Wealth and mortality in US and Europe

[ergophobe]

Spoiler: mortality decreases with wealth but, "Survival in the wealthiest U.S. quartile appeared to be similar to that in the poorest quartile in northern and western Europe."

https://pubmed.ncbi.nlm.nih.gov/40174225/

Summary from Inigo San Millan
https://x.com/doctorinigo/status/2090194765010915331

A study with almost 74,000 subjects ages 50-85.

Conclusion:
-The wealthiest Americans had approximately the same survival rates as the poorest people in Europe.

Wealth helps enormously within the United States, but even high wealth does not completely overcome the US–European mortality disadvantage.

Wealthy Americans presumably have much greater ability to buy excellent medical care, better housing, healthier food, gyms, preventive testing and so forth. Yet their survival remained roughly comparable to the poorest group in Northern/Western Europe.

The study doesn't provide direct answers to why this happens. However, maybe wealth cannot outperform lifestyle, strong social safety net, great food around friends and family, lower stress, walking significantly more everyday to your bakery (yes, believe it or not, Europeans are big on bread), local food stores, coffee shops, affording to retire when it is time without worrying about paying bills especially when you get sick...

As both an American and European citizen, I believe it may be time for Americans to recalibrate how we think about longevity.

We are increasingly chasing the latest intervention such as rapamycin, peptides, cold plunges, red-light therapy...hoping that targeting a single enzyme or metabolic pathway will move the needle.

As a systems physiologist, I struggle with that view. Human physiology is not a collection of isolated pathways. Trillions of cells communicate across metabolic, vascular, endocrine, immune and neurological systems. Health emerges from their integration.

Perhaps longevity is less about hacking individual pathways and more about creating the environment in which the whole organism can thrive.

[rcjordan]

>chasing the latest intervention

My feed can confirm that both old & new media thrive on this stuff. Avoiding dementia is hot-hot-hot currently.

[ergophobe]

The problem with health and fitness news and advice broadly defined is that the things that really matter aren't interesting and the things that are really interesting mostly don't matter.

So there is a focus on, say, cold plunges. Are they "good" for you? Maybe. But they are only significant if you're in the 99th percentile on basic things like getting good sleep, being active and eating vegetables.

But since the advice to get good sleep, be active and eat my vegetables is the exact advice my grandmother gave me 50+ years ago, it's hard to keep writing interesting articles about it.

So the articles are about things like some acai-spirulina "superfood" smoothie or "Norwegian 4x4s" (and BTW, if anyone recommends doing "Norwegians" you can be certain they have no idea what they are talking about).

But the secret is the same non-secret it has always been: persistent and consistent attention to the biggest levers. The one your gramma told you about.

And it was ever so. Here's a quote from the 1970s book Once a Runner:

"What was the secret, they wanted to know; in a thousand different ways they wanted to know The Secret. And not one of them was prepared, truly prepared, to believe that it had not so much to do with chemicals and zippy mental tricks as with that most unprofound and sometimes heartrending process of removing molecule by molecule, the very tough rubber that comprised the bottoms of his training shoes."