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September 2, 2025 46 mins

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In this episode of Causes or Cures, Dr. Eeks chats with Dr. Irene Papanicolas, Professor of Health Services, Policy and Practice at Brown University, about her recent New England Journal of Medicine paper examining the links between wealth and mortality across the United States and Europe.

There’s a lot of focus on longevity today, from biohackers chasing longer lives to new medical innovations. But how much does the money in your bank account matter when it comes to lifespan? And why do those relationships between wealth and health look different across countries?

The study analyzed data from over 73,000 adults, exploring how wealth impacts lifespan within and across countries, including comparisons between the wealthiest and poorest quartiles, the concept of a “survivor effect,” and why even wealthy Americans may be dying earlier than poorer Europeans.

We discuss:

  • How “wealth” was defined in the study.
  • The differences in life expectancy between the U.S. and Europe.
  • What factors might explain why U.S. outcomes lag (diet, food environment, culture, lack of universal healthcare).
  • Which European countries stood out for protecting longevity.
  • Policy implications, and what interventions could have the biggest impact if implemented tomorrow.

 Read the full paper here: NEJM: Wealth, Mortality, and the U.S.–Europe Gap

If you’re curious about the intersections of wealth, health, and longevity, and want to understand what money can (and can’t) buy when it comes to living longer, this episode is for you.

 Dr. Irene Papanicolas is a Professor of Health Services Policy and Practice at Brown University. A health economist and researcher, her work focuses on assessing how health systems perform and using international comparisons to inform policy. She leads the International Collaborative on Costs, Outcomes and Needs in Care (ICCONIC), a 16-country partnership studying care patterns and outcomes for high-need, high-cost patients. Dr. Papanicolas has published widely on health system performance and cross-country comparisons. 

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