Tag Archives: Longevity

Longevity Gap Present Even in Wealthy Americans

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S Machado et al. NEJM 2025;392:1310-1319. Association between Wealth and Mortality in the United States and Europe

Methods: This was a longitudinal, retrospective cohort study with 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.

Key findings:

  • The gap in survival between the top and bottom wealth quartiles was wider in the United States than in Europe
  • The poorest Americans appeared to have the lowest survival among all wealth groups in the study sample
  • 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

The countries in the Survey of Health, Ageing, and Retirement in Europe (SHARE) were split into the following three groups: northern and western Europe (Austria, Belgium, Denmark, France, Germany, the Netherlands, Sweden, and Switzerland), southern Europe (Italy, Portugal, and Spain), and eastern Europe (Czech Republic, Estonia, Hungary, Poland, and Slovenia). The shaded area in Panel A indicates the difference between quartile 4 (the wealthiest) and quartile 1 (the poorest) in the Health and Retirement Study (HRS); the same shaded area was added in Panels B, C, and D for the purposes of comparison. The median duration of follow-up was 10 years in both surveys, and the mean (±SD) age at baseline was 65±9.8 years.

In their discussion, the authors note that health care access should not be a factor for wealthy Americans. However, “systematic factors may influence longevity across social strata, such as diet; environment; behavioral, cultural, and social attitudes; and opportunities for social mobility.2,28,32,33 The poorest are most vulnerable to these systemic factors, but these factors are broad and probably affect the entirety of society.”

My take: This study indicates that mortality in the United States is higher than in Europe, even at higher wealth levels.

Commentary on this article from NBC News (4/2/25): Not even wealth is saving Americans from dying at rates seen among some of the poorest Europeans

“Fifty years ago, life expectancy in the U.S. and wealthy European countries was relatively similar. That began to change around 1980. As European life expectancy steadily increased, the U.S. struggled to keep pace — and its life expectancy even began declining in 2014…The wealthiest group in northern and western Europe had mortality rates about 35% lower than the wealthiest group in the U.S.”

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Ten Americas: Examining Health Disparities and Life Expectancy

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L Dwyer-Lindgren et al. The Lancet; 2024. Online first. Open Access! Ten Americas: a systematic analysis of life expectancy disparities in the USA

Background: Nearly two decades ago, the Eight Americas study offered a novel lens for examining health inequities in the USA by partitioning the US population into eight groups based on geography, race, urbanicity, income per capita, and homicide rate. That study found gaps of 12·8 years for females and 15·4 years for males in life expectancy in 2001 across these eight groups. In this study, we aimed to update and expand the original Eight Americas study, examining trends in life expectancy from 2000 to 2021 for ten Americas (analogues to the original eight, plus two additional groups comprising the US Latino population), by year, sex, and age group.

Methods: The authors tabulated deaths from the National Vital Statistics System and population estimates from the US Census Bureau and the National Center for Health Statistics from Jan 1, 2000, to Dec 31, 2021.

Key findings: .

  •  At the beginning of the 21st century, there was already a 12.6-year gap in life expectancy among Americas, but this gap grew even larger during the 2000s and 2010s and accelerated to 20.4 years after the first 2 years of the COVID-19 pandemic.
  • One’s life expectancy varies dramatically depending on where one lives, the economic conditions in that location, and one’s racial and ethnic identity.
  • There are limitations with the data that were used. For example, there is known to be substantial misreporting of race and ethnicity on death certificates

My take (borrowed from the authors): “The extent and magnitude of health disparities in the USA are truly alarming. In a country with the wealth and resources of the USA, it is intolerable that so many are living in conditions and with health outcomes akin to those of an entirely different country.”

Related blog posts:

Unrelated link: N Kristof NY Times, Gift Ideas That Push Back the Darkness

Gift ideas included the following charities

  • ‘Fistula Foundation which arranges obstetric fistula repair. This restores a woman’s life after this life-altering complication –a corrective surgery that costs just $619 per person
  • Muso Health helps reduce childhood mortality. In Mali, this organization reduced childhood mortality by 95%. The cost of bringing one more person into the Muso health care network is only $22 per year.
  • Reach Out and Read. This U.S-based charity allows doctors to “prescribe” reading to the child. This promotes reading as well as childhood well-child visits.
  • Crisis Text Line is for those who want to volunteer, rather than donate. This organization trains (15-20 hrs) volunteers to help individuals needing mental health support. “More than 90 percent of the volunteers report that their own mental health improves as a result of their participation.”

Hot Study on Hot Dogs & Healthy Eating Habits

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Recently, several news reports highlighted a study which among other things claimed that each hot dog one ingests could costs a person 36 minutes off their lifespan.

Here’s a link to the original study: Small targeted dietary changes can yield substantial gains for human health and the environment (most of article is behind a pay wall)

Here’s a link to the USAToday Coverage: A hot dog shaves 36 minutes off life, study says. Nathan’s champion Joey Chestnut isn’t worried.

An excerpt:

Olivier Jolliet, one of the lead researchers on the study, published in the journal Nature Food, told USA TODAY that 5,800 foods were evaluated and then ranked based on their nutritional disease burden as well as their impact on the environment. Hot dogs were considered the most unhealthy...

The study found that substituting 10% of daily caloric intake from beef and processed meats for a mix of fruits, vegetables, nuts, legumes and select seafood could reduce your dietary carbon footprint by one-third and allow people to gain 48 minutes of healthy life per day...

Regardless of moderation, hot dogs are not exactly healthy. The World Health Organization’s International Agency for Cancer Research (IARC) reported ham, hot dogs and other processed meats may contribute to colorectal cancer. Hot dogs also are high in saturated fat and sodium. Just one hot dog can contain over a quarter of your day’s sodium allowance and over 14 grams of fat...while processed meats like hot dogs can inherently be unhealthy, it’s wrong to zero in on just hot dogs as the study does in highlighting the food. 

Coverage from the University of Michigan: Small Changes in Diet Could Help You Live Healthier, More Sustainably

An excerpt:

Researchers classified foods into three color zones: green, yellow and red, based on their combined nutritional and environmental performances, much like a traffic light. The green zone represents foods that are recommended to increase in one’s diet and contains foods that are both nutritionally beneficial and have low environmental impacts. Foods in this zone are predominantly nuts, fruits, field-grown vegetables, legumes, whole grains and some seafood.

Based on their findings, the researchers suggest:

  • Decreasing foods with the most negative health and environmental impacts including high processed meat, beef, shrimp, followed by pork, lamb and greenhouse-grown vegetables.
  • Increasing the most nutritionally beneficial foods, including field-grown fruits and vegetables, legumes, nuts and low-environmental impact seafood.

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