# Why is money related to positive health

FallenApple
Beyond the obvious i.e resources to buy basic health care etc. The wealth health correlation was observed across the entire income spectrum, even after basic necessities are met. What is the cause of this?

## Answers and Replies

Mentor

russ_watters
FallenApple

For example, strokes affect 3.9% of people with family incomes less than $35,000, 2.5% of people in families earning between$35,000 and $50,000, 2.3% of people in the$50,000 to $75,000 group, 1.8% of people making$75,000 to $100,000, and 1.6% of people whose families earn more than$100,000. The more money you make, the less likely you are to have a stroke, according to the data.

Not really an academic journal, which is why I'm asking if this is a consensus view in the healthcare community.

Homework Helper
Gold Member
I suspect smoking is inversely correlated with wealth. Healthy diet correlated with wealth.

russ_watters and rbelli1
Gold Member
Yes, socioeconomic status (SES) has been fairly clearly linked to health in large numbers of studies and these correlations are pretty widely accepted. For example, the New England Journal of Medicine published a large study of the correlation between SES and health across 22 European countries and found:

First, the results show that in all 16 countries with mortality data, socioeconomically disadvantaged men and women had higher overall mortality rates than did persons with a higher socioeconomic status. The universal link between social class and mortality seems remarkable, given the differing disease prevalence and risk factors in these countries. Moreover, relationships between class and mortality are consistent for almost every cause of death, with only a few exceptions, notably certain cancers.
https://www.nejm.org/doi/full/10.1056/NEJMe0802773

The reasons for why low SES correlates with adverse health outcomes is still not clear, though the CDC has a good page describing various thoughts on the issue (primarily in the context between SES and cancer):
https://www.cdc.gov/cancer/healthdisparities/basic_info/challenges.htm

russ_watters and jim mcnamara
FallenApple
Yes, socioeconomic status (SES) has been fairly clearly linked to health in large numbers of studies and these correlations are pretty widely accepted. For example, the New England Journal of Medicine published a large study of the correlation between SES and health across 22 European countries and found:

https://www.nejm.org/doi/full/10.1056/NEJMe0802773

The reasons for why low SES correlates with adverse health outcomes is still not clear, though the CDC has a good page describing various thoughts on the issue (primarily in the context between SES and cancer):
https://www.cdc.gov/cancer/healthdisparities/basic_info/challenges.htm

Perhaps the reasons are due to the psychological benefits of higher SES. There's no reason to believe that someone making 300k per year would obviously be more healthy than someone making 200k per year when that 200k per year person can clearly afford healthy food and a gym membership.

FallenApple
I suspect smoking is inversely correlated with wealth. Healthy diet correlated with wealth.

True, but past a certain point, the correlation should disappear. For example, those already in the top 10% of income shouldn't differ in smoking and diet habits.

Gold Member
Beyond the obvious i.e resources to buy basic health care etc. The wealth health correlation was observed across the entire income spectrum, even after basic necessities are met. What is the cause of this?
A report by UK Government (Office of National Statistics) in 2015 finds that there is a strong correlation between the age of healthy life and wealth. The age for a healthy (disease free) life averages about 64 overall but there is a difference of about 16 years between rich and poor areas.
https://www.gov.uk/government/news/inequalities-in-health-and-life-expectancies-persist
As to the reasons, the following quote from the report may be of interest:-
Dr Ann Marie Connolly, Deputy Director, Health Equity and Mental Health, at Public Health England, said:
"We know that inequalities in life expectancy emerge from inequalities in the conditions of daily life including people’s incomes, living standards, educational attainment and access to services. These in turn can drive unhealthy behaviours like smoking, poor diet and physical inactivity. Although we’ve seen improvements in physical activity and smoking rates, these have not been enjoyed by all sections of society and so we continue to see these stark differences in outcomes for different communities across England".

Gold Member
Perhaps the reasons are due to the psychological benefits of higher SES. There's no reason to believe that someone making 300k per year would obviously be more healthy than someone making 200k per year when that 200k per year person can clearly afford healthy food and a gym membership.

I agree that psychological effects could be involved. Stress induces a number of physiological changes in the body, including the release of various hormones in the body associated with stress, like glucocorticoids. It is possible that chronic activation of stress signaling pathways can influence the body in many negative ways and contribute to the health disparities associated with differences in SES. For example, it is well known that glucocoricoid signaling can suppress the immune system, which would have negative impacts on many aspects of health. In my own research, I am involved in efforts that aim to understand at the molecular level how some of these stress-mediated signaling pathways affect cancer risk and cancer progression.

FallenApple
Gold Member
True, but past a certain point, the correlation should disappear. For example, those already in the top 10% of income shouldn't differ in smoking and diet habits.
The trend seems to hold up even for the richest little enclave of Chelsea in London where there is great wealth. So even these very rich people do seem to differ beneficially in smoking, diet, physical activity and access to services.

Homework Helper
I wonder if fish intake has something to do with it. We know that eating fish is good for older people. At high incomes, $200k versus$300k, they are unlikely to be buying fish from their local chippy. Rather, they either cook it which is unlikely or choose it in restaurants. Those eating out all the time are more likely to vary their choices, including more choices of fish. Also, many people just don't like seafood, or think they don't, but eating out all the time, one is more likely to try it. And those older people on more fishy diets are going to self-report better health, for example, lower arthritis.

See for example this: Eating fish may benefit older adults at risk of dementia.

Gold Member
It could be something simple such as the boob-tube.

According to this site, watching TV 5 hours a day has an inverse relationship with income, while watching 1 hour of TV a day seems to correlate with income.
https://www.marketplace.org/2013/11...come-upshot/behind-data-tv-viewing-and-income

Of course, besides the sedentary aspect of watching television, there is also the question to be asked - what are the people with higher incomes doing with their time not watching TV, while others are, and does that time count as having a beneficial outcome for a longevity.

Gold Member
watching TV 5 hours a day has an inverse relationship with income, while watching 1 hour of TV a day seems to correlate with income.
The website isn't working for me, but I'm having trouble figuring out what you mean by this statement. How can one data point (watching TV 5 hours a day) correlate with a series of data points like income? Do you mean more lower income people watch 5 hours of TV a day and more upper-income people watch 1 hour of TV? Then you can just say that the time spent watching TV seems to correlate inversely with income.

jim mcnamara
Did anybody checked if there is any correlation between dental spending and this 'positive health' thing?

I might question whether a causal relation has been established, or merely a correlation. While in many cases I don't doubt that there are very clear causal elements at play, it is also worth considering that a person who is generally less healthy is also going to struggle to get ahead financially. Less healthy people will do worse at school because on average they miss more days and aren't able to concentrate as long, and as a result are probably underrepresented in the higher-paying professions. And when they may it into a profession, they need to take more time off of work, probably don't perform as well on average at their healthy counter-parts, are less-likely to be promoted, are probably more subject to stigmas associated with various ill-health conditions (particularly when it comes to mental health). Depending on the severity of health conditions many less healthy people end up not working at all, in which case their SES ends up determined almost entirely by whatever their local support/welfare system offers.

I guess what I'm saying is that you need to control for the fact that the guy who spends half his life battling recurring cancer simply isn't going to have the same career opportunities as the guy doesn't have to worry about that.

PeroK, StatGuy2000, ZeGato and 1 other person
Gold Member
here is the chart that they produced, and see if you, or anyone comes to the same deduction.

Lifestyle, and what people, dependent upon income, are free and able to decide to do with their time.
Higher income could mean more choices, less limiting choices, which could alleviate some stress for a person.

EDit - try again
https://features.marketplace.org/income_upshot/data/income-upshot-television.html

Is copy and paste the image allowed, ( copyright issue ? )

Mentor

Not really an academic journal, which is why I'm asking if this is a consensus view in the healthcare community.
What isn't mentioned there and makes people uncomfortable to say or accept is that income is associated with the quality of life choices. For example:
I suspect smoking is inversely correlated with wealth.
Indeed:
https://www.cdc.gov/tobacco/disparities/low-ses/index.htm
Healthy diet correlated with wealth.
That one is also true, but the "why" is tougher:
https://www.webmd.com/parenting/raising-fit-kids/features/healthy-food-cost

256bits
Mentor
I might question whether a causal relation has been established, or merely a correlation. While in many cases I don't doubt that there are very clear causal elements at play, it is also worth considering that a person who is generally less healthy is also going to struggle to get ahead financially. Less healthy people will do worse at school because on average they miss more days and aren't able to concentrate as long, and as a result are probably underrepresented in the higher-paying professions.
True, the fause-effect relationship should go both ways:
-Unhealthier actions (choices) cause lower incomes.
-Inherrent (unlucky) poor health causes income lowering actions(not by choice).

256bits
Mentor
Moving to General Discussion. SES<->health correlations are extremely interesting, but not suitable for Biology really.

Gold Member
Moving to General Discussion. SES<->health correlations are extremely interesting, but not suitable for Biology really.
Given that the forum is the Biology and Medical board, the topic does seem suitable given that connections between health and SES are extensively discussed in the medical literature:
https://www.nejm.org/doi/full/10.1056/NEJMsa0707519
https://www.sciencedirect.com/science/article/pii/S0140673696072261?via=ihub
https://www.bmj.com/content/316/7145/1636
https://jech.bmj.com/content/52/4/219
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030106
https://www.thelancet.com/series/america-equity-equality-in-health

However, the topic is very interdisciplinary, and moving the topic to General discussion could provide input from others who do not frequent the biology board.

jim mcnamara
OCR
Is copy and paste the image allowed, ( copyright issue ? )

You can usually copy and paste a screen shot... .

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OCR
With Windows 10, you can also take numerous screen shots and save them to your clipboard... if you want.

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nitsuj
Beyond the obvious i.e resources to buy basic health care etc. The wealth health correlation was observed across the entire income spectrum, even after basic necessities are met. What is the cause of this?

Discipline

more specifically, "resource planning" I'd suspect... the perspective being that good health is a resource (asset)...arguably the most valuable and easily achievable.

Gold Member
Discipline

more specifically, "resource planning" I'd suspect... the perspective being that good health is a resource (asset)...arguably the most valuable and easily achievable.

This is essentially the hypothesis from the famous "marshmallow experiment" in psychology, in which children who exibited greater abilities in delayed gratification showed lower levels of obesity and higher academic success later in life: https://www.newyorker.com/magazine/2009/05/18/dont-2

Interesting, many of the criticism of the marshmallow experiment surround the fact that performance in the marshmallow test is correlated with the SES of the parents: https://www.theatlantic.com/family/archive/2018/06/marshmallow-test/561779/

256bits
Gold Member
Thanks @OCR.
Hope this is fine for PF.
I did the copy and paste.

Graph shows grouped income versus hours of TV watched.
@TeethWhitener

We used data from the General Social Survey to build this chart, plotting incomes and hours of TV watched on one graph. In order to ensure a large enough sample size for the TV portion of the data set, we compiled income and hours of TV data from the surveys between 2008-2012.

Income as defined by the GSS is total family income: the total incomes of each person who lives in a household and is related. To acertain the amount of TV watched, the people conducting the survey asked respondents, "On the average day, about how many hours do you personally watch television?"

Responses varied in the original data set from 0-24 hours. We grouped those responses into the following categories:
0 hours, 1 hour, 2 hours, 3 hours, 4 hours and 5+ hours per day.*

Help with research was provided by Dr. Tom W. Smith, Director of the General Social Survey and Senior Fellow at the National Opinion Research Center at the University of Chicago. Source: General Social Surveys of NORC at the University of Chicago

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FallenApple
If we evolved as genetic units( aka tribes), then this would make some logical sense. Those that have more resources in the tribe are on average more useful to the tribe than those with less resources. It would just be more efficient to the tribe's survival if each component of the tribe has some sort of mechanism of preserving itself if that component is highly useful to the tribe. The more useful the component is, the more preservation. And those components that are completely not useful to the tribe might have evolved a self destruct mechanism since they are deadweight. This mechanism would have evolved be biochemical and internally programmed to each individual component (i.e person).

Clearly this is just speculation, but it would explain the paradoxical notion of a billionaire somehow being healthier than a millionaire.

This mechanism would have evolved
I think this contains a bit too much speculation. I think resource-vise any such speculation should address both the old tribal fashion of burying the riches with the dead and also the violent ( or shady) ownership-changes often associated with those resources...

I also think that such kind of speculations should be based not on the modern society, but on the actual age expectations of rulers over old history.

Maybe we would be better to seek the reasons on (modern) medicinal grounds...

russ_watters
FallenApple
I think this contains a bit too much speculation. I think resource-vise any such speculation should address both the old tribal fashion of burying the riches with the dead and also the violent ( or shady) ownership-changes often associated with those resources...

I also think that such kind of speculations should be based not on the modern society, but on the actual age expectations of rulers over old history.

Maybe we would be better to seek the reasons on (modern) medicinal grounds...

A lot of our traits and reactions to certain external stimuli, even in the modern context, can in principle be explained by evolutionary reasoning. That's the whole reason for the existence for evolutionary psychology.

But good point, I didn't know burying riches with the dead is a tribal tradition. Still, those with resources are crucial to the operations of the tribe and even if their personal share got buried with them, it's still more efficient for the tribe's survival if the boss just lives longer to keep the place operating.

Violent ownership changes are not good for the tribe. But when they did happen, it would have been efficient for the survival of the tribe if the new boss to got some sort of a health boost to maximize the probability that they can smoothly control tribal operations, until someone new usurps.

I agree, this should be tested on medincal grounds. But my reasoning shows that its not completely implausible that we may have evolved mechanisms in which resource control may causally affect health.

We just need to test it, perhaps via twin studies on already healthy and moderately wealthy identical twins but estranged from each other, then we make one twin much richer than the other and track the health of both over the long run. Of course, this is probably extremely expensive to test. and probably impractical too.

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nitsuj
This is essentially the hypothesis from the famous "marshmallow experiment" in psychology, in which children who exibited greater abilities in delayed gratification showed lower levels of obesity and higher academic success later in life: https://www.newyorker.com/magazine/2009/05/18/dont-2

Interesting, many of the criticism of the marshmallow experiment surround the fact that performance in the marshmallow test is correlated with the SES of the parents: https://www.theatlantic.com/family/archive/2018/06/marshmallow-test/561779/

lol that's drawing allot from marshmallows. What a strange choice of study to test the hypothesis.

I do mean discipline, but don't believe that necessarily means the person is "resisting", restraining themselves from being "gluttonous" with their resources...generally speaking

The marshmallow is a treat, and is purely emotional. imo that is entirely different from the concept of "security" and how resources impact that.

So much more can be said on this interesting topic

EngWiPy
Maybe because they are less stressed in life, more conscious about their body (they notice the slightest change), eat healthier, exercise more... etc. When you are barely making it, you don't care too much about health as much as surviving, and the stress of life can cause mental and physical problems.

FallenApple
Maybe because they are less stressed in life, more conscious about their body (they notice the slightest change), eat healthier, exercise more... etc. When you are barely making it, you don't care too much about health as much as surviving, and the stress of life can cause mental and physical problems.

Which is interesting because there are careers that are fiercely competitive and time consuming like investment banking, which clearly have more stressful on the job demands than say working as a burger flipper at McDonalds. But the banker has low worries and good self esteem which could imply that even though the banker has a much more stressful job, the banker is less stressed in life.

Stressful job and overtime? Not a big deal so long as it makes you rich.

EngWiPy
Which is interesting because there are careers that are fiercely competitive and time consuming like investment banking, which clearly have more stressful on the job demands than say working as a burger flipper at McDonalds. But the banker has low worries and good self esteem which could imply that even though the banker has a much more stressful job, the banker is less stressed in life.

Stressful job and overtime? Not a big deal so long as it makes you rich.

The people who make less money like the burger flipper in your example, are constantly stressed and anxious to end up in the streets, to not be able to provide for their families, to be evicted from their apartments, ... etc. I think this is somewhat different than the work stress, where you get paid enough money, and live comfortably, but work long hours. They are both stresses in life, but are at different levels. Besides, this is only one factor. Not eating healthy because healthy food is usually more expensive, and not having an adequate health care insurance, which makes people ignore their early symptoms to avoid paying "extra" money on their health, contribute to this as well.

FallenApple
The people who make less money like the burger flipper in your example, are constantly stressed and anxious to end up in the streets, to not be able to provide for their families, to be evicted from their apartments, ... etc. I think this is somewhat different than the work stress, where you get paid enough money, and live comfortably, but work long hours. They are both stresses in life, but are at different levels. Besides, this is only one factor. Not eating healthy because healthy food is usually more expensive, and not having an adequate health care insurance, which makes people ignore their early symptoms to avoid paying "extra" money on their health, contribute to this as well.

Not only fear and lack of healthcare, but also self esteem too. Being poor makes one feel like a loser, which can result in severe psychological issues. Famous psychologist, Jordon Peterson has mentioned that being low in the social hierarchy results in lower serotonin levels and that is merely an artifact of millions of years of evolution.

Thus, say a poor person remains proactive in making health conscious decisions, avoiding alcohol and cigarettes, and frequently exercises, all in an attempt to not have to make frequent visits to the doctor by trying to prevent health problems before they start. So problem solved? No, not even close. They will still have an obliterated self esteem and low serotonin levels and this alone would derail their health.

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