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Greater Wealth Linked to Lower Mortality, With Stronger Link in U.S.

Medically reviewed by Carmen Pope, BPharm. Last updated on April 4, 2025.

By Elana Gotkine HealthDay Reporter

FRIDAY, April 4, 2025 -- Greater wealth is associated with lower mortality, and the association seems stronger in the United States than in Europe, according to a study published in the April 3 issue of the New England Journal of Medicine.

Sara Machado, Ph.D., from the Brown University School of Public Health in Providence, Rhode Island, and colleagues conducted a longitudinal retrospective cohort study involving adults aged 50 to 85 years from the Health and Retirement Study and the Survey of Health, Ageing, and Retirement in Europe between 2010 and 2022. Wealth groups were defined according to age group and country, with the poorest participants in quartile 1.

The researchers found that 18.7 percent of the 73,838 adults died during a median follow-up of 10 years. Greater wealth was associated with lower mortality across all participants, with adjusted hazard ratios for death of 0.80, 0.68, and 0.60 for quartiles 2, 3, or 4, respectively, versus 1. Compared with Europe, the United States had a wider gap in survival between the top and bottom wealth quartiles. Participants in the top wealth quartiles in Northern and Western Europe and Southern Europe seemed to have higher survival than the wealthiest Americans. Similar survival was seen in the wealthiest U.S. quartile and the poorest quartile in Northern and Western Europe.

"We found that wealth was associated with mortality across the United States and Europe and that the difference in mortality between the top and bottom quartiles of wealth appeared to be larger in the United States than in Europe," the authors write.

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