There’s a strong correlation between wealth and longevity. For example, a study out of the University of Wisconsin that tracked nearly 5,500 adults over 24 years found that every $50,000 of additional net wealth accumulated in midlife was associated with a 5% reduction in all-cause mortality. Interestingly, this held true for twins, as richer twins tended to live longer than their poorer sibling.

In addition to living longer, the wealthy tend to live better longer. A study by researchers at University College London and Harvard University of 25,000 adults over age 50 in England and the U.S. found that the wealthy lived eight to nine more “disability-free” years than their poor counterparts. In classifying the study participants, they divided them in thirds according to their total household wealth with the lowest third having total average wealth of $29,000, the middle had $180,000 and the wealthiest third averaged $980,000 total wealth.

A few important points about the England/U.S. study:

• The results were nearly identical in both countries. Given that the U.K. has universal health care and the U.S. does not and yet the results were the same is surprising. You’d think that the U.K. would exhibit less disparity of outcomes.
• Other socioeconomic factors such as level of education, and occupational social class were considered as well as race. These factors had an effect, but nowhere near as big as wealth which had by far the biggest effect.

Another study by the Brookings Institution in 2016 similarly found that high-income earners live longer than lower earners and that the longevity gap has been growing. Here’s an interesting chart from the Brookings study illustrating the differences between the life expectancies of top decile earners vs. lowest decile earners born in 1920 and 1940:

Another study by the Social Security Administration found that “life expectancy for the wealthiest American men at age 60 was just below the rates in Iceland and Japan, two countries where people live the longest. Americans in the bottom quarter of the wage scale, however, ranked much further down — one notch above Poland and the Czech Republic.” Source.

What are the causes of the huge difference in life expectancy and disability-free living among the wealthy and poor? Many factors are at play, which may include health care access, opioid/prescription drug abuse, obesity, and social/cultural factors . Researchers are still trying to pinpoint the exact causes. One cause, however, is clear: the poor smoke more than the wealthy and smoking shaves years off life expectancy and health. Jessica Ho of Duke University estimates that differences in smoking prevalence may account for 1/3rd of the difference in life expectancies.

Here’s a chart of poll results from Gallup from 2008 showing what percentage of Americans smoke by income level. You can see that smoking declines as incomes rise:

Similarly, the top ten states (and Guam) in terms of the percentage of residents who smoke are:

And here’s how these top ten states rank in terms of per capita income?

• West Virginia: 49th
• Kentucky: 46th
• Arkansas: 44th
• Mississippi: 50th
• Tennessee: 33rd
• Louisiana: 35th
• Ohio: 32nd
• Indiana: 34th
• Missouri: 37th
• Michigan: 36th

See a pattern? Plus, West Virginia, Kentucky, Arkansas, Mississippi, and Louisiana are five of the top six states in terms of the percentage of residents living below the poverty level.