Greater Individual Wealth Correlates with Longer Life Expectancy
Individual wealth correlates with life expectancy, with an effect size that is in the same ballpark as those related to lifestyle choices involving exercise, diet, and consequences thereof. It remains unclear as to why wealth correlates with life expectancy. It is a part of a tangled web of correlations including intelligence, education, social status, personality traits, access to and ability to use medical services, as well as the suspicion that genetic associations with at least some of those line items (largely intelligence) may also independently affect health. Theorizing is easy, but assessing the relative contributions of the various proposed mechanisms is a challenge; proposing to fix the issue by top-down redistribution is naive for a number of reasons, perhaps the least of which being that absent an understanding of the mechanisms there is no guarantee that it would work.
This longitudinal cohort study analyzed the association between wealth and survival among participants in the Health and Retirement Study (1992-2018), a nationally representative panel study of middle-aged and older (≥50 years) community-dwelling, noninstitutionalized US adults. The data analysis was performed between November 15, 2022, and September 24, 2023. Household wealth was assessed on study entry, calculated as the sum of all assets minus the value of debts and classified into deciles. Weibull survival models were used to estimate the association between per-person wealth decile and survival, adjusting for age, sex, marital status, household size, and race and ethnicity. Changes in longevity that might occur under alternative wealth distributions were then estimated.
The sample included 35,164 participants (mean age at study entry, 59.1 years). The hazard of death generally decreased with increasing wealth, wherein participants in the highest wealth decile had a hazard ratio of 0.59 for death compared with those in the lowest decile, corresponding to a 13.5-year difference in survival. A simulated wealth distribution of perfect equality would increase populationwide median longevity by 2.2 years, fully closing the mortality gap between the US and the OECD average. A simulated minimum inheritance proposal would increase populationwide median longevity by 1.7 years; a simulated wealth distribution similar to Japan's would increase populationwide median longevity by 1.2 years; and a simulated baby bonds proposal would increase populationwide median longevity by 1.0 year.