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

[ucbalumnus]

Even the richest Americans face shorter lifespans than their European...

https://www.nejm.org/doi/full/10.1056/NEJMsa2408259 (study paper behind paywall)

This was a study of 73,000 adults age 50-85 in 2010.

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.

According to the study, individuals in the wealthiest quartile had a death rate that is 40% lower than for individuals in the poorest quartile. Individuals in Continental Europe died at rates approximately 40% lower than participants in the U.S. throughout the study period. Participants from Southern Europe had estimated death rates around 30% lower than U.S. participants over the study period, while participants from Eastern Europe have estimated death rates 13% to 20% lower.

[DadTwoGirls]

I am not surprised.

[TatinG]

Hard to believe given the higher rates of smoking in Europe.

[ucbalumnus]

Comparison of smoking rates depends on what is counted as “smoking”. In the US, it looks like around 12% for cigarettes, but around 23% including other tobacco use.

EU seems to list about 20% for all tobacco use, but with considerable variation across countries. But some countries in Europe not in the EU may have higher smoking rates.

[DadTwoGirls]

Some things that I have wondered about (all of which might lead to a lower lifespan in the US):

In many cases, depending upon where you are, Europe seems to have better public transportation. However, public transportation does not take you from exactly where you are to exactly where you are going. Instead it takes you from somewhere near where you are to somewhere near where you are going. You walk a bit at both ends. I have wondered whether a large number of short walks contributes to a longer life span.

Many years ago I was flying in to attend a meeting in Pittsburgh. Pittsburgh is the home of a large well known ketchup company. I happened to be sitting next to a ketchup expert, so we discussed ketchup. Who would have known that someone could be a ketchup expert? I asked him why ketchup in the US is so sweet. He said that there were federal regulations that require a lot of sugar in ketchup. Apparently this is considered a “health and safety” regulation. This got me to wondering what was the root cause behind the appearance that food in the US might not seem to be quite as healthy as food in Europe.

I am a pretty big guy (over 6 feet) and keep relatively active. I have noticed that in restaurants in the US the proportions are usually way greater than anything I could possibly eat in one sitting. I usually end up taking half my meal home. This does mean that I have a pretty good collection of plastic containers that originally came from restaurants (I use them for a range of other purposes). Why are our restaurant meals so large?

Of course all of these could contribute to greater obesity in the US.

[momofboiler1]

I too am not surprised. I still have a lot of family in Western Europe. They walk more, eat better, and weigh less. When we were there last year, no one thought twice about walking 30 minutes one way to public transportation - not the oldest with cancer, nor the youngest. They market almost daily for what they are going to eat that day or the next so fresh food, no preservatives and no pesticides (highly regulated), and everyone is fit (probably because of that previous two points). And with government health care, everyone gets the care they need without worry about the cost so there isn’t hesitation to go to the doctor when needed.

[fiftyfifty1]

Yes, I noticed that the use of public transport with walking on either end was also the norm in Japan when we visited.

Telling people to walk for exercise doesn’t work nearly as well as having exercise just built into their life. But funding public transport is very political.

[TatinG]

And yet, the survival rate for many cancers, like breast cancer, is highest in the US. Earlier detection, better higher quality treatments, lower wait times.

[kelsmom]

For now. We shall see where we are compared to other countries in a few years. And we’ll need to determine our outcomes for all affected by the diseases, not just those able to afford the healthcare necessary to treat them.

[ucbalumnus]

@momofboiler1

I still have a lot of family in Western Europe. They walk more, eat better, and weigh less. When we were there last year, no one thought twice about walking 30 minutes one way to public transportation - not the oldest with cancer, nor the youngest. They market almost daily for what they are going to eat that day or the next so fresh food, no preservatives and no pesticides (highly regulated), and everyone is fit (probably because of that previous two points).

There was research on how much people walk when moving from less/more walkable places to more/less walkable places:

https://www.nature.com/articles/s41586-025-09321-3

[fendrock]

Many apartment houses in Germany do not have an elevator, as they are not required for buildings with four or fewer floors.

I went hiking my German friends who live on the fourth floor with no elevator, 4.5 miles with a 1000 foot change in elevation, and they didn’t think anything of it - one of them is over 65.

[ucbalumnus]

When I commuted by subway, I had the stairs going up from the platform to the street level all to myself while there was a queue for the packed escalator. Seems like your German friends who lived on the fourth floor with no elevator would have taken the stairs in a similar situation.