Americans have never earned more or lived longer. Median household income reached $87,460 in 2025, the highest figure since the Census Bureau began tracking the indicator in 1967, according to data released in September. Life expectancy reached 79 years in 2024, also a record.
Even so, that money does not translate into Americans having a life expectancy comparable to Europeans. A Brown University study, published last year in the New England Journal of Medicine, found that Americans die sooner than Europeans at every wealth level. The study also concluded that the wealthier Americans do not fare better than the poorer people across much of Western Europe.
“The twist is that even the richest quartile of Americans does not fare better than most residents of northern and western Europe,” says Sara Machado, a researcher at Brown’s Center for Health System Sustainability. “This was unexpected and runs counter to much of the narrative we are used to.”
Read more: Boomers control US$ 90 trillion and set the pace of the “G economy” in the United States
What the Brown Study Found
The researchers followed more than 73,000 adults aged 50 to 85 in the United States and 16 European countries. The study began in 2010 and tracked participants for roughly a decade, using data from the Health and Retirement Study in the United States and the SHARE study in Europe.
Those who were wealthier in northern and western Europe showed a mortality rate about 35% lower than that of the wealthiest Americans. Survival in the United States’ richest quartile was statistically equivalent to that of the poorest quartile in countries such as France, Germany, and the Netherlands.
Overall, during the period analyzed, people in continental Europe died at death rates roughly 40% lower than Americans, according to Brown. In Southern Europe, mortality rates were about 30% lower.
Wealth continues to matter within each country. “We found that the position you occupy in your country’s wealth distribution matters for your longevity, just as your relative position to people in other countries matters,” says Machado.
Why Money Doesn’t Eliminate the Gap
The United States spent about $14,775 per person on health care in 2024—nearly $7,000 more per person than the average in comparable wealthy countries, according to the Peterson-KFF Health System Tracker. In those countries, the average life expectancy was 82.7 years, 3.7 years longer than in the United States. Fortune has previously explained why health-care costs in the United States are roughly twice as high as in similar high-income countries.
This spending does not guarantee universal coverage. About 26.7 million Americans were uninsured for the entire year 2025, according to Census Bureau data. Additionally, in early 2026, about 2.6 million fewer Americans had health plans from the Affordable Care Act (ACA) marketplace than at the start of 2025.
“Fixing health outcomes is not only a challenge for the most vulnerable— even people in the wealthiest quartile are affected,” says Machado.
Lifestyle also plays a role. Americans tend to have less healthy diets and more sedentary lifestyles. Heart disease and cancer remain the two leading causes of death in the country. The researchers noted that smoking and living in rural areas, both associated with poorer health, were more common in the United States.
Europe also houses two of the so-called Blue Zones: Sardinia, in Italy, and Ikaria, in Greece. In these locations, longevity is attributed to physical activity, diet, rest, and strong social ties, though some researchers contest these claims.
When Fortune first published the study, lead author Irene Papanicolas highlighted the higher rates in the United States of deaths that are preventable due to firearms, alcohol, and suicide; the higher cardiovascular disease mortality; and a more limited safety net, with health coverage more tightly tied to employment.
Inequality compounds the problem. The United States has a much larger gap between rich and poor than Europe—a split that Peter Mallouk, CEO of Creative Planning, recently warned is unsustainable.
“Our prior work showed that, while wealth inequality narrows after age 65 in both the United States and Europe, in the United States it narrows because poorer Americans die sooner and in greater numbers,” explains Papanicolas, a professor of health services, policy, and practice who directs Brown’s Center for Health System Sustainability.
Read more: A study shows the most affordable countries to live in retirement. Compare rankings
What Researchers Say Will Happen Next
Recent gains in American longevity occurred largely as a result of the end of the pandemic. There was also a decline in overdose deaths and suicides in 2024, according to the U.S. Centers for Disease Control and Prevention (CDC). These advances, however, did not close the gap with Europe.
“If we want to improve health in the United States,” explains Papanicolas, “we need to better understand the underlying factors that contribute to these differences—particularly among similarly situated socioeconomic groups—and why they translate into different health outcomes across countries.”
“There is a lot of collective stuff at play here,” agrees Machado. “But I would tell people that they really need to think about retirement—about when they will retire, how they will retire, and how they can be happy after retirement.”
Machado adds: “When we look at other countries, we see better results, and that means we can learn from them and improve. It isn’t necessarily about spending more, but about addressing the factors we are leaving out—something that could yield benefits far beyond what we imagine.”
This article was originally published on Fortune.com.
2026 Fortune Media IP Limited
