Institute for Policy Research, Northwestern University, Evanston, Illinois.
Department of Psychology, Northwestern University, Evanston, Illinois.
JAMA Health Forum. 2021 Jul 23;2(7):e211652. doi: 10.1001/jamahealthforum.2021.1652. eCollection 2021 Jul.
Wealthy adults tend to live longer than those with less wealth. However, a challenge in this area of research has been the reduction of potential confounding by factors associated with the early environment and heritable traits, which could simultaneously affect socioeconomic circumstances in adulthood and health across the life course.
To identify the association between net worth at midlife and subsequent all-cause mortality in individuals as well as within siblings and twin pairs.
This cohort study conducted a series of analyses using data from the Midlife in the United States (MIDUS) study, an ongoing national study of health and aging. The sample included adults (unrelated individuals, full siblings, and dizygotic and monozygotic twins) aged 20 to 75 years, who participated in wave 1 of the MIDUS study, which occurred from 1994 to 1996. The analyses were conducted between November 16, 2019, and May 18, 2021.
Self-reported net worth (total financial assets minus liabilities) at midlife (the middle years of life).
All-cause mortality was tracked over nearly 24 years of follow-up, with a censor date of October 31, 2018. Survival models tested the association between net worth and all-cause mortality. Discordant sibling and twin analyses compared longevity within siblings and twin pairs who, given their shared early experiences and genetic backgrounds, were matched on these factors.
The full sample comprised 5414 participants, who had a mean (SD) age of 46.7 (12.7) years and included 2766 women (51.1%). Higher net worth was associated with lower mortality risk (hazard ratio [HR], 0.95; 95% CI, 0.94-0.97; < .001). Among siblings and twin pairs specifically (n = 2490), a similar within-family association was observed between higher net worth and lower mortality (HR, 0.94; 95% CI, 0.91-0.97; = .001), suggesting that the sibling or twin with more wealth tended to live longer than their co-sibling or co-twin with less wealth. When separate estimates were performed for the subsamples of siblings (HR, 0.94; 95% CI, 0.90-0.97; = .002), dizygotic twins (HR, 0.94; 95% CI, 0.86-1.02; = .19), and monozygotic twins (HR, 0.95; 95% CI, 0.87-1.04; = .34), the within-family estimates of the net worth-mortality association were similar, although the precision of estimates was reduced among twins.
This cohort study found that wealth accumulation at midlife was associated with longevity in US adults. Discordant sibling analyses suggested that this association is unlikely to be simply an artifact of early experiences or heritable characteristics shared by families.
富裕的成年人往往比财富较少的成年人寿命更长。然而，这一研究领域的一个挑战是，通过与早期环境和遗传特征相关的因素来减少潜在的混杂因素，这些因素可能同时影响成年期的社会经济状况和整个生命周期的健康状况。
确定中年人净资产与个体以及兄弟姐妹和双胞胎对之间随后的全因死亡率之间的关联。
设计、设置和参与者：本队列研究使用来自美国中期生活（MIDUS）研究的数据进行了一系列分析，这是一项正在进行的关于健康和老龄化的全国性研究。该样本包括年龄在 20 至 75 岁之间的成年人（无血缘关系的个体、全兄弟姐妹、异卵双胞胎和同卵双胞胎），他们参加了 MIDUS 研究的第 1 波，该研究于 1994 年至 1996 年进行。分析于 2019 年 11 月 16 日至 2021 年 5 月 18 日之间进行。
中年（生命中期）的自我报告净资产（金融资产总额减去负债）。
在近 24 年的随访期间，追踪了全因死亡率，并以 2018 年 10 月 31 日为截止日期。生存模型测试了净资产与全因死亡率之间的关联。不同步的兄弟姐妹和双胞胎分析比较了兄弟姐妹和双胞胎对中的长寿情况，鉴于他们共同的早期经历和遗传背景，这些因素在他们之间是匹配的。
共有 5414 名参与者参加了完整的样本，平均（SD）年龄为 46.7（12.7）岁，其中包括 2766 名女性（51.1%）。较高的净资产与较低的死亡率风险相关（风险比[HR]，0.95；95%置信区间，0.94-0.97； < .001）。特别是在兄弟姐妹和双胞胎对中（n = 2490），在更高的净资产与更低的死亡率之间观察到了类似的家庭内关联（HR，0.94；95%置信区间，0.91-0.97； = .001），这表明财富更多的兄弟姐妹或双胞胎往往比财富较少的兄弟姐妹或双胞胎活得更长。当对兄弟姐妹（HR，0.94；95%置信区间，0.90-0.97； = .002）、异卵双胞胎（HR，0.94；95%置信区间，0.86-1.02； = .19）和同卵双胞胎（HR，0.95；95%置信区间，0.87-1.04； = .34）的亚样本分别进行估计时，家庭内净资产-死亡率关联的估计值相似，尽管双胞胎的估计精度降低了。
这项队列研究发现，中年人财富的积累与美国成年人的长寿有关。不同步的兄弟姐妹分析表明，这种关联不太可能仅仅是家庭早期经历或遗传特征共同作用的一种假象。
