Americans at all wealth levels are more likely to die sooner than their European counterparts, with even the richest U.S. citizens living shorter lives than northern and western Europeans. That is the key finding of our new study, published in the New England Journal of Medicine.
We also found that while the wealthiest Americans live longer than the poorest, the wealth-mortality gap in the U.S. is far more pronounced than in Europe.
We analyzed survey data from 73,838 adults ages 50 to 85 across the United States and 16 European countries over a 12-year period and compared how long people across the wealth spectrum lived during the course of our study. The 16 European countries are grouped into European regions: northern and western, southern and eastern Europe.
Our research revealed that people in the wealthiest 25% of the study population across the U.S. and Europe were 40% less likely to die during the study period than the poorest quarter of people. The wealthiest 25% of people in northern and western Europe had mortality rates that were about 35% lower than participants in the wealthiest quartile in the U.S. For those from southern Europe, during the study period this value ranged from 24% to 33%. For those from eastern Europe, the value ranged from 1% to 7%. The poorest individuals in the U.S. appear to have the worst survival, including when compared with the poorest quarter of people in each European region.
Our study also reveals a wider wealth-mortality gap in the U.S. when compared with Europe. In other words, personal wealth does buy more years of life in the U.S. than in Europe. These findings suggest that personal wealth alone is not enough to compensate for other factors that tend to affect how long people live, such as health behaviors like smoking or heavy drinking, education or social support.
At its core, our research suggests that health outcomes are shaped by much more than just health care systems. It is likely that economic and social policies − from education and employment to housing and food security − play a crucial role in determining how long people live, including across the wealth distribution.
European countries have found ways to reduce health disparities without dramatically increasing health spending. By distributing health-promoting resources more equally across wealth groups, these nations may have created environments where longevity is less dependent on individual wealth.
What still isn’t known
While our study shows clear longevity differences between Americans and Europeans across wealth levels, more work still needs to be done to determine which specific aspects of European social systems − whether health care delivery, education access, retirement security or tax policies − most effectively protect health regardless of personal wealth.
Pinpointing exactly how these factors interact with wealth to influence health outcomes would allow researchers to identify which European policies could be most successfully adapted to improve longevity for all Americans.
What’s next
Looking ahead, we plan to identify which of those policy levers might be most effective in reducing mortality gaps.
The Research Brief is a short take on interesting academic work.
Whooping cough, a bacterial infection that can be especially dangerous for babies and young children, is on the rise. Already in 2025 the U.S. has recorded 8,485 cases. That’s compared with 4,266 cases during the same period in 2024.
The Conversation asked epidemiologist Annette Regan to explain why pertussis has become so prevalent and how families can protect themselves from the disease.
Infection can cause an acute respiratory illness characterized by severe and spasmodic coughing spells. The classic symptom of pertussis is a “whoop” sound caused by someone trying to breath during a bad cough. Severe complications of pertussis include slowed or stopped breathing, pneumonia and seizures. The disease is most severe in young babies, although severe cases and deaths can also occur in older children and adults.
Some doctors call pertussis “the 100-day cough” because symptoms can linger for weeks or even months.
The World Health Organization estimates that 24.1 million pertussis cases and 160,700 deaths occur worldwide in children under 5 each year. Pertussis is highly contagious. Upon exposure, 80% of people who have not been previously exposed to the bacterium or vaccinated against the disease will develop an infection.
Whooping cough causes violent fits of coughing that can make it difficult to inhale.
How do cases last year and this year compare with past years?
During the COVID-19 pandemic between 2020 and 2022, pertussis cases were lower than usual. This may have been a result of limited social contact due to social distancing, masking, school closures and lockdown measures, which reduced the spread of disease overall.
In the past two years, however, pertussis cases have surpassed figures from before the pandemic. In 2024, local and state public health agencies reported 35,435 pertussis cases to the Centers for Disease Control and Prevention – a rate five times higher than the 7,063 cases reported in 2023 and nearly double the 18,617 cases reported in 2019 prior to the pandemic.
Although vaccines have resulted in a dramatic decline in pertussis infections in the U.S., incidence of the disease has been rising since the 1990s, except for a brief dip during the COVID-19 pandemic.
Starting in the 1980s and 1990s, however, the U.S. and several other countries have been seeing a steady resurgence of pertussis cases, which have exceeded 10,000 cases in the U.S. every year from 2003 to 2019. They dropped again during the pandemic until last year’s resurgence.
There is no single explanation for why cases have been rising recently, but several factors probably contribute. First, pertussis naturally occurs in cyclic epidemics, peaking every two to five years. It is possible that the U.S. is headed into one of these peaks after a period of low activity between 2020 and 2022. However, some scientists have noted that the increase in cases is larger than what would be expected during a usual peak.
In the 1990s, national vaccine programs began to transition to a vaccine that contains purified components of the bacterial cell but not the whole cell. Some scientists now believe that although this partial-cell vaccine is less likely to cause high fevers in children, it provides protection for a shorter time. Immunity after whole-cell vaccination is thought to last 10-12 years compared with three to five years after the partial-cell vaccine. This means people may become susceptible to infection more quickly after vaccination.
How can people protect themselves and their families?
Routine vaccination for children starting in infancy followed by booster doses in adolescents and adults can help keep immunity high.
Public health experts recommend that children receive five doses of the pertussis vaccine. According to the recommendations, they should receive the first three doses at 2, 4 and 6 months of age, then two additional doses at 15 months and 4 years of age, with the aim of providing protection through early adolescence.
Infants younger than 6 weeks are not old enough to get a pertussis vaccine but are at the greatest risk of severe illness from pertussis. Vaccination during pregnancy can offer protection from birth due to antibodies that pass from the mother to the developing fetus. Many countries, including the U.S., now recommend that women receive one dose of pertussis vaccine between the 27th and 36th week of every pregnancy to protect their babies.
To maintain protection against pertussis after childhood, a booster dose of pertussis vaccine is recommended for adolescents at 11 to 12 years of age. The CDC recommends that all adults receive at least one booster dose.
The pertussis vaccine’s protction wanes over time, so public health experts recommend a booster around age 11 or 12. SELF Magazine via flickr, CC BY
Vaccine safety studies over the past 80 years have proven the pertussis vaccine to be safe. Around 20% to 40% of vaccinated infants experience local reactions, such as pain, redness and swelling at the vaccination site, and 3% to 5% of vaccinated infants experience a low-grade fever. More severe reactions are much less common and occur in fewer than 1% of vaccinated infants.
The vaccine is also highly effective: For the first year after receiving all five doses of the pertussis vaccine, 98% of children are protected from pertussis. Five years after the fifth dose, 65% of vaccinated children remain protected.
Booster vaccination during adolescence protects 74% of teens against pertussis, and booster vaccination during pregnancy protects 91% to 94% of immunized babies against hospitalization due to pertussis.
Families can talk to their regular health care providers about whether a pertussis vaccine is needed for their child, themselves or other family members.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
The content has a Center-Left political bias as it emphasizes public health measures such as vaccination and vaccination programs, highlighting the dangers of vaccine hesitancy and cuts to immunization services. It relies heavily on scientific data and expert opinions to explain whooping cough and the importance of vaccines, while implicitly criticizing reductions in public health funding and vaccine skepticism typically associated with conservative policies. However, the tone remains generally factual and non-partisan, focusing on health outcomes rather than overt political rhetoric, which places it slightly left of center but still largely mainstream in its approach.
The Conversation U.S. interviewed University of Tennessee Assistant Professor of Veterinary Medicine Joe Smith, a specialist in farm animal medicine and veterinary clinical pharmacology, about this trend. He describes acupuncture’s current uses for treating many species, from household dogs and cats to large animals like horses, cows and llamas:
Is veterinary acupuncture modeled on the traditional Chinese version?
There are two schools of thought about veterinary acupuncture. The original form of acupuncture, which has been practiced for thousands of years, follows principles of traditional Chinese medicine. It views the patient through a lens of five elements: wood, fire, earth, metal and water.
Each element is associated with a different type of energy. Practitioners work to maintain balance between those energies, which they believe is essential for a healthy body to function.
Another approach focuses on anatomical effects on the body. Practitioners place needles to achieve specific effects by stimulating muscles or nerves.
Both versions of acupuncture can help veterinary patients. They use very small, flexible needles, about two-tenths of a millimeter wide – less than one-hundredth of an inch. The needles are placed at various parts of the body to elicit specific responses from connective tissues, muscles and nerves.
The needles can be used by themselves, or with low levels of electrical current – a process called electroacupuncture. Both approaches are effective, but research suggests that benefits from electroacupunture last longer.
Veterinary acupuncturists can treat nearly any animal, from a bear to a porcupine, a dog or a sea turtle.
What does research show about using acupuncture on animals?
Acupuncture and electroacupuncture both increase the body’s levels of compounds called endogenous opioids. These are pain-relieving substances that the body produces naturally. They work similarly to pharmaceutical opioids, such as fentanyl and morphine.
Studies in small animal medicine show that using acupuncture can speed up healing from nerve injuries, such as spinal cord damage from herniated disks. This is a condition in which material from the disks in between the vertebra of the spinal cord is damaged, and puts pressure on the spinal cord and other parts of the nervous system.
Herniated disks can be very painful for animals. A 2023 study found that when dogs with this condition were treated with acupuncture, nearly 80% recovered, compared with 60% of animals whose cases were managed conservatively without acupuncture. Acupuncture can also make other techniques, such as epidural nerve blocks, more effective when both methods are used together.
Many vets are using acupuncture creatively for other purposes, such as increasing sick animals’ appetites, improving their digestion and accelerating healing from injuries.
How does your veterinary medicine group use acupuncture?
Our practice at the University of Tennessee has used acupuncture most extensively to help rehabilitate animals recovering from conditions like radial nerve paralysis and femoral nerve injury. We can use acupuncture to stimulate muscles or to provide pain relief, either by itself or combined with other therapies.
In our Farm Animal Hospital, we regularly use acupuncture for recumbent or “down” animals. That’s a veterinary term for animals that have been unable to stand for extended periods of time.
With acupuncture, and occasionally electroacupuncture, we can stimulate muscles and nerves that aren’t functioning normally. This help to prevent atrophy, or wasting and thinning of muscle mass.
For every day that a large animal is down, its muscles atrophy and fluid builds up around injured limbs or joints. These effects can prolong their recovery, or even make it less likely that they will recover.
By using acupuncture to stimulate atrophied muscles, veterinarians can start to reverse this process. We have used acupuncture extensively on large animals, including cattle, horses, llamas, alpacas, sheep, goats, pigs and even camels.
One example is goats that have spinal cord injuries caused by parasite migration – a condition called cerebrospinal nematodiasis, or “meningeal worm.” Worm larvae that normally are parasites of white tail deer infect goats through the animals’ digestive tracts, then migrate to the spinal cord and nervous system. They get lost and die there, causing inflammation that can do significant damage.
We use acupuncture and electroacupuncture to stimulate the goats’ large and accessory spinal nerves and the muscles in the animals’ legs and backs. This gives the goats more muscle function when the inflammation clears, and we believe it helps reduce their pain.
We’ve also had good results with acupuncture treatment for llamas and alpacas, which are widely used in Tennessee’s Smokey Mountains to carry tourists’ gear up- and downhill. As large animals like these age, they can develop osteoarthritis, a degenerative joint disease that’s incredibly painful and debilitating for them. Acupuncture and electroacupuncture can help keep them moving.
Our equine services mainly use acupuncture for rehabilitation, helping horses recover from injuries.
One advantage of acupuncture and electroacupuncture in large animals is that they don’t have many adverse effects. Drugs can have side effects such as nausea and diarrhea, and may cause potentially serious complications. An acupuncture needle placed by a trained veterinarian has few to no adverse effects when it’s done correctly.
A crow and an opossum at the Nashville Zoo receive acupuncture treatment for mobility issues.
Can pet owners be confident if their vet recommends acupuncture?
If there is a nerve or muscle involved, there is probably a veterinary treatment option using acupuncture or electroacupuncture. New studies regularly add to our understanding of the neurology and biochemistry that underlie these therapies.
Although we’re still learning, if your vet recommends acupuncture for an aging dog or cat – especially for chronic pain – you can be confident that it’s not a fringe treatment. As long as the person treating your pet is a licensed veterinarian, and is certified by a professional organization like Curacore, Chi University or the American Academy of Veterinary Acupuncture, acupuncture should make your pet more comfortable and improve its quality of life.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
The article presents information on veterinary acupuncture in a balanced and neutral manner. It outlines both traditional Chinese acupuncture and the anatomical approach to acupuncture, providing an overview of research findings and expert opinions. There is no overt advocacy for or against the practice, and the sources, such as the University of Tennessee’s veterinary expert, provide a scientific perspective. The tone is factual and informative, focusing on the medical aspects of acupuncture for animals, and does not show a clear political bias or attempt to influence the reader’s views on the subject.
Cancer research in the U.S. doesn’t rely on a single institution or funding stream − it’s a complex ecosystem made up of interdependent parts: academia, pharmaceutical companies, biotechnology startups, federal agencies and private foundations. As a cancer biologist who has worked in each of these sectors over the past three decades, I’ve seen firsthand how each piece supports the others.
When one falters, the whole system becomes vulnerable.
The United States has long led the world in cancer research. It has spent more on cancer research than any other country, including more than US$7.2 billion annually through the National Cancer Institute alone. Since the 1971 National Cancer Act, this sustained public investment has helped drive dramatic declines in cancer mortality, with death rates falling by 34% since 1991. In the past five years, the Food and Drug Administration has approved over 100 new cancer drugs, and the U.S. has brought more cancer drugs to the global market than any other nation.
But that legacy is under threat. Funding delays, political shifts and instability across sectors have created an environment where basic research into the fundamentals of cancer biology is struggling to keep traction and the drug development pipeline is showing signs of stress.
These disruptions go far beyond uncertainty and have real consequences. Early-career scientists faced with unstable funding and limited job prospects may leave academia altogether. Mid-career researchers often spend more time chasing scarce funding than conducting research. Interrupted research budgets and shifting policy priorities can unravel multiyear collaborations. I, along with many other researchers, believe these setbacks will slow progress, break training pipelines and drain expertise from critical areas of cancer research – delays that ultimately hurt patients waiting for new treatments.
A 50-year foundation of federal investment
The modern era of U.S. cancer research began with the signing of the National Cancer Act in 1971. That law dramatically expanded the National Cancer Institute, an agency within the National Institutes of Health focusing on cancer research and education. The NCI laid the groundwork for a robust national infrastructure for cancer science, funding everything from early research in the lab to large-scale clinical trials and supporting the training of a generation of cancer researchers.
This federal support has driven advances leading to higher survival rates and the transformation of some cancers into a manageable chronic or curable condition. Progress in screening, diagnostics and targeted therapies – and the patients who have benefited from them – owe much to decades of NIH support.
The Trump administration is cutting billions of dollars of biomedical research funding.
But federal funding has always been vulnerable to political headwinds. During the first Trump administration, deep cuts to biomedical science budgets threatened to stall the progress made under initiatives such as the 2016 Cancer Moonshot. The rationale given for these cuts was to slash overall spending, despite facing strong bipartisan opposition in Congress. Lawmakers ultimately rejected the administration’s proposal and instead increased NIH funding. In 2022, the Biden administration worked to relaunch the Cancer Moonshot.
This uncertainty has worsened in 2025 as the second Trump administration has cut or canceled many NIH grants. Labs that relied on these awards are suddenly facing funding cliffs, forcing them to lay off staff, pause experiments or shutter entirely. Deliberate delays in communication from the Department of Health and Human Services have stalled new NIH grant reviews and funding decisions, putting many promising research proposals already in the pipeline at risk.
Philanthropy’s support is powerful – but limited
While federal agencies remain the backbone of cancer research funding, philanthropic organizations provide the critical support for breakthroughs – especially for new ideas and riskier projects.
Groups such as the American Cancer Society, Stand Up To Cancer and major hospital foundations have filled important gaps in support, often funding pilot studies or supporting early-career investigators before they secure federal grants. By supporting bold ideas and providing seed funding, they help launch innovative research that may later attract large-scale support from the NIH.
Without the bureaucratic constraints of federal agencies, philanthropy is more nimble and flexible. It can move faster to support work in emerging areas, such as immunotherapy and precision oncology. For example, the American Cancer Society grant review process typically takes about four months from submission, while the NIH grant review process takes an average of eight months.
Ted Kennedy Jr., right, and Jeff Keith raise money for the American Cancer Society in 1984. Mikki Ansin/Getty Images
But philanthropic funds are smaller in scale and often disease-specific. Many foundations are created around a specific cause, such as advancing cures for pancreatic, breast or pediatric cancers. Their urgency to make an impact allows them to fund bold approaches that federal funders may see as too preliminary or speculative. Their giving also fluctuates. For instance, the American Cancer Society awarded nearly $60 million less in research grants in 2020 compared with 2019.
While private foundations are vital partners for cancer research, they cannot replace the scale and consistency of federal funding. Total U.S. philanthropic funding for cancer research is estimated at a few billion dollars per year, spread across hundreds of organizations. In comparison, the federal government has typically contributed roughly five to eight times more than philanthropy to cancer research each year.
Industry innovation − and its priorities
Private-sector innovation is essential for translating discoveries into treatments. In 2021, nearly 80% of the roughly $57 billion the U.S. spent on cancer drugs came from pharmaceutical and biotech companies. Many of the treatments used in oncology today, including immunotherapies and targeted therapies, emerged from collaborations between academic labs and industry partners.
But commercial priorities don’t always align with public health needs. Companies naturally focus on areas with strong financial returns: common cancers, projects that qualify for fast-track regulatory approval, and high-priced drugs. Rare cancers, pediatric cancers and basic science often receive less attention.
Industry is also saddled with uncertainty. Rising R&D costs, tough regulatory requirements and investor wariness have created a challenging environment to bring new drugs to market. Several biotech startups have folded or downsized in the past year, leaving promising new drugs stranded in limbo in the lab before they can reach clinical trials.
Without federal or philanthropic entities to pick up the slack, these discoveries may never reach the patients who need them.
A system under strain
Cancer is not going away. As the U.S. population ages, the burden of cancer on society will only grow. Disparities in treatment access and outcomes persist across race, income and geography. And factors such as environmental exposures and infectious diseases continue to intersect with cancer risk in new and complex ways.
Addressing these challenges requires a strong, stable and well-coordinated research system. But that system is under strain. National Cancer Institute grant paylines, or funding cutoffs, remain highly competitive. Early-career researchers face precarious job prospects. Labs are losing technicians and postdoctoral researchers to higher-paying roles in industry or to burnout. And patients, especially those hoping to enroll in clinical trials, face delays, disruptions and dwindling options.
Researchers have been rallying to protect the future of science in the U.S. AP Photo/John McDonnell
This is not just a funding issue. It’s a coordination issue between the federal government, academia and industry. There are currently no long-term policy solutions that ensure sustained federal investment, foster collaboration between academia and industry, or make room for philanthropy to drive innovation instead of just filling gaps.
I believe that for the U.S. to remain a global leader in cancer research, it will need to recommit to the model that made success possible: a balanced ecosystem of public funding, private investment and nonprofit support. Up until recently, that meant fully funding the NIH and NCI with predictable, long-term budgets that allow labs to plan for the future; incentivizing partnerships that move discoveries from bench to bedside without compromising academic freedom; supporting career pathways for young scientists so talent doesn’t leave the field; and creating mechanisms for equity to ensure that research includes and benefits all communities.
Cancer research and science has come a long way, saving about 4.5 million lives in the U.S. from cancer from 1991 to 2022. Today, patients are living longer and better because of decades of hard-won discoveries made by thousands of researchers. But science doesn’t run on good intentions alone. It needs universities. It needs philanthropy. It needs industry. It needs vision. And it requires continued support from the federal government.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
This article reflects a centrist-left perspective, primarily emphasizing the critical role of federal funding in cancer research and its vulnerability due to political shifts, particularly under the Trump administration. It also highlights the challenges faced by researchers and the urgent need for stable funding to maintain U.S. leadership in cancer research. While it acknowledges the importance of private and philanthropic contributions, it leans towards advocating for government involvement in maintaining a balanced and effective research ecosystem. The discussion of past funding cuts and their impact further signals a mild left-leaning concern over government policy changes.
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