Rich people stay healthy nearly a decade longer than poor people

Rich people live an average of seven to nine more disability-free years than their socioeconomically disadvantaged peers, according to research published in the Journals of Gerontology: Medical Sciences Jan. 15.

The research was the result of a collaboration, led by Paola Zaninotto, PhD, between scientists in Europe and the U.S. and involved taking an exhaustive look at the socioeconomic differences between the U.S. and U.K. Life expectancy has increased “dramatically” in both countries over the last 100 years, the team wrote, but recent evidence suggests life expectancy at birth is decreasing in the U.S. and leveling off in the U.K.

There are also stark differences between the healthcare systems in both nations, including the fact that health coverage in England is publicly funded while U.S. coverage relies on either private insurance or publicly funded Medicare and Medicaid programs. The U.K. also enjoys a more generous welfare state system than its counterpart across the pond, offering unemployment compensation, sick pay, housing policies and social retirement benefits. Zaninotto et al. said those factors can play a major part in promoting psychosocial well-being, which is linked to better overall health and mortality.

“Although it is well-established that individuals in lower socioeconomic groups in England have better health than people in higher socioeconomic groups in the United States, the extent to which these socioeconomic differences between the two countries extend to healthy life expectancy is not known,” Zaninotto, of University College London, and colleagues wrote. “The aim of this study was to explore whether the health disadvantage of older Americans extends to healthy life expectancy.”

The researchers compared a handful of measures of socioeconomic status between the countries, including education, wealth and social class. They said wealth is considered a particularly useful indicator of long-term socioeconomic status among seniors since it captures both past and present circumstances.

Zaninotto and co-authors pulled information on 14,803 individuals aged 50 and up from the U.S. Health and Retirement Study (HRS) and on 10,754 people from the English Longitudinal Study of Aging (ELSA), analyzing the data with one of the key metrics of health expectancy—disability-free life expectancy—in mind. Disability was measured in terms of impaired activities and instrumental activities of daily living.

The team reported that socioeconomic inequalities in disability-free life expectancy were similar between the U.K. and U.S., with the greatest similarities between women. Zaninotto et al. said they observed a small advantage of up to one year for older American men compared to older English men, but that advantage was insignificant in later estimates of disability-free life expectancy by socioeconomic status.

Wealth seemed to present the greatest divide in both countries, with the poorest people in each nation living on average seven to nine fewer disability-free years than their well-off counterparts. The researchers said their findings indicate that although people are living longer lives in both the U.K. and U.S., those increased years might not be spent in optimal health.

“Our findings have implications for policymakers interested in reducing health expectancy inequalities,” they wrote. “Improving both the quality and quantity of years that individuals are expected to live has implications for public expenditure on health, income and long-term care needs of older people as well as work participation in older ages.”

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