Even the wealthiest Americans are suffering from shorter lifespans than those in Europe. A new study cites 3 major reasons
Americans are dying earlier than Europeans—and the rich are not exempt.
In a new study published today, researchers at Brown University analyzed the survival rates and wealth of older adults in the U.S. and Europe over 12 years. They found that Americans' survival rate was lower than their European counterparts across all wealth tiers. The wealthiest in Northern and Western Europe had a mortality rate roughly 35% lower than that of the wealthiest Americans.
'Whatever is happening with mortality in the U.S. and these decreases that we see in life expectancy are not just things that are happening to the poorest Americans,' Irene Papanicolas, senior author of the study and a professor of health services, policy, and practice at Brown School of Public Health, tells Fortune. 'There's something systemic that's happening that affects every American.'
In the study, published in the New England Journal of Medicine, researchers used data from over 73,000 adults between the ages of 50 and 85 in the U.S. and 16 European countries.
Despite socioeconomic privilege, the researchers found that the survival rate of the wealthiest bracket of Americans 'was statistically equivalent to the poorest wealth quartile in North and Western Europe,' Papanicolas says. 'So they're not just doing worse than the richest quartile. They're statistically equivalent to the poorest quartile in that region.'
Papanicolas hypothesizes that several of the European countries at play, like Germany, the Netherlands, and Switzerland, are high spenders on health care, but they address the social determinants that exacerbate the health and wealth gap more adequately than the U.S.
Despite the discrepancy for the wealthiest in the U.S., across the board, the study underscores that wealth impacts health. The richest have better survival rates than the poorest, explained by the ability to pay for out-of-pocket health care costs, access to safer living situations, and education that provides health literacy, says Papanicolas.
But the study found that America's health gap between the richest and poorest was most stark. The poorest Americans had the lowest survival rates of all the study participants.
'Greater inequity might just make a lot of what we need for a healthy life inaccessible to more and more people,' she says. 'For a country that spends so much more, we really should be doing more.' The researchers conclude that a mixture of culture, policy, and environment can influence how much wealth impacts health, which seems most notable in the U.S.
'Across all wealth quartiles [in Europe], people were more likely to have a college education as compared to the U.S. where that was much more concentrated across the most wealthy. Even things like smoking, we saw that there was less of a social gradient than we saw in the U.S,' Papanicolas says. 'In a lot of the European countries, the top three quartiles were much more clustered together, so it didn't really seem to make that much of a difference. The poorest do worse everywhere, but the majority of people had a much more similar trajectory in Europe [than in the U.S.].' (The authors note that the sample size in Europe cannot be generalized across all European countries).
Papanicolas notes that the paper does not conclude definitive causes for the results but does extrapolate on the potential systemic issues afflicting the U.S. survival rates.
'As we think of policies to address this, we really need to think, what are these factors that are so prevalent that they're influencing everybody but that in other countries aren't?' Papanicolas says.
Here are three reasons for shorter U.S. lifespans:
In the U.S., external deaths, such as from firearms, alcohol, and suicide, were higher compared to other wealthy countries.
'This points to a weaker public health infrastructure that isn't protecting people, as well as other high-income countries are from these deaths,' says Papanicolas. 'I think we really need to think about how we bolster public health and protect people.'
High rates of heart disease, a significant risk factor for early mortality, also plague the U.S more dramatically than other high-income countries.
'We need to think about diagnosis and treatment and making sure that everybody has access to affordable medications and is able to prevent the risk factors that can lead to deaths from heart disease,' Papanicolas says.
Compared to the U.S., Papanicolas says European countries 'invest in, potentially, a more robust social state that protects you from the stress of losing your job.'
'Your healthcare isn't attached necessarily to your employment, and you have, maybe with more equal access to education, also more equal opportunities to become wealthy throughout the life course,' she says.
Another flag for a weaker social state: The U.S. dropped to its lowest rank on the annual World Happiness Report last month. 'All of these play a role in the population, not only in the short term, but particularly in the long term,' Papanicolas says.
The study points to an urgent priority: a public health strategy with a goal of equal access to aging well, just as the Trump admin is dismantling health agencies charged with offering services to older adults, from mental health care to access to healthy food.
'Look to other countries and understand what they do, because it is possible to achieve a better survival with less,' says Papanicolas. 'There's also potentially a note of hope here that we can do better.'
This story was originally featured on Fortune.com
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USA Today
an hour ago
- USA Today
Medicaid churn: How working Americans could mistakenly lose coverage under Trump tax bill
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They say mandating a Medicaid work requirement − combined with more frequent eligibility checks − would create an administrative nightmare that drops coverage for many who qualify for the public health insurance program for low-income and disabled residents. What is Medicaid churn? Medicaid rolls vary from month to month as people lose eligibility due to a new job, a raise or other income source that disqualifies them for coverage. A job loss or change in life circumstances could make someone newly eligible. The constant change of Medicaid rolls is what health policy experts call churn. A person who temporarily loses coverage due to a paperwork issue or mistake then must again sign up. "Churn is what happens when these eligibility systems become difficult to navigate," said Jennifer Tolbert, deputy director of the program on Medicaid and the uninsured for KFF, a health policy nonprofit. The federal government requires state Medicaid programs to check enrollees eligibility once a year. The Trump tax cut legislation would mandate states double eligibility checks to twice a year. And states would have the added duty of verifying a person's employment or exemption status. The legislation, which passed the House and awaits Senate approval, mandates Medicaid recipients who are "able-bodied" adults without children work 80 hours per month or qualify for an exemption such as being a student, caregiver or having a disability. The bill defines able-bodied as people who are not medically certified as physically or unfit for employment. The legislation also would strip coverage from undocumented immigrants who get Medicaid through state-funded programs. Health policy experts say more frequent eligibility checks and red tape will add administrative costs and cut off people who qualify but fall through the cracks due to administrative miscues. "People are going to have to document work status or exemption status multiple times a year, and at each point there's a risk that someone who is eligible could lose coverage," Tolbert said. Thousands lost coverage under Arkansas work requirement During the first Trump administration, the Centers for Medicare & Medicaid Services gave states the option of implementing a work requirement for nondisabled adults on Medicaid. Arkansas' work requirement cut more than 18,000 residents from Medicaid within the first seven months of the program. People were removed often because people were unaware of paperwork requirements to keep their coverage, research shows and analysts said. In April, a study by researchers from the Urban Institute and Loyola University Chicago found the Arkansas uninsured rate jumped 7.4 percentage points among low-income adults age 30 to 49 after the state's work requirement began. 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The ranks of the uninsured could grow larger if Congress doesn't extend the COVID-19 pandemic-era tax credits that have made ACA plans more affordable for consumers. If the tax credits expire and Congress passes the current version of the Trump tax bill, as many as 16 million Americans would lose coverage , according to CBO. "Coverage loss from work requirements should actually be very small," said Kathy Hempstead, a senior policy officer at the Robert Wood Johnson Foundation. "But we anticipate it will be very large, because people will not be able to comply with the requirements and will lose their coverage." Dr. Oz: Medicaid spending is 'crippling the system' The Trump administration's top Medicaid official has defended the House legislation as a necessary step to slow spending for the federal health program that covers nearly 80 million low-income and disabled Americans. In a June 4 interview with Fox Business, Dr. Oz challenged Medicaid recipients who would face work requirements should "prove that you matter." Oz, the Trump-appointed administrator of the Centers for Medicare & Medicaid Services, said the work requirement asks "able-bodied individuals who are able to go back to work at least try to get a job or volunteer or take care of a loved one who needs help or go back into school. Do something to show you have agency over your future." In a Fox News interview posted on the social media site X, Oz said Medicaid spending has surged 50% since 2019, a pace that is "crippling the system." However, some Republicans have pushed back on the proposed cuts. In a May opinion piece in the New York Times, Sen. Josh Hawley, R- Missouri, said "slashing health insurance for the working poor" is "morally wrong and politically suicidal." Survey: Americans worried about Medicaid cuts The public is paying attention to the proposed Medicaid cuts. Slightly more than half of adults said they're worried significant cuts in Medicaid spending would negatively affect their family's ability to obtain and afford health care, according to a KFF health tracking poll released June 6. The survey this survey of 2,539 U.S. adults was conducted online and by telephone over three weeks in May. The survey said nearly 6 in 10 adults said the Trump administration's policies would weaken Medicaid, but there is a stark divide based on party affiliation. Nine in 10 Democrats but just 2 in 10 Republicans expect the administration's policies would weaken Medicaid. Republicans also were far more likely than Democrats to say that the Trump's policies would strengthen Medicaid. Still, while the survey suggests people are tracking the news, many likely wouldn't know whether their coverage has changed until they try to get medical care. "People don't often know that they've lost coverage until they try and fill a prescription or see a doctor," Tolbert said.
Yahoo
an hour ago
- Yahoo
Goodbye, dad bod: Weight loss medications are changing fathers' physiques — and their relationships with their kids.
Neal Bland has done Ironman competitions and marathons. He's given countless personal training sessions over the course of his life and has always prided himself on staying in shape, especially given that obesity runs in his family. But by age 52, time and genetics had begun to catch up with Bland (who asked that we not use his real last name for privacy reasons). His blood pressure and blood sugar were climbing, his body mass index was hovering in the low 30s, and his joints were aching. Then, during a photo shoot with his wife last year, the photographer told Bland he 'looked good for a dad bod.' Bland knew the photographer had 'meant it as a compliment,' he tells Yahoo Life, 'but it really stuck.' He was still maintaining a rigorous diet and exercise regimen at the time, but it wasn't working for him. So, in March of 2024, he started on the GLP-1 medication tirzepatide. He's lost 45 pounds in a phase of his life he's dubbed his 'dad bod reboot.' Let's be clear: There's nothing wrong with a dad bod. In fact, the expectation for men to have chiseled abs — at any point, but especially in middle and older age — can be harmful. But for the 38% of American dads who are obese, their bodies may be putting them at risk of type 2 diabetes, heart disease and other potentially life-threatening medical conditions. Some of these fathers have started taking GLP-1 weight loss medications, a decision that can bring about not just changes to their 'bods' and health indicators, but also to their lives as parents. We spoke to some of them about what it's like to be a dad, minus their former bods. Thirty-seven-year-old father of two Noah Wiggins is taking his nursing board exams and looking forward to beginning his new career in health care. 'But I looked in the mirror and thought, I can't expect patients to be healthy and maintain a healthy weight if I can't,' he tells Yahoo Life. Plus, Wiggins loves coaching his children's sports teams, but he found himself getting winded and sore when he tried to demonstrate athletic skills for the kids. While he could shed pounds for a time with the help of various diets, he couldn't maintain a healthy weight long-term. So Wiggins talked to his own health care provider, who agreed that GLP-1 medication could be a good option for him. He started taking Zepbound in January 2024. The medication, along with the support of his two children, has helped him lose more than 80 pounds since then. 'As I started to lose weight and get more active, they started making comments and encouraging me to make healthy food choices … without judgment,' says Wiggins. His daughter, who is about to turn 16, has been especially vocal, keeping Wiggins accountable when he picks up an unhealthy snack or tries to flake on going to the gym. 'I've had to fight the urge to say, 'I'm the parent, I'll go when I want to,'' says Wiggins. But ultimately, he's grateful for the tough-loving support from his kids. 'I think it's been a growing moment for them and for me,' he says. Wiggins's children have also noticed that he has more energy and can just be more fully present for them. Despite his progress, Wiggins still struggles with his body image. Like others that Wiggins has spoken to within the GLP-1 community, he half-expected that once the scale reached a certain number, he would feel satisfied with his body and appearance. 'But I don't know anyone who actually hits that number and feels like that,' he says. 'I look in the mirror and am happy with how I look and especially how I feel, but body dysmorphia is a real thing, and a lot of times you don't know you have it until you've lost weight.' At his lowest weight, Wiggins was tempted to lose another 20 pounds to make his reflection match the idealized version of himself in his mind, but he knew that would have put him below a healthy weight. That's when Wiggins realized that it wasn't about losing more weight. He needed to make a conscious effort to improve his mental health and confidence to help him feel content in his own skin. It's an important lesson that he wants his children to learn: how to 'be comfortable in your body, but balance that with good health,' Wiggins says. He's pushed himself to talk more openly with his kids about his own journey toward striking that balance. 'The best thing to do was just have more conversations with them about all of that, and they'll actually take the lead on those conversations once you start them.' Twenty years ago, when Ryan Rasmussen and his wife, AnnaLyn, were young newlyweds, they wanted desperately to start a family. After three years of trying, AnnaLyn got pregnant with quadruplets. But tragedy struck: None of the four babies survived more than about an hour after birth. The Rasmussens managed to pick up the pieces of their shattered hearts and eventually went on to have four children, born individually. But even as someone moves on, grief can linger in the body, wreaking havoc. For Rasmussen, the loss of his newborns quietly ate at him and, in turn, Rasmussen now recognizes he ate to cope with his grief. He reached nearly 300 pounds, he told Yahoo Life for our series On My Weigh. For those intervening 20 years, Rasmussen tried the Atkins diet and various other low-carb eating plans. He'd lose a little weight, then gain back as much or more. In the meantime, his family stayed active and went on ski trips. 'Annalyn is a marathon runner, and she's kept [the kids] in shape, but I think they've probably worried about me,' says Rasmussen. He tried to join their athletic activities, but skiing and hiking were hard on his overburdened joints. Two of his sisters, who also struggled with their weight, found success with GLP-1 medications. Impressed with their progress, Rasmussen tried the new class of weight loss drugs too. Within a year, he dropped 80 pounds. 'Being there for my family was the goal,' he says. Not only can Rasmussen now join the family ski trips, but hiking and spending time outdoors are day-to-day ways he bonds with his kids. His weight loss 'has definitely allowed us as a family to do more healthy activities,' Rasmussen says. Plus, his good habits have rubbed off on his children. Desserts, once a staple, are reserved for special occasions, and the household's midnight snacking has all but disappeared. Rasmussen's new body has also allowed him to get back in touch with his fashion sense. 'I like to look good and dress well, but when you're big, [that's] difficult,' he says. Now that he's lost weight, 'being able to dress with purpose in the morning has probably been one of the best things for me and my mental health,' says Rasmussen. And he's not the only one who's noticed his new look. One of his daughter's friends used the viral 'hear me out' cake trend on TikTok as an excuse to show some appreciation for Rasmussen. 'She said, 'hear me out, but Charlie's dad is attractive,'' Rasmussen explains. 'But [Charlie] was a good sport, she laughed about it.' Bland's now adult children grew up knowing him as the ultra-fit dad, who was always on the go for his job as a pharmaceutical researcher, or hitting the gym to train for his next big event. But he was always fighting against his genetics. 'I come from a long line of fluffy people,' Bland says. He spent his own childhood watching his mother constantly watch her weight. Despite avoiding smoking and drinking and maintaining a reasonably healthy diet, she eventually had to have both of her knees and one hip replaced and also suffered a stroke, 'all of which can be attributed to [extra] weight on your frame,' says Bland. Recognizing his family's propensity to obesity was part of what drove Bland to be so disciplined. 'But my genetics eventually outran my lifestyle,' he says. Even with the same routines in place, Bland gained weight in his early 50s, saw his A1C and blood pressure rise, and had inflammation in his hips and knees. And Bland admits that vanity was also a factor. The shirtless man in his vacation photos no longer looked like the version of himself he expected to see. 'I gained about 35 pounds in 10 years; it was the classic 'man-o-pause,'' he says. Though he didn't meet the clinical qualifications for brand-name GLP-1 medications, Bland tried compounded tirzepatide, suspecting that it would not only help him keep weight off but also reduce the inflammation in his joints. Once he started the medication, 'it was literally like somebody flipped a switch,' says Bland. The food noise (constant, intrusive thoughts about food) disappeared. He no longer ate just because he was bored. The joint pain was barely noticeable, and his workout recovery time improved. He also started to look more like himself in gym selfies. Bland didn't initially tell his children that he was taking GLP-1 medications. But one of his adult sons noticed that Bland was looking pretty shredded in some of his photos; in fact, he was a bit concerned. He told his father, 'You've lost so much weight and went from really fluffy to really not. Are you sure you're not ... taking PEDs,' meaning performance-enhancing drugs, recalls Bland. Though Bland, now 53, has been taking testosterone replacement therapy for years, that and the GLP-1 have allowed him to return to the weight and energy levels of his younger years. And he's now switched to a very low maintenance dose of tirzepatide to make sure he doesn't lose too much weight. 'It's been a little bit of a return to what they were used to when they were kids,' he says of his new — or, maybe more accurately, restored — bod. 'And I feel like I'm back to the person that my wife married,' Bland adds.
Newsweek
an hour ago
- Newsweek
Americans Are Suffering From 'Time Poverty'
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. With labor market uncertainty, jobs rewarding employees for "going the extra mile" and competing responsibilities inside and outside the workplace, a growing number of Americans are suffering from what experts refer to as "time poverty." The term has been increasingly adopted by psychologists to denote the chronic imbalance between the time a person requires and that which their work life allows them. A new survey by wellness firm Wondr Health revealed the extent of the issue, finding that the majority (62 percent) of U.S. workers do not take their allotted time off because of the internalized pressures of work and let about one-third of their annual vacation days go unspent. "No one is harder on most of us than ourselves and it leads to time poverty, a condition where we simply do not have enough time for a meaningful work-life balance," said Dr. Tim Church, chief medical officer at Wondr Health. "This is a wakeup call for employees and their employers. It's time to rethink workplace culture." A growing number of Americans are suffering from what experts refer to as "time poverty." A growing number of Americans are suffering from what experts refer to as "time poverty." Annie Ng/AP Illustration David Ballard, vice president of One Mind at Work, a company focused on mental health solutions for the workplace, said: "Some work cultures actually discourage taking time off, reward overworking, and position stress and being on 24/7 as a badge of honor. "In this type of environment, employees may avoid taking time off because they would feel guilty or worry they would be seen unfavorably or be penalized if they did." Ron Goetzel, senior scientist at Johns Hopkins Bloomberg School of Public Health and an expert in employee well-being, told Newsweek that the issue of time poverty "takes a toll on individuals, businesses and the larger society." "Although all of us are given 24 hours in a day, people feel they need to cram in as much activity into that time as possible—without sitting back and asking whether the activity enhances their quality of life, happiness and a sense of accomplishment, or not." The mental health implications have already become clear. According to a 2020 study, time poverty is linked to lower mental well-being, productivity and even physical health. Researchers also found that "subjective feelings of time poverty had a stronger negative effect on well-being than being unemployed." Despite this, they noted that the issue was one that had long gone underappreciated by either policymakers or employers. This is in spite of the potential deleterious impacts, not just on individuals, but on the businesses themselves. As workplace wellness experts and psychologists told Newsweek, time poverty among workers can mean lower productivity, higher rates of absenteeism or presenteeism—employees being at work but not fully functional—and increased employee turnover. "Employees that don't take time off are at risk for burnout, which is detrimental to both the employee and the business," said Dr. Chloe Carmichael, a clinical psychologist known for her work on anxiety and stress management. "The employees can also become resentful of the employer and less productive." Church added: "It's costly, plain and simple. When employees are burnt out or stressed, productivity and creativity drop. That's lost potential right there." This is indicative of the wider struggles of stress in the workplace, which several studies have linked to employees looking for opportunities elsewhere. "Burnout is a complex, multi-factorial problem, but we know for sure that chronic exposure to work-related stress, without the ability to recover, leads inevitably to mental and emotional exhaustion, detachment and decreased productivity and effectiveness," wellness expert Dr. Susan Biali Haas told Newsweek. Yasemin Besen-Cassino, a sociologist at Montclair State University, said the current climate in the U.S. labor had added to this troubling status quo, which she described as "overwork culture," with mass layoffs and broader economic uncertainty weighing on employees' minds. In addition, she told Newsweek that new technologies permitting workers to be ever-present made many feel they must contribute to work via emails or zoom calls even during off days. She added that many workers choose to use their paid time off to provide child care because of lack of affordable alternatives. "Therefore many workers are not recharging on these days, but rather performing caregiving," she told Newsweek. However, experts pointed to potential remedies—some easy, others not—that could limit the exposure to workplace stress to the benefit of employees and employers. Carmichael suggested that businesses consider mandatory time off, which would "remove the potential for internalized pressure." Author and stress researcher Rebecca Heiss said that taking vacations was far from a panacea for workplace-related stress, as despite a yoga retreat or week away employees will "ultimately will have to return to work and when we do all of those emails and projects are waiting for us and have compounded." Some pointed to the need for allotted "mental health days," as well as the willingness of businesses to invest in employee wellness programs and foster open communication with their workforces. Others advocated a wider cultural shift that would need to take place. "It's important to create a culture where taking a vacation is normalized and encouraged so that workers can fully recharge," Besen-Cassino said. "Shifting workplace culture can ensure workers can take vacations and are healthier and more productive in the long run." While employers might be reticent, Church said it is in their interest to consider the stress on their workers. "Maybe most importantly, businesses risk losing their best people," he said. "If the culture doesn't support rest and wellness, employees look for other places where their well-being is valued. "Addressing burnout and time poverty isn't just about being better employers, it's smart business."
