A new study that highlights the serious impacts of wealth inequality in the United Kingdom and United States suggests that being rich can add about nine "healthy" years to a person's life.
The transatlantic study on "healthy life expectancy," published Wednesday in the Journal of Gerontology, is based on data from more than 25,000 adults—10,754 in the U.K. and 14,803 in the U.S.—aged 50 and older. The data came from the English Longitudinal Study of Ageing (ELSA) and the U.S. Health and Retirement Study (HRS).
Although life expectancy for both countries has significantly risen over the past century, recent evidence has shown life expectancy falling in the U.S. and leveling off in the U.K. amid rising rates of disability and chronic conditions among older adults, the study notes. Previous research also has shown that Americans are worse off in terms of health compared to the British.
"While life expectancy is a useful indicator of health, the quality of life as we get older is also crucial," said lead author Paola Zaninotto, an associate professor of epidemiology and public health at University College London and a member of the ELSA management group.
"By measuring healthy life expectancy we can get an estimate of the number of years of life spent in favorable states of health or without disability," Zaninotto added. "Our study makes a unique contribution to understanding the levels of inequalities in health expectancies between England and the U.S. where healthcare systems are very different."
"Being wealthy adds nine years to healthy life expectancy: a life free from disability & pain."
— Medact (@Medact) January 15, 2020
With the exceptions of Medicare, which serves people aged 65 and older, and Medicaid, which serves people with low incomes or disabilities, most Americans are stuck relying on a private healthcare system, despite public pressure to transition to a single-payer program. The U.K., meanwhile, established its National Health Service (NHS) in 1948. British conservative politicians repeatedly have pushed for increased privatization of the government-run NHS, but such calls have sparked swift backlash.
Referencing other research showing an American disadvantage in health compared with the British, the study says that "since access to healthcare is not the only explanation for inequalities in health, cross-national comparisons of health expectancy can also help evaluating strategies adopted in different countries to help reducing health inequalities."
"Other possible explanations for greater health inequalities in the United States compared to England might relate to a more generous welfare state system in England compared to the United States, including unemployment compensation, sick pay, housing policies, and social retirement benefits," explains the study. "These contextual factors can in turn provide better psychosocial health and reduced stress, especially among socioeconomically disadvantaged groups. It is possible that older Americans are exposed to more psychosocial distress, which has been shown to increase the risk of chronic conditions and early mortality."
Along with acknowledging some of the differences between the two countries, the researchers also emphasize some similarities—notably, that "it is now well established that in the United States and England, there are striking socioeconomic inequalities, in both general health and life expectancy, with apparent socioeconomic gradations, rather than differences only being seen between rich and poor."
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The researchers found that wealth was the "biggest socioeconomic advantage" in terms of healthy life expectancy in both countries and across all age groups. Specifically, they found that from the age 50, the wealthiest British and American men lived 31 more "healthy" years compared with 22–23 years for the poorest men; rich women lived about 33 additional "healthy" years compared compared with 24–26.6 years for their poor counterparts.
"Levels of disability-free life expectancy in the United States and in England (from HRS and ELSA) are approximately the same," explains the study. "We have shown that in England and the United States, despite living longer lives, not all the increased years of life are being spent in optimal health. Our findings have implications for policymakers interested in reducing health expectancy inequalities."
Our latest research on inequalities in disability-free life expectancy comparing @ELSA_Study and @hrsisr shows that in both countries wealthier people compared to poorest live up to 9 years longer in good health @HydeM1976 @Jenny_anne1 @SariStenholm https://t.co/YpuzHwVgcD
— Paola Zaninotto (@PZaninotto) January 15, 2020
"Improving both the quality and the quantity of years that individuals are expected to live has implications for public expenditure on health, income, and long-term care need of older people as well as work participation in older ages," the study concludes. "Furthermore, our results of similar levels of socioeconomic disadvantage in health expectancy in England and the United States suggest that in both countries greater efforts should be put into reducing health inequalities."
Echoing the study's conclusion, Zaninotto said that "our results suggest that policymakers in both England and the U.S. must make greater efforts into reducing health inequalities."
That call also came from politicians and political figures on both sides of the Atlantic who responded on social media to reporting on the study's findings.
Zarah Lultana, a Labour member of Parliament in the U.K., declared on Twitter that "extreme economic inequality scars our society" and expressed a desire to "live in a Britain that cares for everyone equally."
Extreme economic inequality scars our society.
It effects all areas of our lives: from educational opportunities and job prospects, to health and life expectancy.
Dr. Victoria Dooley, a family medicine physician who also serves as a surrogate for Sen. Bernie Sanders's presidential campaign, also took to Twitter to share her reaction to the study. As she put it: "Starvation wages, bad for workers, helps the super rich literally drain their life force so that they can live longer lives."