Those looking for a magic elixir to keep them healthy and happy need look no further than their bank account. Wealth and, more broadly, socioeconomic status, play a powerful role in determining how long we live.
"It's clear that those who have less wealth will have fewer years to live than those with more wealth," says James Smith,
senior economist at the research group RAND. The connection is so
widely accepted that researchers have given it a name: "the wealth
gradient in mortality." What's far more complicated to understand is why
the connection exists, and whether wealth causes better health, or vice
versa.
The longest-running longitudinal study of health, run by George Vaillant, professor of psychiatry at Harvard Medical School,
found education to be one of the biggest determinants of longevity,
along with behavioral factors--excessive drinkers were more likely to
die young, for example. Out of the 500-plus Harvard students
and inner-city Boston men the study has followed since 1937, the
Harvard students lived an average of 10 years longer than the inner-city
men, says Vaillant. In fact, 3 in 10 of the Harvard students lived to
90, compared to the 3 to 5 percent one would expect from that age group.
Among the inner-city men who attended college, health was just as
good as that of Harvard students who attended college but not graduate
school, says Vaillant. "[The Boston men] went to terrible colleges by
Harvard standards, but they did get 16 years of education, and that
absolutely evened the playing field," says Vaillant. People who go to
college tend to drink less, smoke less, and are less likely to be obese,
he adds, all factors that contribute to longevity. In fact, after
controlling for education and other factors, Vaillant found that income
alone had little effect on longevity.
People who pursue higher education, explains Vaillant, tend be
more focused on the future, which probably also helps them make
healthier choices. "In order to get an education, especially if you're
poor, you have to think you have a future," he says.
Indeed, says Smith, one hypothesis is that "more-educated people
are more forward-looking, and when they make decisions, they take into
account the future more than uneducated people. A lot of things you
might do don't have an immediate negative impact--excessive drinking,
smoking, and doing drugs can [feel good in the short-term]--but the fact
is it's going to kill you in the future." Another possibility is that
people with higher levels of education are more likely to maintain their
health, have better access to healthcare, and follow doctors'
directions when it comes to taking pills or other instructions.
Smith's research also suggests that causality doesn't just run
one way; health contributes to wealth, as well. "Because you are healthy
and able to work, you are wealthier," he explains. At the same time,
poor health often takes a toll on a person's wealth, either because it
prevents one from working or because of expensive medical treatments.
Taken together, researchers at the University of Chicago estimate that the gains in life expectancy between 1970 and 2000 resulted in an additional $3.2 trillion a year in national wealth.
Meanwhile, as income disparities continue to grow in this
country, so do life expectancy disparities. According an analysis by
from the Social Security Administration,
life expectancy for 65-year-old men in the top half of the earnings
distribution has increased by five years, to 21.5 more years. For those
in the bottom half of the earnings distribution, life expectancy has
increased just over one year, to 16.1 more years.
A likely factor, says Monique Morrissey, an economist at the
Economic Policy Institute, is differing access to healthcare. "Not just
people who are not insured, but if you have better insurance, you might
get tested earlier, have better access to care, and be better able to
follow complicated treatments--there have been a lot of improvements in
cardiovascular care, especially for men," she says. While behavioral factors
such as smoking and obesity likely explain much of the overall
connection between wealth and health, they can't account for the growing
disparity in life expectancy, since those behavioral factors are not
growing disproportionately themselves.
Among younger Americans, health disparities are particularly
pronounced, which could adversely affect U.S. life expectancy in the
future. Eric Reither, associate professor of sociology at Utah State
University, has found that among younger Americans, obesity-related
diseases like heart disease and diabetes will likely increase.
As a result, Reither says he envisions two Americas in the coming
decades. "One that is relatively poor and adversely affected by obesity
and related conditions, and one that is relatively well-off and less
affected by these diseases. Life expectancy trajectories for these
groups will likely follow different paths, with the former stagnating
and perhaps even experiencing some decline, and the latter continuing to
inch upward."
As for that magic elixir, a group of British scientists now say
they have identified a hormone more prevalent in the wealthy that they
link to longevity. The hormone regulates one's stress response and is
connected to diet, exercise, and relationships--all known
longevity-inducing factors. One can imagine that hormone being packaged
and marketed as some kind of magic youth serum, next to antioxidant
pills and superfoods.
But for Vaillant, the answer is much simpler. "Those wonderful
pills that are marketed to let you live forever--those things just don't
seem to be terribly important," he says. Instead, it's making bigger
behavioral choices, such as avoiding drinking too much and nurturing a
stable marriage, that let people prolong their lives. And as for what
makes people happy in old age, Vaillant says it has more to do with
strong, loving relationships than anything for sale at a store. Says
Vaillant, "I'm 77, and what I enjoy most are my grandchildren."
At Dennis Basso's show this week, a model took a major tumble
