The researchers, at the University of Michigan in Ann Arbor, write in the upcoming August issue of the Journal of Palliative Care that "men and women age 70 or older whose net worth was $70,000 or higher were 30 percent less likely than poorer people to have felt pain often during the year before they died."

The results of the study, comprising 2,604 men and women who died between 1993 and 2000, remain stable across factors such as race, gender, ethnicity, education and diagnosis, the researchers said.

The results were obtained from questionnaires that were a part of the Health and Retirement Study conducted by the university's Institute of Social Research and funded by the National Institute of Aging. The researchers asked participants questions about the amount of pain and suffering they were experiencing.

Dr. Maria Silveira, lead researcher and assistant professor at the University of Michigan Medical School, said the study is the first to link wealth and dying in comfort.

"Wealth is a strong predictor (of comfort level)," Silveira told United Press International.

She said the results establish a need in the United States to focus more on hospice and palliative care, home care and end-of-life care -- particularly in relation to cost of treatments.

"Newer medications (and treatment) are easier to obtain by patients who can pay more out of pocket," Silveira said. "Society will have to demand better coverage."

That means, she said, palliative hospice care, which is granted only by Medicare to lower income individuals who have six months' life expectancy, should be made available to anyone who needs it.

"Hospice has been shown to relieve suffering," Silveira said. "Medicare only covers $110 to $120 a day (for hospice). Even then, hospice care will not cover costs of everything."

Val J. Halamandaris, president of the National Association of Home Care and Hospice in Washington, who also was involved in the first hearing on death and dying by the Senate Committee on Aging in 1971, said he thinks expanded Medicare coverage would create an equality among socio-economic classes of comfort level leading to the time of death.

"Nothing has changed much regarding policy on death and dying since 1983," Halamandaris told UPI, "but things have changed ... people are living longer (and) disparities between the rich and poor need to be addressed."

As the average life expectancy increases for everyone in the United States -- to 77.5 years, up from 75.8 years in 1995, according to the National Center for Health Statistics at the Centers for Disease Control and Prevention in Atlanta -- society must accommodate the effects of cutting-edge healthcare technologies and widespread comprehensive social-care programs that cater to the terminally ill and dying.

Recently, doctors at the Mayo Clinic in Jacksonville, Fla., completed the first pancreas transplant -- considered a tremendous step forward for treatment of diabetes, a leading cause of death, according to the latest data from the NCHS.

"Americans, and western society in particular, have this death-defying attitude." Halamandaris said. "The questions (in policy) since the beginning have been on extending life ... I believe it should be taken from a more natural standpoint."

He said he thinks future policy debates on death and on life extension will continue for many years.

"Terry Schiavo was the beginning," Halamandaris said, referring to the recent case that generated national headlines about the young woman, presumed brain-dead, whose death was hastened by a court order. That case should be considered "the opening gun in a war that will last a while."

Ray Pregeant is an intern for UPI Science News.

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