Americans live shorter lives and spend more time in poor health compared to Europeans, despite earning some of the highest salaries globally and spending twice as much on healthcare as comparable countries. A study published in the New England Journal of Medicine, involving 74,000 adults, indicated that the wealthiest Americans experience higher mortality rates than the wealthiest Europeans. Their mortality rates were found to be similar to those of the poorest residents in northern and western Europe.
Across all wealth categories, Americans were more likely to die younger than Europeans. This suggests that wealth does not protect against broader factors affecting life expectancy. Factors contributing to this disparity include the US being a uniquely violent high-income country, with guns being the leading cause of death for children and adolescents, followed by road traffic collisions.
Additionally, the US is the only high-income country that does not guarantee healthcare. Approximately 26 million Americans are uninsured, and millions more have insurance plans with high deductibles or loopholes, making medical care financially risky. A Commonwealth Fund survey estimated that 57% of underinsured adults delayed or avoided medical care due to cost, leading to preventable and treatable diseases becoming more serious and expensive.