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updated 4/12/2005 5:21:37 PM ET 2005-04-12T21:21:37

Think trophy wives, boating accidents and feckless dependents are the primary causes of death for billionaires? Think again. Billionaires are killed by the same unglamorous things that kill the rest of us: diseases such as cancer, heart attacks, kidney failure and others.

The only difference is they may live a little longer.

The average age of death for the 20 billionaires featured in the 2004 and 2005 "In Memoriam" sections of the annual Forbes Billionaires list was 78. We compared this number with the average male life expectancy in the U.S., since all but one of the 20 billionaires on our list that died were males: the billionaires lived 3.5 years longer than average American males. The results would be even more dramatic if we took into account average life expectancies from around the world, since the billionaires on our list are of all different nationalities.

According to a 1999 study in the British Medical Journal, higher income is, in fact, "casually associated with greater longevity." But when it comes to living longer, billionaires may not be that much better off than mere millionaires. "While an extra dollar of income is protective," the study reads, "the amount of protective effect tails off as total income rises."

The rich not only tend to live longer, but are healthier as well. According to the National Center for Health Statistics, 23 percent of people below the poverty threshold, defined as "poor," are limited by chronic disease, whereas only 10 percent of "non-poor," those with an income 200 percent or greater than the poverty threshold, are.

What accounts for these gaps? Traditional theories espouse that greater wealth means greater access to medical care. But as Forbes' Dan Seligman points out in his June 2004 article, "Why the Rich Live Longer," if access was the key, the health gap between the upper and lower classes should have shrunk with the advent of America's Medicare and Medicaid, not to mention employer-sponsored health insurance.

Some use the "inequality is a killer" theory, arguing that the health gap between the rich and the poor exists because low social status increases stress and anxiety, which increases susceptibility to disease. It's not entirely clear, though, whether lower-level civil servants suffer less anxiety than, say, chief executives and billionaires. Struggling to pay your bills and having to answer to angry stockholders are both stressful, each in their own way.

Some studies contend that rich live longer because of intellectual Darwinism. "Social status," Seligman writes, "correlates strongly and positively with IQ and other measures of intelligence, and intelligence correlates strongly with health literacy — the ability to understand and follow a prescription for disease prevention and treatment." This theory is not without evidence: Seligman cites a 2003 study by psychologist Ian Deary of the University of Edinburgh that found mortality rates to be 17 percent higher for each 15-point falloff in IQ.

Since most of what kills Americans today is chronic disease, health literacy may, in fact, be a key to longevity. Understanding and monitoring risk factors for the major conditions that predispose us to death — heart disease, cancer, diabetes, obesity, high blood pressure — requires a considerable amount of awareness, discipline and foresight.

And when it comes to prevention, being rich certainly doesn't hurt. So-called executive physicals, offered at places like the Princeton Longevity Center, Canyon Ranch and the Mayo Clinic, cost anywhere from $2,000 to $7,000, and most insurers cover only a small percentage of that. These pricey super-physicals get done in one day, in one office, instead of what would normally involve a half-dozen different doctor's appointments with various specialists. Included are usually the latest diagnostic imaging techniques, like CT-scans of the heart, which detect calcium buildup in arteries that can signal heart disease, and virtual colonoscopies, as well as advanced blood tests that might detect early stages of disease, and nutrition and fitness assessments.

Many of the facilities that offer executive physicals have on-site labs that provide same-day results, which give "executive" patients the added benefit of being able to discuss the results — and any suggested targeted therapies--with the team of doctors, without any hassle.

Enough money can even make an otherwise dreary hospital stay that much more comfortable. A handful of the nation's top hospitals have "luxury" accommodations, an indulgence that must be, of course, paid for out-of-pocket. The rooms and suites in the 16th-floor Shapiro Pavilion at Brigham and Women's Hospital in Boston, Mass., for example, are priced at $325 to $800 out-of-pocket. The 14 rooms feature bidets in all bathrooms, 300-thread-count sheets, kitchenettes, flat-screen TVs and pull-out couches for guests who want to spend the night. The unit has a gourmet chef, and is even locked for high-security. Other hospitals such as Johns Hopkins, Massachusetts General and Cedars-Sinai — just to name a few — all have similar luxury units.

Most people don't think of themselves as lucky if their health or mental status require around the clock home health care, but the alternative — being in a nursing home — might make them feel fortunate. Perhaps not surprisingly, home health care costs, on average, more than double what it costs to be in a nursing home.

According to the 2004 MetLife Market Survey of Nursing Home and Home Care Costs, the average daily cost of a private room in a nursing home in the U.S. is $70,080 per year, or $192 per day. The study found that the cost of a home health care aide averaged $18 per hour nationally, which turns out to be $432 per day.

Three of the billionaires were not included in the list because their causes of death were not specified. Marvin Davis, famous for buying 20th Century Fox and selling it four years later to Rupert Murdoch's News Corp., and also for owing Pebble Beach Co., the Aspen Skiing Co., and the Beverly Hills Hotel, for instance, died after a "long illness." Friends say he had long suffered from heart trouble, diabetes and other effects of obesity, but what actually caused his death was not released. Portugal's richest man, Antonio Champalimaud, who passed away in May of 2004, suffered a "prolonged illness," and reportedly died in his home in Lisbon. Saudi billionaire Abdulaziz Bin Hamad Algosaibi's cause of death was also not specified.

Around the clock personal nurses and 300 thread-count sheets aside, even all their money can't buy billionaires immortality.

© 2012 Forbes.com

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