analysis that

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u/dariznelli 1d ago

We're in a science sub, so you are technically correct. I'm in healthcare, so I can say the main focus for obesity treatment is to address diet and exercise. I would have to dig into the research, but I would posit there is much more evidence to support this approach for weight control compared to just stress management. stress can most definitely be a contributing factor, but I have yet to see it cause obesity if a patient already has proper diet and exercise.

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u/dnyank1 20h ago

nope. RCA means finding out WHY 

So WHY are people drawn to poor diet choices, a sedentary lifestyle? 

One of the clearest correlations you can draw is between mental and physical health. 

“Stress” doesn’t just mean ‘feeling pressured’ - obviously.

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u/picklestheyellowcat 1d ago

You can't get fat if you don't eat too much

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u/BishoxX 1d ago

40% of US adults are obese...

Thats the reason

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u/Heavy_Brilliant104 1d ago

You also have terrible infant mortality so its not just stress, its lack of healthcare-

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u/AnAttemptReason 1d ago

How about some of that chlorinated chicken? It's OK, it's clean. (Now). 

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u/DeadlyFern 1d ago

The good news is the high level scientists are moving to Europe.

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u/Seriously_nopenope 1d ago

I’m going to theorize that it has to do with the individualism that is at the core of American culture. We are better off in a community and there are many unmeasured benefits, with health likely being one of them. In America so many people move away from their family and community to strike it out on their own. Rich people even more so are isolated.

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u/battlehotdog 1d ago

Or BMI. In china the BMI increases with wealth and then decreases and in USA they seem constant across wealthy and lower class. (From a quick Google search)

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u/Bay1Bri 1d ago

Yea that's completely untrue. BMI is much higher on the lowest income groups.

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u/battlehotdog 21h ago

What I said about china seems to be true. After reading a bit more it's usually a reverse relationship of BMI and income. But not in this case.

https://pmc.ncbi.nlm.nih.gov/articles/PMC5122533/

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u/Bay1Bri 20h ago

You said:

in USA they [BMI] seem constant across wealthy and lower class.

This is incorrect.

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u/battlehotdog 20h ago

Yes I'm aware and you said it's completely incorrect. I wasn't aware you only meant parts of it

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u/Bay1Bri 15h ago

Ok bud, you just hold on to that if it makes you feel better

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u/scyyythe 19h ago

Try stratifying by gender. IIRC it's very weird (BMI vs income for Americans), with a positive correlation for men and a negative correlation for women. 

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u/battlehotdog 15h ago

Oh damn that is really weird. I wonder if that has something to do with gender disproportion. Men being more often rich and just "buying" love. You see those old rich guys with super models, but maybe that's scewed through the media...

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u/Masseyrati80 1d ago

I've read books by two Finns who got U.S. citicenship and lived there for some years.

Both mentioned how it seems like people have to be much more "on guard" due to the different levels of social safetynets in case anything goes wrong. In Finland, you're one accident or serious illness away from... well, resorting to safety nets. You don't end up in massive medical debt if you fall ill without health insurance, and your risk of ending up living in a car or under a bridge if you're fired is practically zero.

One of them had been t-boned by another motorist and told how while face to face the other driver had admitted it was their fault, apparently upon realizing the financial consequences, went to a mode of full-on denial and blaming the one they had collided with. In Finland, the consequences would be primarily legal, not financial.

A smaller scale example was consumer laws and other regulations, which are, on average, more on the individual citizen's side in Nordic countries and more on the businesses side in the U.S.

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u/Danny_III 1d ago

For example, smoking rates and living in rural areas — both linked to poorer health — were more common in the U.S.

This is from the article. Without being able to see the data, this comes off as poor research. Whoever did the study should control for things like the above, obesity, etc.

Regarding rural areas:

https://www.reddit.com/r/MapPorn/comments/13cuyr/size_comparison_of_texas_and_western_europe_990_x/

That's just Texas. Imagine being in Bern and having to fly to Paris to get care. That's the equivalent of being in a rural location but having to go to an urban center. Urban sprawl doesn't help especially if it's time sensitive like stroke, MI

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u/Bay1Bri 1d ago

Smoking rates are much higher in Europe than the US

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u/Skyremmer102 1d ago

Perhaps also their incredibly high shooting rate and 3rd world level road safety.

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u/beekersavant 1d ago

And a poor healthcare system that now doesn’t even work for the rich.

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u/Sad-Razzmatazz-5188 1d ago

The funny (?) thing is even middle class USAmericans told me that their system is fairer "why would you want your tax money to pay healthcare for a homeless guilty of being a homeless?"

Turns out rich countries manage to spend overall less than the USA and have better healthcare both for the poor and the wealthy, respectively, and with less of a gap.

The USAmerican system has really no more excuses to stand as it is, and it's time for the issue to become bipartisan. Democrats are too light on that and Republicans are completely alienated (the ability of poor Republicans to vote against their interest is astonishing).

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u/Uninterested_Viewer 1d ago

If the US were to switch to a European-style healthcare system, I'd be curious what, if any, impacts it would have on the amount of money invested into drug research. Certainly a lot of bloat throughout the US healthcare system, but presumably some of that extra money being spent is driving incentives for private research? I could be completely off base here and/or fishing for some silver lining.

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u/cornonthekopp 1d ago

Idk if youve been paying attentiom but the vast majority of medical research in the united states is funded by the government. (Or was until trump cancelled them all for being woke).

Private companies get government funds to do medical research which they proceed to privatize and sell back to us at whatever price they want

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u/shitholejedi 1d ago

This isn't anywhere close to true or hasn't been for almost 70 years.

In Basic research government funds are matched by private funds. In majority of medical research upto drug trials and FDA approval it is nearly 70-80% private funds.

https://ncses.nsf.gov/pubs/nsf24332

This is a statement that shouldn't be made if you are aware of any primary sources about science funding in the US.

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u/Sad-Razzmatazz-5188 1d ago

Look up how much of the basic research needed to develop FDA approved drugs is funded by the NIH, and look up the life long expenditure of a USAmerican diabetic vs a French, German or Italian diabetic.

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u/Asbjoern135 1d ago

Yeah thevactual funding for research is done with public money, then the research is bought and commercialised by private corporations

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u/yes______hornberger 1d ago

They do claw a lot of it back, it’s called “march-in rights” and they made a lot of progress in that area under Biden and the former NIH Director.

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u/apistograma 1d ago

It’s kinda funny that the US is hooked on ozempic and it’s essentially a Danish (Novo Nordisk) patent.

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u/cowinabadplace 1d ago

Alzheimer’s affects the people covered by government healthcare and what that caused is that drug companies nearly fraudulently got a drug approved so that the government would end up paying them money.

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u/superioso 1d ago

Look to the UK as an example.

The NHS (national health service) is one of the biggest buyers of drugs in the world, so they have enormous negotiation power to get lower prices for drugs from the pharma companies. They also have massive amounts of anonymised patient data they can use themselves for research, or in partnership with other companies. It's not just about the money they spend but rather how they spend it.

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u/semideclared 1d ago

I dont have the UK, but close. And its not Drugs that are the issue

Canada, Australia, and the US
as Numbers

We spend a lot of money at Hopitals and Doctors Offices and that has to be cut out

50% of that spending is Personal

2.86 million registered nurses in the US, Registered Nurses 2018 Median Pay $71,730 per year

In 2018, The Royal College of Nursing calculated the average weekly pay for an NHS Nurse as being £642, and annually, our figure of £33,384. Or about $44,000 Newly Qualified Nurse start at a Salary of $33,900

  • To progress to Band 6, you will need to pursue some further training within a specialist area to get to $42,700
  • Those with a Master’s level degree or equivalent – Advanced Nurse Practitioners (ANPs), whose advanced training allows them to conduct detailed assessments, make diagnoses and prescribe medicine. have a Starting Salary $52,900

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u/semideclared 1d ago

So, In 2005 The University of Tennessee gets $3 Million in Grant money

A brain cancer stem cell program has been established at the University of Tennessee Health Science Center (UTHSC) Operating as part of the UTHSC Department of Neurosurgery in collaboration with Semmes-Murphey Neurologic and Spine Institute and Methodist University Hospital Neuro-science Institute.

  • the program is funded primarily by the Methodist Healthcare Foundation.
    • Its a Non-Profit Organization, lets pretend the $3 Million is Taxpayer money

"This research team will unite physicians and scientists of diverse backgrounds and will attempt to answer questions about the role of cancer stem cells in all biological aspects of brain tumors from both children and adults,"

That idea leads to answers on Brain Cancer and a Massive Research for the University to this day


But also opens the door to other answers

In 2008 Discgenics, Inc is founded using a Patent from results from the UT Study

  • Discgenics is funded with $7 Million in Capital through Venture Capitalist to see about this Patent

DiscGenics's first product candidate, IDCT (rebonuputemcel), is an allogeneic, injectable discogenic progenitor cell therapy for symptomatic, mild to moderate lumbar disc degeneration.

By January 2023, DiscGenics has raised $71 million in Investor funding to do that, more to come following DiscGenics Announces Positive Two-Year Clinical Data from Study

  • That requires more testing and funding

Should UT have funded the $71 Million and 20 Years of research

Wheres the Profit?

Lets Assume, To Bring the Drug to Market DiscGenics has to raise Another $200 million in funding to do that

$200 Million would be cheap of course. Mabye its More than likely $500 Million

So Total Investment is $400 Million

You get 15 years of selling it

And Research says about ~1 million patients a year will use it

How much do charge?

What kind of Profit is acceptable?

  • That Profit encourages investors to put up the previous $400 Million, or where does the $400 Million come from

u/XXXYinSe 40m ago

Pharma companies spend about 20% of their revenues on R&D in the US. Note that number includes expenses on mergers and acquisitions of assets from smaller biotech companies, they don’t have to do the R&D in-house for it to count.

Europe has 1/2 the sales/revenues of USA pharma (source: https://www.efpia.eu/media/637143/the-pharmaceutical-industry-in-figures-2022.pdf). They also have twice the USA’s population. Adjust that for the purchasing power parity between media US and Europe. Median American makes 58k USD (https://www.census.gov/library/publications/2024/demo/p60-282.html), median European makes 28k(https://www.statista.com/topics/11909/earnings-and-wages-in-europe/#topicOverview). So comparatively, USA spends twice the per capita (as % of average income) amount on drugs.

Europe spends around 15% of their revenues on R&D because pharma is less profitable. So doubling the market size/potential profits only increases the percentage that goes to R&D by 33%. If we could fix our healthcare system in a way that the costs to the patients stays the same, but we cut out healthcare middlemen, maybe we could get closer to actually doubling the rate of Europe’s R&D spend to make it 30% total of revenues here

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u/Ulyks 1d ago

While I fully support your reasoning,

I do wonder what factor obesity plays in this. Obesity rates in the US are much higher. It has a huge impact on healthcare and life expectancy.

And importantly, obesity rates in other countries are also still rising so in the future life expectancy will also be impacted...

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u/Sad-Razzmatazz-5188 1d ago

I am not sure obesity rates of, say, the top 5% are significantly different between US and EU, and I think they are quite different from the respective bottom 50%.

Anyways, that is still a healthcare issue and evenmoreso a systemic one. Is the public sector investing enough in information and prevention for the people? Is the lifestyle more influenced by food industry-induced consumerism? Why so? Etc

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u/Ulyks 1d ago

Yeah, I tried looking up the weight of US and EU billionaires but they aren't disclosing that information...

But you're right about the government in the US not doing enough prevention and not promoting healthy food enough. (European governments are also not doing enough but it's a bit better)

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u/hotredsam2 9h ago

Obesity is a huge factor but also our salaries are just higher here. Nurses make 2-3 times what they make in the EU sometimes more. Doctors can be close to 5-10x. With 70% of the cost of healthcare being labor it makes sense why it wouldn’t be feasible in the states. There’s just not enough people to work.

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u/Lesurous 1d ago

It's because our media landscape is far different than the EU's, it's overly sanitized in the mainstream, downright propaganda on the conservative end. The former paints things as normal and status quo even when it's not (i.e. not calling the Trump administrations actions illegal when they are), while the latter is employed to create echo-chambers of disinformation and rage baiting. Fox "News" is the single biggest pusher of utter garbage and lies, treating Nazi rhetoric as reasonable.

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u/jdjdthrow 1d ago

USAmericans

In English it's just "American".

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u/Sad-Razzmatazz-5188 1d ago

I honestly don't care. I don't want all nations of North, Central and South American to feel conflated or ignored.

We're writing in English but we're not only native English speakers nor only people that care about the US worldview.

Everybody understands what USAmerican means even when reading it for the first time in their life

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u/even_the_losers_1979 11h ago

I’ve never heard of anyone in Canada referring to themselves as North American or anyone from Brazil referring to themselves as American. US American is a solution to a made up problem.

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u/Sad-Razzmatazz-5188 8h ago

I don't care what you have not experienced, I've heard plenty of "Latin Americans" (e.g. Mexicans and Argentinians, so both Mesoamerican and South American people) complain that "America" is not just the USA and "american" should not refer only to "gringos", "yankees", etc.

Canadians are clearly North Americans, of course the specification makes sense when they are talking of both themselves and the USAmerican comparing, say, to South Americans, or to Asians. It's not like the French call themselves Europeans when comparing France and Spain.

I don't care that you don't have a problem, I despise that you think a problem you don't have is a made up problem, and I don't think there's a problem with USAmerican: it's not offensive, it's not ambiguous, and y'all aren't even fully grasping what is bothering y'all. I know what, but I'm not here to tell you and I'm not even here to ask you to use the same words I use.

If the problem is made up, continue ignoring it and don't keep annoying me with useless, uninformative and uninteresting replies

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u/AdmiralAkbar1 1d ago

Democrats are too light on that and Republicans are completely alienated (the ability of poor Republicans to vote against their interest is astonishing).

Always fascinating to see someone proclaim that they know the true interests of a foreign country's voter base better than the voters themselves.

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u/Sad-Razzmatazz-5188 23h ago

Yeah, it's really crazy to imagine a person interest to live healthy for little money rather than die suffering and bankrupt, human nature must be totally different in the US

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u/binkerfluid 1d ago

I dont think we will ever get a euro style healthcare system just because we have SO many jobs in the healthcare/health insurance system. Whoever creates a system that fires them all wont be able to win an election.

I wish we would but it just seems like such a large sector that they will be afraid to touch it, not even our Dem politicians really even talk about it (aside from Bernie)

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u/semideclared 1d ago

I dont think we will ever get a euro style healthcare system just because

Taxes

Its taxes

Jobs will be cut and pay lowered to get there.

But its taxes

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u/mvea Professor | Medicine 1d ago

I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article:

https://www.nejm.org/doi/full/10.1056/NEJMsa2408259

Results

Among 73,838 adults (mean [±SD] age, 65±9.8 years), a total of 13,802 (18.7%) died during a median follow-up of 10 years. Across all participants, greater wealth was associated with lower mortality, with adjusted hazard ratios for death (quartile 2, 3, or 4 vs. quartile 1) of 0.80 (95% confidence interval [CI], 0.76 to 0.83), 0.68 (95% CI, 0.65 to 0.71), and 0.60 (95% CI, 0.57 to 0.63), respectively. The gap in survival between the top and bottom wealth quartiles was wider in the United States than in Europe. Survival among the participants in the top wealth quartiles in northern and western Europe and southern Europe appeared to be higher than that among the wealthiest Americans. Survival in the wealthiest U.S. quartile appeared to be similar to that in the poorest quartile in northern and western Europe.

Conclusions

In cohort studies conducted in the United States and Europe, greater wealth was associated with lower mortality, and the association between wealth and mortality appeared to be more pronounced in the United States than in Europe.

From the linked article:

Even the richest Americans face shorter lifespans than their European counterparts, study finds

A study by researchers at the Brown University School of Public Health found that Americans have poorer survival rates than Europeans across all wealth levels and detailed factors driving the disparity.

Comparing wealth and survival rates in the U.S. with those in Europe, researchers found that over a 10-year period, Americans across all wealth levels were more likely to die than their European counterparts.

The findings were detailed in a new study in the New England Journal of Medicine by a team led by researchers at the Brown University School of Public Health.

The analysis compared data from more than 73,000 adults in the U.S. and different regions of Europe who were age 50 to 85 in 2010 to determine how wealth affects a person’s chances of dying. The results revealed that people with more wealth tend to live longer than those with less wealth, especially in the U.S., where the gap between the rich and poor is much larger than in Europe.

Comparison data also showed that at every wealth level in the U.S., mortality rates were higher than those in the parts of Europe the researchers studied. The nation’s wealthiest Americans have shorter lifespans on average than the wealthiest Europeans; in some cases, the wealthiest Americans have survival rates on par with the poorest Europeans in western parts of Europe such as Germany, France and the Netherlands.

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u/Mundane-Mechanic-547 1d ago

From the author - interview on NPR - the wealthiest Americans age of death (average I guess, i do not know), was similar to the poorest Europeans.

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u/Yami350 1d ago

Numbers would be nice. Just to get a quantitative view.

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u/IneedHennessey 1d ago

Garbage culture, garbage food, garbage cities that can't be walked in safely or biked in. Long hours at work and little to no down time. Sounds like the source too me. (I know not very scientific)

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u/dutchie1966 1d ago

Add ‘access to health care too expensive for a large part of the population’, and you’ve hit all the nails on their heads.

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u/XBA40 1d ago

That is all true, and the US is an obesogenic country, but most people can successfully fight this at an individual level by switching to whole nutritional foods. It is not expensive to eat very healthy in most parts of the US. Only 6% of Americans live in a food desert. Example: An average height male can eat healthy and cook at home, quickly, for under $7 a day in California. It is all very simple, but psychologically difficult for those who weren’t prepped correctly as children. However, most of my low income friends are now switching to healthy eating and hitting the gym multiple times a week. They are moving from 250+ pounds to under 200 this past year, and part of that is me talking about nutrition non stop.

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u/istareatscreens 1d ago

Life in the US looks quite tough. Debt, healthcare, poor employee rights, etc. Also pressure to be consumerist and spend.

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u/Sensitive-Bee3803 8h ago

It's very stressful. Our systems are the worst.

I have been unemployed since the beginning of March. In mid-February I started applying for health insurance and since then that has consumed maybe 20-25 hours of my time. And my case is still going through reviews.

Last year I had to go through the same process. It was my first time to do it and I messed up my application. For the first few months of the year I was enrolled in Medi-Cal. Then in April I received a letter that I wasn't eligible for Medi-Cal. They terminated my coverage and it was made retroactive to Jan 1. so I went from thinking I had coverage to having no coverage and facing penalties for not having coverage. Plus, at that point I was outside of the 60day window for a qualifying event so I couldn't apply for coverage. Without a qualifying event I would be without coverage for the full year. Mid-year I got lucky and had a qualifying event. But the incompetent people with the county couldn't get me removed from the state system associated with Medi-Cal so I was temporarily blocked from getting health insurance.

I was trying so hard to get coverage last year and it was such a struggle.

These experiences have made me cry. I made a good faith effort to get health insurance and they way our system is set up it's just kicking you while you're down. If I had had a major medical event I'd be bankrupt for sure.

On top of this I have spent so much time dealing with other unemployment related stuff that it's like a part-time job. Things really shouldn't be so hard. It's like we have to fight and hustle for everything. It exhausting and depressing.

It might be a good thing that the wealthiest people in the US don't live as long as the poor in Europe. If our wealthy people are impacted then maybe people will take notice and try to change something. Money seems to be the only thing motivating a lot of people over here.

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u/ThatIndianBoi 1d ago

I know this is absolutely anecdotal, but I spent a month in Eastern Europe as part of an international medical rotation. That month was the healthiest I’d ever felt. The food is better for you, or at least it made me feel far less bloated, you have to walk more, and it’s more pleasant to walk because there are things to see.

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u/Thegrillman2233 1d ago

Too much stress, not enough physical activity and too much consumption of ultra processed foods. The bread there tastes like cake given high levels of sugar content.

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u/bluewhale3030 17h ago

I generally agree with you except for the bread. Yes there is some bread high in sugar, but it's very possible to find bread here that doesn't have added sugar. And bread in other countries (such as France) also has sugar added if it's processed bread at the grocery store. Mostly we need to address the social determinants of health and create a society that makes it possible to be healthy physically and mentally, something that we keep moving farther away from due to capitalism and corporate greed (as well as people in charge who hate poor people)

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u/Electrical-Reason-97 1d ago

I just returned from Europe. Even though US mega corps are doing their best to shove sugary crap down the throats of Europeans, the quality of the raw ingredients is unmatched as are prepared meals and restaurant foods. All Italians and French I know drink wine, eat fruits, veggies and fish, don’t snack and eat less meat and drive less than we do as a whole. Their carbon footprint, on average is 1/3 to 1/2of ours. Access to health services is universally decent even in southern areas of both countries. All of these factors contribute to a better quality of life and longevity. There is overwhelming data to support these broad statements.

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u/is0ph 1d ago

even in southern areas of both countries

That’s an interesting view, probably a little US-based. The most disenfranchised area in France is the northeast. But the north-south divide seems valid in Italy.

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u/apistograma 1d ago

I’m a wine drinker but it’s not really healthy. On the other hand we drink less soda and that’s very important for public health.

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u/nickiter 22h ago

It seems clear at this point that the US food system is resulting in much worse health outcomes for people who live here, but I still haven't seen a satisfactory explanation for exactly why. Ultra processed foods, probably. EDCs and micro plastics, also probably. But there's no cigarette level clarity. Frustrating.

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u/Wooden-Map-6449 1d ago

Probably due to lax American regulations we are exposed over the course of our lifetimes to much higher levels of harmful ingredients in our food, cosmetics and environment than in Western Europe.

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u/jeffwulf 1d ago

It's mostly just that Americans drive more and walk less.

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u/turroflux 1d ago

When it comes to health outcome, overmedicating can lead to greater harm long term harm. It doesn't matter if you have better access to high level healthcare, surgeries and treatments take it out of you, years off your life sometimes. There is no magic pill that makes up for cleaner air, walking, better diet, and probably more sleep and less stress.

Rich Americans also opt for more electives, cosmetic surgeries, have open paths to self-medicate on experimental drugs, if there is a new fad drug, it'll be used by rich Americans first, before anyone else. In many places in the world, even if you have money, you wouldn't take any drugs or see a doctor unless something was wrong, and many places like Europe have have a doctors culture of wait and see before they start treatments, they will not give out pills or suggest surgery unless they have to, and even then you might have to push.

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u/Memory_Less 17h ago

Read the fine print. US citizens sign off on the fine print that says you give up years of your life for working an indentured life of 24/7, 365.

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u/DeLoreanAirlines 1d ago

Our food and water are poison

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u/Specific-Aide9475 1d ago

The food quality in America sucks. Even the rich eat the overprotected crap that we call junk food.

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u/apistograma 1d ago

It kinda remarkable so many rich dudes are hooked on junk food when they could pay for chef food. It’s not just Trump, allegedly Bill Clinton is also a big fan of McDonalds

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u/HelenEk7 1d ago edited 1d ago

My guess would be that there is little difference in quality of healthcare? (Since its the wealthiest segment of the US population we are talking about here). So it must be due to some other factors.

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u/AanAleinn 1d ago

That's what they want man. Get rid of us earlier would fix a lot of problems.

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u/farkmemealt 1d ago

White male life expectancy is going down, mostly do to opioid abuse. (American) Asian privilege is off the charts (higher income, better educated, longer life expectancy).

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u/Sad-Razzmatazz-5188 1d ago

You can find in the title that this study comprises wealthy US Americans vs wealthy Europeans too

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u/Thegrillman2233 1d ago

It’s not Asian “privilege”

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u/PRIMAWESOME 1d ago

If they stopped taking a helicopter like it's an Uber, maybe they would live longer.

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u/RudeCheetah4642 1d ago

A political system that has been skewed to be less concerned with its inhabitant's well being.

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u/ChampionshipOk5046 1d ago

You drive everywhere You hardly walk or cycle Your food portions are huge You take doggy bags home  Your all-you-can-eat buffets You're constantly drinking Coke You only get two weeks vacation Your health system is terrible 

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u/yesiknowimsexy 1d ago

I haven’t seen anyone mention this yet BUT I bet liking where you live has a lot to do with it too.

Such a difference to wake up, look outside your window and WANT to visit a nature trail or walk to the end of your street just because you enjoy being…there.

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u/asoupo77 23h ago

Lifespan is such a meaningless stat to me. I would gladly trade having more years of simply existing for fewer years at a higher quality of life. This endless pursuit of ever-increasing lifespans feels like a hollow endeavor.

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u/sonostreet 21h ago

"WARNING: If you're Gambling your money away, most likely your brain is hacked by a.i."

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u/DGlen 20h ago

And poorer Americans have a 7 year shorter average life span than the wealthy ones. Yet we pay more per capita for health care than anyone else on the planet.

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u/ShrikeMeDown 12h ago

Food. It's always food.

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u/snowflake37wao 7h ago

We have known, can we move on to culprits soon or naw? Like what are they mixing in with the US ketchup that is not allowed in any EU food, especially ketchup? Get back to me science

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u/fiddlemonkey 3h ago

Private insurance encourages a lot of practices that are probably not best for patient care but because of their prevalence they become systemic and everyone experiences it regardless of income level. Fast discharging of patients from the hospital, even if it probably would be safer to keep them, for example. Keeping staffing at as low a level as possible for profitability affects every single patient. The amount of charting that needs done to be appropriately reimbursed by insurance keeps doctors visits shorter than they should be, and that will affect every single appointment regardless of someone’s wealth. Same with doctors being pulled away to do peer to peers with an insurance company, or with discussions with other staff about what tests they need to order to get a prior authorization for something. That affects the time the physician can spend with any patient, and the patient’s income level isn’t going to affect it.
Same in the hospital-the amount of time spent charting to ensure reimbursement and fighting with insurance companies about things means the physicians have a lot less time to spend with each patient.

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u/Lorward185 1d ago

I wonder if it has something to do with the stuff they spray their crops with? A European study proved that a certain American pesticide was a know cause of cancer. That pesticide is no longer for sale in Europe because of the harmful effect it has on its population. America is the only country that still uses this pesticide in large quantities.

There was an interesting case a few years ago where there was a famine in an African country. America offered to supply the grain. The WHO had one stipulation. The grain had to meet modern food safety standards and be fit for human consumption. America refused and pulled out of the deal.

It says a lot when a country feeds its population that the rest of the world deems unfit for human consumption. This is the same grain that makes your bread and beer.

Unfit for people who are dying of hunger to eat.

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u/Alarmed-Ad-5426 1d ago

They just really got it figured out over there

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u/PointlessTrivia 1d ago

A baby girl born in the US today will on average live as long as a baby boy born in (for example) Australia.

The US diet and health care system have managed to completely erase the mortality gender gap. Except that a newborn American boys will on average die more than five years before his Australian equivalent.

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u/Bornagainchola 1d ago

Americans do not have healthcare.

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u/Allison87 1d ago

Everything is just so bleak

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u/CPNZ 1d ago

Gap with Europe about to get a lot worse - at least for the next 4 years.