Longevity Gap: Wealthy Outlive Poor by Nearly 10 Years

By Deborah Jeanne Sergeant

Researchers with University College London recently published a study that correlates wealth as the greatest factor that indicates when a person’s health will begin declining with age.

Wealthy people in the study of more than 25,000 adults over age 50 in England and the U.S. lived nine years longer in good health than poor people.

The study indicated that wealthy women were expected to live an average of 33 years without age-related disability compared with those with less money, who live only 23 to 24.6 years in good health.

Well-to-do men could anticipate 31 healthy years but poor men could expect 22 to 23 years.

One reason behind the gap is where a person lives.

According to Erie County New York Community Health Assessment 2017-2019, more than 70% of patients at the county’s health clinic come from ZIP codes 14204, 14206, 14211, 14212 and 14215. In these areas, the unemployment rate “is significantly higher” than in the rest of Erie County, New York state, and the nation.

“Median household income and per capita income are about half of Erie County income levels in three of five of these ZIP codes,” the report further stated. “Analysis of demographic trends as they relate to poor health and need for public health services indicates that where poverty is the highest, poor health outcomes are the greatest” compared with other parts of the county and the state.

It’s tough to correlate how where one lives affects healthy longevity, according to Ju Joh, family medicine physician and associate chief medical officer with Primary Mobile Healthcare Partners in Buffalo.

“It’s a difficult question to answer,” he said. “It comes with a lot of cofounding factors. Do you have access to fresh food and groceries? Is it safe to walk around? Social structure becomes very important for maintaining health.

“People of a lower socioeconomic level don’t have that social structure. Their ability to invest in their health and the extra time to exercise and eat properly and being able to have resources for that is another way to think about it.”

The stressors of living as a poor person can negatively affect health. Can we pay the rent? How can we afford these bills? How can I get to work? What will happen if we have an unexpected bill?

Joh added that it matters whether a person understands how to access health insurance so they can afford to prevent bigger health issues.

Neighborhood factors such as high smoking rates, a lack of access to healthful food and exercise opportunities, and unhealthy housing can significantly reduce life expectancies.

The Erie County report states that 19.2% of Erie County adults currently smoke, most of them in the Buffalo metro region, compared with 15.9% in the entire state.

As for access to healthful food, transportation to stores selling fresh foods makes a difference for residents who have no vehicle. The county report stated that public transportation is mostly within city limits.

“There is inadequate coverage of bus lines linking the city of Buffalo to either first ring suburbs — Tonawanda, Kenmore Cheektowaga, West Seneca — or second ring suburbs, Amherst, Lancaster, Orchard Park, Clarence, Hamburg,” said Joh.

“This inadequacy and infrequency of runs limits residents without access to personal vehicles to only those services that can be reached through the public transportation system.”

The exception is people who receive Medicaid and seniors, who have limited access to transportation offered through Erie County resources.

“When you look at supermarkets and areas to work out, there are disparities depending on where you’re living,” Joh said.

Sufficient safe places to walk and for children to play can help promote good health.

Access to healthcare also makes a big difference for preventing pre-term birth, chronic health problems, and emergency room visits.

Protective factors include family and social support, community safety and education. Not everyone who has a low income is uneducated. For example, an artist or childcare provider may have a good education but not make a lot of money. Their education helps them make better lifestyle choices about health, which can help mitigate other factors of receiving a low income.

“It’s about understanding factors about your health and having health literacy,” Joh said. “Some diseases don’t show up right away. They manifest later.

“I don’t think your fiscal status has to do with your health. There are low-cost lifestyle changes to go through to keep yourself healthy. It’s more about understanding that what you do now will affect your health later.

“Even with healthcare literacy, if you have no motivation to follow it, if your concentration and work is towards being financially successful rather than healthy, health literacy goes out the window.”

That could include people who are well educated and well-off financially but unhealthy because they do not take the time to care for their health as they should.

The Centers for Disease Control and Prevention states that adults who are 25 and lack a high school diploma can expect to die nine years earlier than college graduates. Approximately 24.6% of Buffalo residents and 31.6% of Erie County residents have a bachelor’s degree, lower than the statewide rate of 34.2% percent.

Richard Derwald is 85 and coordinates Erie County Senior Fitness Program in Erie County. Until the pandemic, about 1,000 seniors in Erie County attended his fitness programs weekly.

An athlete from his teen years, Derwald believes that “life extension depends upon information. I got a lot of information when I was young and I continue to learn about health.”

He recalls that in his youth, schools lacked weight rooms and other amenities that would encourage fitness. Women were cautioned to not lift weights. He is thankful he began lifting weights and wresting as a teen and young adult and continued in fitness while working.

“Just by virtue of the way I make a living the last 25 years keeps me going,” Derwald said. “For a lot of widows, my class is their first experience working out and training. They say they feel so much better.”