Wealth gaps drive 15-year functional aging difference in England versus 9 years in Canada

The study used mixed-effects models on longitudinal data tracking gait speed, grip strength, FEV1 and ADL/IADL scores over multiple waves. Predicted trajectories showed the least-wealthy English 60-year-olds matching the walking speed of the wealthiest 75-year-olds, a gap equivalent to 15 years of aging; the Canadian gap reached 9 years. Wealth remained predictive after controlling for smoking, BMI and chronic disease.

England-Canada differences point to structural factors beyond universal health coverage. Broader income supports, disability benefits and housing policies in Canada may buffer functional decline, while England's steeper gradients align with documented austerity effects on older adults since 2010. Women in the lowest wealth quintile faced compounded mobility and ADL deficits compared with men in both countries.

These observational findings cannot establish causation or rule out unmeasured childhood exposures. Next steps require quasi-experimental evaluations of income or housing interventions to test whether narrowing wealth gaps slows functional trajectories by measurable percentages within five-year follow-up windows.