Death rates in Europe and the USA

By David Jolley

Amongst the interesting headlines this past week was one, which drew attention to the fact that, on average, your chances of surviving to old age are much higher in Europe than in the USA. Study reveals alarming trend in US death rates since 2000 | US news | The Guardian

This is a phenomenon, which has been recognised for several decades, but the gap is getting wider rather than narrower. The greatest differences are amongst young adults – in their 20s and 30s where the excess of deaths is of the order of threefold. Deaths in these age groups are mostly from road traffic accidents, homicide, suicide or from accidental overdose or other consequences of the use of illicit drugs Why Are Young Americans Dying in Increasing Numbers? (

People would say that a great deal could be done to prevent this early loss of life by revised legislation.

In 2017 it is estimated that the loss of lives compared with Europe was 400,732. Deaths from Covid-19 in the USA currently total 567,000.

Surprisingly the differential of death rates is reversed amongst residents who are aged 85+. This phenomenon has also been recognised for at least two decades:

Excess mortality in the United States in the 21st century | PNAS

US Mortality in an International Context: Age Variations (

Survival after the age of 80 in the United States, Sweden, France, England, and Japan – PubMed (

Is the US Old-Age Mortality Advantage Vanishing? (

Explanations for the better survival of older Americans include suggestions that they receive better health care than their European equivalents. This is a challenge to us. Nothing I have ever read has encouraged me to believe that care for older people overall in the USA is as good as that in the UK or Europe. Perhaps that is blind prejudice. It is certainly something worth closer study.

Is it not possible that the relatively fewer Americans who have survived into late life are selected survivors?

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