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Wealth alone does not guarantee a longer life. Researchers led by Irene Papanicolas, PhD, from the Brown University School of Public Health in Providence, Rhode Island, explained in The New England Journal of Medicine how they compared the health of American adults and seniors with their European counterparts by examining wealth distribution.

As the experts noted, wealth — defined as the total assets and resources a person controls — plays a significant role in health, especially for older adults. For example, retirees with low or no income may rely on their wealth to access healthcare and long-term care.

“Comparing disparities in the relationship between wealth and health in the United States with those in European countries that have different health and long-term care services and other social supports may highlight the extent of the challenges of inequality in the United States,” Papanicolas and colleagues explained.

Health Beyond Wealth

This longitudinal, retrospective cohort study included US and European adults aged 50-85 years from the Health and Retirement Study and the Survey of Health, Ageing, and Retirement in Europe between 2010 and 2022. The sample was divided into wealth quartiles (with the fourth quartile being the wealthiest), and mortality rates were estimated for each quartile in both the United States and 16 European countries.

The analysis revealed significant differences in all-cause mortality based on wealth quartile. In general, mortality was higher in lower wealth quartiles (poorer individuals), and in the United States, the mortality gap between the lowest and highest quartiles was wider compared with Europe.

However, even among wealthier Americans, mortality was higher than among their counterparts in Northern, Western, and Southern Europe and similar to those in the lowest quartiles in Northern and Western Europe, as well as much of Eastern Europe. “Wealth can influence health by affecting access to education, job opportunities, healthcare, and social networks, all of which are important predictors of health. Cultural, economic, and policy differences may influence the degree to which wealth influences these factors,” Papanicolas and colleagues explained.

Weaker social structures and limited access to healthcare likely contribute to the larger gap between wealth quartiles in the United States compared with Europe, but they do not explain why wealthier Europeans have better survival rates than wealthier Americans in the same quartile. “Other systematic factors may influence longevity across social strata, such as diet; environment; behavioral, cultural, and social attitudes; and opportunities for social mobility,” the authors noted, reminding us that the poorest are more vulnerable to these factors, which affect society as a whole.

This story was translated from Univadis Italy using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.