Older people with money not only have the means
to buy expensive cuts of steak and good bottles
of Beaujolais, they also have an easier time walking
through the store shopping for their purchases
and then carrying them home.
A new study, co-authored by University of Toronto
social work professor Esme Fuller-Thomson, has found
it's not just greater purchasing power that older
people with more money enjoy, it's also greater
physical prowess.
And each increase or decrease in level of household
income, from poverty to wealth, correlates to a
similar change in physical functioning.
"The discrepancy between poorest and richest is
huge," says Fuller-Thomson, "but even very high
up the spectrum, the richer are doing better than
the people just one step down.
"Why would the top 75th percentile be worse off
than the 85th percentile?" she wonders. "If it was
just health, housing and nutrition, one wouldn't
expect any difference between them."
The research, published in the current
New England
Journal of Medicine, found that Americans ages
55 to 84 who are wealthier have an easier time walking,
carrying, reaching, lifting objects and climbing
stairs than those with less money.
For example, people ages 55 to 64 who are living
below the poverty level are six times more likely
than the wealthiest groups to say they have functional
limitations, reports the U.S. National Institute
on Aging, in collaboration with the University of
Toronto and the University of California, Berkeley.
The large set of data from the U.S. census "allowed
us to explore something that hadn't been explored
before," explains Fuller-Thomson, who says the research
backs Canadian work on different physical health
outcomes depending on income, but with more fine-tuning.
Why should money make a difference in climbing stairs?
"We've known for a long time that people at the
low end of the socio-economic spectrum do much more
poorly health-wise than people at the higher end,"
explains senior author Dr. Jack Guralnik, chief
of the NIA Laboratory of Epidemiology, Demography
and Biometry.
"And many chronic conditions — heart disease, arthritis
— can have an impact on functioning, strength and
balance."
He was surprised to find, however, that differences
in functioning were reported even at the uppermost
incremental levels of income. The highest income
category used in the analysis — 700 per cent or
more of the U.S. poverty line — began at $57,813
for an older adult living alone and $124,327 for
a four-person household.
But York University professor and health policy
researcher Dennis Raphael explains, "It reflects
a lifetime of lived experience. And each step in
income represents a difference in lived experience.
"These effects are independent of health care and
they are evident in Canada as well."
What surprises Raphael most about the U.S. study
is the analysis by income.
"Income is consistently downplayed or ignored,"
he says. "Americans would agree that nobody should
be at a disadvantage because of colour or cultural
origins. But if you talk about inequalities related
to income, then it opens up questions about how
great are income differences and should it be a
cause for concern."
Observes Fuller-Thomson, "Almost every disease,
you see higher rates in the poor. If it is causal,
as we're anticipating, the war on poverty was the
right solution. Making sure there are no people
in absolute poverty makes a huge difference, with
a huge payback."