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Less wealth tied to higher odds of disability and premature death
October 23, 2017 / 9:07 PM / a month ago

Less wealth tied to higher odds of disability and premature death

(Reuters Health) - People with fewer assets like real estate, savings, stocks and retirement accounts may be more likely to develop disabilities or die prematurely than wealthier individuals, a new study suggests.

While plenty of previous research has documented health problems associated with poverty, the current study looked beyond just income to focus on a wide variety of financial resources that adults in the U.S. and UK may accumulate by middle age and beyond.

“Interestingly, the link between wealth and health outcomes was seen in both the U.S. and England, which are two countries with very different health and social safety net systems,” said study leader Dr. Lena Makaroun of the VA Puget Sound Health Care System and the University of Washington in Seattle.

“We also saw the same pattern for older adults both above and below age 65, at which age Medicare becomes available in the U.S. and around which age retirement benefits kick in in both countries,” Makaroun said by email.

The similarities suggest that for low-wealth individuals, health care or financial benefits alone may not be enough to improve their health trajectory, she added.

For 10 years, the researchers tracked nearly 20,000 participants in the U.S. and England from nationally representative groups of older adults. They looked at two different age groups - 54 to 64 and 66 to 76 - because Medicare and Social Security benefits in the U.S. and the State Pension in England typically begin around age 65.

The connection between wealth and health was clear even among the younger people in the study, researchers report in JAMA Internal Medicine.

In the U.S., people aged 54 to 64 in the lowest of five levels of wealth, with assets of no more than $39,000, had 17 percent risk of death and 48 percent risk of disability over 10 years.

By contrast, the wealthiest of the five groups, with more than $560,000, had a death risk of 5 percent and a disability risk of 15 percent.

Disability was defined as any difficulty in performing activities of daily living, such as dressing, eating and bathing.

In the U.K., people aged 54 to 64 in the lowest wealth group, with no more than 34,000 euros, had a 16 percent death risk and a 42 percent disability risk over 10 years. The wealthiest group, with more than 310,550 euros, had a death risk of 4 percent and a disability risk of 17 percent.

For the adults aged 66 to 76, the absolute risk of death and disability was higher, but the differences across levels of wealth were similar, the study found.

One limitation of the study is the differences between financial and health circumstances for adults in the U.S. and the U.K., the authors note. Another shortcoming is the lack of disability data for some people included in the disability analysis.

In some instances, people may also receive retirement benefits in either country, or government health benefits in the U.S., before age 65, the researchers also point out.

Even so, the findings add to a large and growing body of evidence linking wealth to health outcomes, said Dr. Martin McKee, author of an accompanying editorial and a public health researcher at the London School of Hygiene and Tropical Medicine.

“It highlights how the health system is only one input into health, something we have known for many years,” McKee said by email.

“We do know that greater wealth and income gives you the resources to make healthy choices in diet, leisure, etc.,” McKee added. “Moreover, having greater wealth is like having an insurance policy against things going badly wrong, giving you a more positive outlook on the future.”

SOURCE: bit.ly/2lb7iVF JAMA Internal Medicine, online October 23, 2017.

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