StemCell Therapy

Dr. Sal Iaquinta

The song God Part II on the album Rattle and Hum by U2 has the lyrics: The rich get healthy, while the sick stay poor. Bono sung those words in 1988. Since then, a number of researchers have tackled what exactly is the link between wealth and health, and why.

At first glance, one would expect a simple explanation: people with more money live longer. Clearly such a relationship cannot be strictly linear, as people dont fall dead if they declare bankruptcy and at some point, wealth has a ceiling in which no matter how much more money you have to spend, you cant buy any more medicine or access to doctors.

Yet it isnt all about access either. Studies in European countries with free access to health care have still demonstrated that income disparities in longevity are considerable, so it is more than just access that creates the difference and that difference is significant.

A Harvard study examined de-identified tax records, the United States Census and the Medicare database, along with other population surveys, to try to determine the link between longevity and income in people age 40 or older. Obviously, they had to adjust the income and how it related to health for the retired group separately from those employed the higher earner at age 61 who retired at age 62 was kept a high earner at age 63 using their study design.

They looked at 14 years worth of data to see trends related to income both longitudinally per person and by each age group. For example, there were a lot of low-earning 40 year olds in every year that were studied. There were fewer 45 year olds in that same income percentile because some of them got better jobs and some of them died.

They found that men in the top 1% income bracket lived to 87.3 years old, a whole 14.6 years longer than men in the bottom 1% of income, living only 72.7 years. For women, the gap was narrower with the top 1% living until 88.9 years and the lowest 1% at 78.8 years.

During the period studied, they also found that the lifespan increased more for wealthier people than for poorer people. The disparity of being poor versus rich increased from 2001 to 2014 with the top 5% of earners adding three years to their lifespan, whereas the bottom 5% had no advance.

The studied databases also included zip codes, so the researchers were able to determine which parts of the country did better with longevity. New York and San Francisco had the longest life expectancy and places like Detroit fared far worse. In the lowest income brackets, the lifespan in Detroit is five years shorter than in San Francisco.

Then they looked at the data with available health information. No surprise, obesity and smoking lowered lifespan and exercising increased it. It is important to know that a woman who is a lifelong smoker on average has almost a 10-year shorter lifespan than one whom doesnt. These relationships were strongest in the lowest 25% of income earners. This age group suffers a higher incidence of heart disease and cancer than higher-income brackets, whereas automobile accidents and homicides are equal to the other income brackets.

Increased population density was associated with better longevity. The air might be fresher out in the country, but the folks are polluting themselves by smoking at a higher rate than their urban counterparts. At the same time, people in rural areas are more likely to be obese. Interestingly, increased access to health insurance didnt seem to make a significant difference joining Medicare at age 65 doesnt affect the trajectory of longevity, whereas income bracket and lifestyle does.

Your money or your life? Not really. The take-home lesson is that preventative health care getting people to quit smoking, maintain an ideal weight and exercise is far more important than just throwing money at building more hospitals and hiring more doctors.

Dr. Salvatore Iaquinta is a head and neck surgeon at Kaiser Permanente San Rafael and the author of The Year They Tried To Kill Me. He takes you on the Highway to Health every fourth Monday.

Go here to read the rest:
Exploring the health-wealth connection - Marin Independent Journal

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