Over the last 50 years, as life expectancy has increased, so has the disparity of life expectancy between the rich and the poor.^1,2 This study looked at 2 new aspects of this problem. First, it examined the relationship between wealth and mortality, not just income and mortality. In so doing it could show the relationship between financial well-being over time, not just current income, and could thereby give a firmer perspective on that relationship among retired people, who may have little income but a great deal of wealth. In addition, it looked at that relationship before and after age 65, a time when most people are eligible for Medicare, and so have access to government-sponsored health insurance. The results show that there is a large disparity between those who have accumulated wealth and those who have not, and since that disparity exists similarly before and after age 65, it is not simply related to access to health insurance. In this era of political debate, what is clear is that a large disparity in health exists and needs to be addressed. —Neil Skolnik, MD

1. McMichael AJ, McKee M, Shkolnikov V, Valkonen T. Mortality trends and setbacks: global convergence or divergence? Lancet. 2004;363(9415):1155-1159. doi:10.1016/S0140-6736(04)15902-3.
2. Pappas G, Queen S, Hadden W, Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med. 1993;329(2):103-109. doi:10.1056/NEJM199307083290207.