April 2025: Association between Wealth and Mortality in the United States and Europe
The issue
Low wealth shortens life: the poorer an older adult is, the higher their risk of dying—and the rich–poor survival gap is wider in the United States than anywhere in Europe.
What do I need to know?
A study of 73,838 adults aged 50‑85 in the U.S. and 16 European countries (follow‑up 2010‑2022) found a strong “wealth‑health” gradient. Moving up the wealth ladder cut the chance of death by 20 %–40 %; adjusted hazard ratios were 0.80, 0.68 and 0.60 for the second, third and fourth wealth quartiles versus the poorest group. Yet even the wealthiest Americans lived no longer than the poorest seniors in Northern and Western Europe, while the poorest Americans fared worst of all. Within the U.S., the mortality gap is greatest in the Midwest and South and smallest in the West.
Potential risk of wealth‑related health disadvantage
An older adult has limited savings but still covers basic needs.
Recommended Actions
Review finances yearly with a trusted relative or advisor.
Use free preventive services (Medicare annual visit, blood‑pressure checks).
Ask the doctor to screen for depression, malnutrition and social isolation.
Imminent risk of wealth‑related health disadvantage
Savings are running out; the person skips medicines, healthy food or appointments because of cost.
Recommended Actions
Meet a social worker about Medicare Savings Programs, SNAP and utility assistance.
Request generic‑only or $0‑copay medication plans and referrals to sliding‑scale clinics.
Arrange subsidized meals, transport and home‑safety checks through the local senior center.
Confirmed wealth‑linked hardship
The patient is in poverty, struggling with housing, food and medical bills; health is already declining.
Recommended Actions
Apply for Medicaid, housing vouchers and Supplemental Security Income with a case manager’s help.
Enlist a geriatric care manager to coordinate clinic visits and reduce costly ER trips.
Engage community health workers for regular check‑ins and medication support.
What can I do?
Bring money matters to every doctor visit: ask, “Am I at potential, imminent or confirmed wealth‑related risk, and what should I do now?” Keep a simple monthly budget and note any skipped doses or meals. Use BenefitsCheckUp.org or your Area Agency on Aging to uncover programs that stretch income. Caregivers can gather tax returns, bills and medication lists so professionals can act quickly.
