Most educated people try to take care of themselves in terms of their health and life style.

As a doctor, I would frequently ask patients, with an eye to motivating them into changing their habits: “Would you like to live longer, to a ripe old age, or die younger…in just a few years?” Of course, they all, without exception, chose the former.

They would be give me all sorts of excuses for living “to a ripe old age”: “I’d like to see my kids, (or grand kids) grow up.” “Who wants to die young?” “I’m not ready to kick the bucket.” “I have to take care of my wife, or my husband, or my dog or my cat, etc., etc.”

They all had a non-selfish excuse, but, in reality, I and the patient were aware that death carries with it fear.

As Shakespeare put it so beautifully in his soliloquy:

To be or not to be? That is the question
To die, to sleep-
To sleep – perchance to dream. Ay, there’s the rub;
For in that sleep of death what dreams may come,
When we have shuffled off this mortal coil
To grunt and sweat under a weary life,
But that the dread of something after death,
The undiscovered country from whose bourn
No traveler returns, puzzles the will”

This quotation and this soliloquy is the most quoted and the famous in the entire world. There must be a reason.

When I was asking my patients the question about their desire to live, Shakespeare’s question was in the back of my mind. I knew in advance what there answer would be, assuming they were not lying, and then I would explain what they should do to ensure a longer life expectancy.

I knew also that Monaco would be the place to live to achieve their goals of long life. After all, the life expectancy in Monaco is almost 90 years for all people. And women, as per usual, live to be almost 95 years old!


Monaco used to be a colony of Italy for hundreds of years. It is now controlled by France, but, politically, it is a monarchy.


There are only a little over 35 thousand permanent residents, and since there are absolutely no income taxes, the residents do not care who is in control as long as there is law and order and the streets are clean.

Women who would like to live to be 95 years old should take a trip to Monaco and see what life is like on this pretty enclave on the Mediterranean sea.

There is a beautiful port which can be seen from most points along the mountain side. In the port, there are no commercial ships, only yachts, owned by the richest people in the world. This gives you a clue as to the longevity characteristics of the citizens of Monaco.

If you can own a yacht you must have a fairly good yearly income. The yearly income, on the average, was over US $215,000 in 2010. Living long, obviously, requires lots of money. But, there is also another major factor.

Monaco is not alone in longevity. Here is the list from the CIA taken from Wikipedia:

Rank by UN member state Rank by entity Entity Overall life expectancy at birth Male life expectancy at birth Female life expectancy at birth
1 1 Monaco 89.73 85.77 93.84
2 Macau 84.41 81.45 87.52
2 3 San Marino 83.01 80.5 85.74
3 4 Andorra 82.43 80.35 84.64
4 5 Japan 82.25 78.96 85.72
5 6 Singapore 82.14 79.53 84.96
7 Hong Kong 82.04 79.32 84.97

As the reader can see, apart from Japan, all the countries with high life expectancy are extremely small! The governments in these small countries are non-intrusive, life is pleasant and the environment is conducive to relaxation.

Monaco, on the edge of Europe, has a citizenry of almost self-selected people. Wealthy people in Europe who don’t want to be bothered by politicians and mainstream vocal groups, opt to be a citizens of Monaco.

Of course, it takes millions of dollars and quite a bit of fame to become a citizen of Monaco. However, if one has an unusually high income, one can live there as a permanent tourist and still enjoy the tranquility and, hopefully, the life expectancy.


The food in Monaco is the typical Mediterranean diet.

Eating out, however, is much more expensive than eating in an Italian or French restaurant in one of these countries. Since the residents, and even the tourists, are very wealthy, the restaurants are costly.

The people who live in Monaco typically have their own chef and other servants. This may be one reason why their health is so good. Food is prepared by an expert and totally without the hassle and anxiety suffered by the home cook.

We know that anxiety is a cause of hypertension and contributes to all sorts of disease, from gastritis of the stomach due to too much acid production and to cardio-vascular disease from the hypertension.


The city of Monaco is small and maintained like a fine garden. All the flowers are manicured daily by a well paid staff of gardeners. The streets are cleaned by sweepers who still use old fashioned brooms and not noisy large machines that only pick up part of the dirt.

The neighborhoods are quiet and peaceful. There is an excellent staff of security personnel who silently waft away intruders who might disrupt the peace.

Monaco harbourMonaco harbourMonaco harbour


Living to the ripe old age of 95 for women and to 86 for men is quite simple.

One should move to Monaco and follow the life style of that enclave. Of course, this means you must be clever enough to amass millions of dollars so that your annual income is over $250,000 per year.

Such intelligence is almost always associated with longevity. If you are intelligent enough to become rich, you are also intelligent enough to avoid the dangers of chronic illnesses and imprudent behavior.

You will also understand that “Big is Bad” and “Small is Sweet.”

You will eschew mass countries like the U.S. or the E.U., which are simply killing fields for the international profit cartels.

Like Jim Rogers, a perfect example of a rich self made man, who lives in Singapore, and pick a small country where the population is also educated and self disciplined, and where fine living and fine dining and long life all go together.

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Comments (17)

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  1. Ahtremblay says:

    Listen good sir. Although I appreciate the effort and the exposure that you bring about “limited governments heaven” and life expancy and prosperity.. I have to tell you that you are surely mistaken if you believe the cause is the smallness of the country. The size has nothing to do with prosperity. The united states of the 1900 had the highest life expectancy and income of anywhere on the planet. It also had the most limited government on the planet. I highly recommend that you redo your analysis. Instead of looking at the geographical size of the government, look at how limited by law their governments are. You will find perfect correlation between size and limits of government to prosperity and life expectancy.

    • Ray says:

      theres no income tax it says

    • Jim K says:

      Perfect correlation between limited government and life expectancy? Now there’s a good laugh. France and Sweden, with high taxes and socialized medicine, are both around 81 years. Somalia, which has no effective government: 50.6 years. Are you a troll?

      It’s pretty obvious from the data that richer countries do a lot better than poorer countries. The variation within richer countries likely has a fair bit to do with diet and lifestyle. (Obesity is a big killer in the U.S.)

      • John says:

        Absolutely. When you can afford to abandon “the Golden Arches” the Golden Years would be a lot longer. Affluence is the key here. From it flows the rest of the “key” contributing factors.

    • Jim K says:

      Sweden, France, Norway: life expectancy around 81. High taxes, large safety net.

      Somalia: life expectancy around 50. No effective government.

      Not quite that perfect correlation.

      • Jim,

        You missed the message.

        Good genes = brains = money = longevity.

        Forget politics.

        Politics are for the masses (read morons).

        Dr. Pinna

        • Max56 says:

          Money equals health.

          I personally knew (he passed away several years ago) a man who because he was rich, survived LONG past when he should have died from a horrible accident. He was able to afford the worlds best back surgeon.

          Ray Kurzweil can afford 150 of the top vitamins per day (probably costs thousands of dollars per month.)

          The average person can’t afford that.

        • Rosalyn says:

          I agree with you Dr. Pinna. This is true in the United States. Affluent counties in the United States have higher rates of longevity and low rates of chronic diseases such as cancer, diabetes, and so forth. I enjoyed reading your article.

        • John says:

          I totally disagree.

          Money does equal opportunity


          For some it’s, Opportunity + Good Decisions = Money = “move to Monaco” = Lifestyle = Longevity.

          Remember, not all of the residents were born there. They’ve just ended up there.

  2. Randy K. says:

    “The people who live in Monaco typically have their own chef and other servants.” Do these people also live in Monaco, or do they live outside of Monaco and commute to work? Most of the very rich surround themselves with a large number of servants, so maybe it’s these people who are doing physical work and getting paid a good wage for it who are actually driving up the life expectancy.

    • Randy,

      That is an excellent observation. I doubt the servants can
      afford to live in Monaco. They probably live in France–or
      some may have rooms in those expensive houses and apartments.

      Whichever it may be, do the wealthy physically work or exercise
      in order to live so long?

      I guarantee they do not work, but walking in Monaco is arduous.
      It is basically the side of a small mountain.

      This entire nation is into sports big time.

      I would guess they exercise, eat well, sleep well,
      see a doctor whenever they sneeze and ultimately
      get the most out of their genes.

      We have to spread some of that wealth and wisdom around.

      Dr. Pinna

  3. Pierre says:

    I am gonna be honest and say I don’t know what this Dr. Pinna website is ;-)
    It may well be very good in parts, but your analysis of health in Monaco just is a collection of prejudices: the details are from your imagination…and yet you may well be correct.

    1) “Monaco used to be a colony of Italy for hundreds of years. It is now controlled by France”
    Now that’s something interesting. Though no one is denying that French culture and political decisions affect Monaco indirectly, I don’t know where you got those facts. Monaco is a member of the United-Nations, the Council of Europe, and has embassies in many countries (including the US). You can check all this, don’t take my word for it…and of course, it wouldn’t make sense of the CIA World Factbook to rank Monaco if it weren’t a country.

    2) “Eating out, however, is much more expensive than eating in an Italian or French restaurant in one of these countries. Since the residents, and even the tourists, are very wealthy, the restaurants are costly.”
    You haven’t been to Monaco recently…though there are expensive restaurants, I suggest you compare prices with the neighboring French restaurants: they are exactly the same. Surely you know that the entire Riviera is an expensive place…were you comparing with prices with some village in the center of France or Kansas?

    3) “All the flowers are manicured daily by a well paid staff of gardeners”
    I grew up in Monaco, and though our gardens may well be well maintained, I can assure you there is not such thing as a daily visit!

    4) “The people who live in Monaco typically have their own chef and other servants. ”
    What??? No one is denying that Monaco has a very high rate of Millionaires and Billionaires…but you’ve never been to Monaco obviously. You’ve never gone to high school in Monaco, you’ve never met people barely being able to pay the high rents (which I can assure you, compensate for the absence of taxes).
    Saying that every single inhabitant as a servant in Monaco is like saying that every American has a cowboy hat and a gun at the belt…there may be some reason for this prejudice to exist, but it’s just not true.

    5) “The governments in these small countries are non-intrusive”
    That may be up to debate…but you forget one thing, especially important for US readers: Monaco has a compulsory state-run health system. It is fully public, and you can’t opt out. This is normal in the EU, but the system in Monaco is of course much better funded as in the “large” nations. This item should have been in the article: universal healthcare is not a positive argument for everybody.

    Again, I say that respectfully. Your article gets it right all in all: general wealth and mediterranean diet are surely the explanation for Monaco’s situation. Add to this a universal healthcare system, and you’ve got the recipe.

    But please, next time you write an article, back it up with facts, not exaggerations. There is nothing wrong with making general statements, your article would still be worthy…
    I can assure you: we are not just old ladies being served a olive-oil salads by British servants, under the (strange but omnipotent) control of the neighboring French Republic.

    Hoping this will raise (serious) curiosity about Monaco…

    • Anyone who grew up in Monaco should be quite
      wealthy and well educated.

      Education normally includes the ability to represent
      one’s self with charm.

      Dr. Pinna

      • Pierre says:

        It is sad, your reaction to my – polite – criticism doesn’t really speak highly of you (attacking my elegance?).

        Facts matter more than elegance, and I (hopefully elegantly ;-) ) maintain that your article contains factual misconceptions,

        This is your blog, and I appreciate your publishing my initial comment nevertheless. I will gladly leave you the last world, just please gather more reliable information on Monaco if you mention it again. Respect to other people’s nations, no matter how small, is a sign of elegance many people value as well


        • Ciao Pierre!

          Our family is meeting in Salzburg for the Christmas

          We have friends from Nice.

          I will ask if there is anything new about Monaco,
          and refer your comments.

          I’ll be back in January and report any updates.


          Dr. Pinna

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