Researchers from Brown University compared survival rates in the US and Europe across different socioeconomic classes. It turned out that in the US, the gap in survival rates between the rich and the poor is greater than in Europe. In addition, survival rates even among the richest Americans do not exceed those of the poorest Europeans from Western and Northern Europe. The work was published in The New England Journal of Medicine.
Life expectancy and survival rates are used to assess the demographics of a society. Life expectancy is a numerical value in years, while survival rates allow us to find out the proportion of people who have lived to a certain time. Survival rates depend on the prevalence of diseases, the level of medicine, social conditions, and the level of well-being. At the same time, differences in income levels between groups of people can be compensated for by social programs aimed at reducing the gap in access to medical care and social security.
American scientists led by Irene Papanicolas from Brown University compared survival in different socioeconomic groups in the United States and Europe. In a retrospective cohort study (2010-2022), they used information from databases on health, mortality, and sociodemographic characteristics of people aged 50 to 85. People were divided into four groups by wealth level, where the first quartile corresponded to the poorest participants, and the fourth to the richest.
The researchers then constructed Kaplan-Meier survival curves for each quartile for the United States and countries in Northern, Western, Eastern, and Southern Europe. The analysis used a proportional hazards model that included adjustments for sociodemographic variables (age, gender, education level, place of residence).
Of the 73,838 study participants, 18.7 percent (13,802 people) died during the study period. Among all participants, high wealth was associated with low mortality.
According to the Kaplan-Meier curves, the gap in survival between the poor and the rich in the United States was greater than in European countries, and the survival rate among the richest Americans was at the level of the poorest Europeans from Northern and Western Europe (about 80 percent).
Commenting on the work, the authors point out the shortcomings of the social support system in the United States and the greater socioeconomic gap between classes compared to European countries. The work will help to understand how the existing social protection and health care systems can be improved.
Life expectancy increased steadily throughout the 20th century, but has slowed since 1990. This trend was reported by American researchers who analyzed the demographic indicators of the countries with the longest life expectancy.