I am a dual national with roots in Europe. A far greater contributor is the lack of avoidable chronic disease in Europe. I know many middle class and above Americans who have ongoing battles with their insurance companies to treat and manage relatively mundane issues. If they apply enough time and money they can usually resolve things though often this requires pausing treatment or changing doctors recommendations.

This does not exist in Europe. What your doctors recommend happens regardless of your income.

There is an image I see when in the US. A homeless person who is crippled and pushing themselves with a stick or one leg in a wheelchair. Lame thanks to lack of treatment. You never see that in Europe. Homeless people exist but they aren’t chronically ill.

This has positive effects for everyone. There is less disease in the environment and it’s easier for people to literally get back on their feet.

It’s a bit of wishful thinking to presume Americans poor health is all lifestyle choices and advertising. It’s the system and a pervasive lack of easy to access treatment at all levels of society.