A Matter of Life and Death

Life expectancy is always better for those with resources to afford the best healthcare, the healthiest food, a lifestyle that promotes wellness and an educational awareness of what risks to avoid (and the money to avoid them). For example, you can read statistics of how many people die from the effects of air pollution, but when you drill down into the numbers, you know that the richer members of cities with the worst air can afford the expensive air filters (mostly expensive Swiss-made) for their homes and offices; the poor cannot escape the toxicity.

“More than 5.5 million people [globally] die from air pollution each year, with more than 3 million of these deaths occurring in China and India, announced researchers [February 12^th] at the 2016 annual meeting for the American Association for the Advancement of Science. 

“‘Air pollution is the fourth highest risk factor for death globally and by far the leading environmental risk factor for disease,’ said Dr. Michael Brauer, a professor at the University of British Columbia’s School of Population and Public Health in Vancouver, Canada, in a press release. ‘Reducing air pollution is an incredibly efficient way to improve the health of a population.’ 

“In 2013, an estimated 1.6 million people died in China and 1.4 million died in India from poor air quality.” The Christian Science Monitor, February 13^th. The overwhelming majority of those fatalities were among the less affluent.

Even here in the United States, income is very much an indicator of life expectancy… richer folks just plain live longer, and it’s getting worse. “[A] growing body of data shows a … disturbing pattern: Despite big advances in medicine, technology and education, the longevity gap between high-income and low-income Americans has been widening sharply.

“The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. In the early 1970s, a 60-year-old man in the top half of the earnings ladder could expect to live 1.2 years longer than a man of the same age in the bottom half, according to an analysis by the Social Security Administration. Fast-forward to 2001, and he could expect to live 5.8 years longer than his poorer counterpart.

“New research released on [February 12^th] contains even more jarring numbers. Looking at the extreme ends of the income spectrum, economists at the Brookings Institution found that for men born in 1920, there was a six-year difference in life expectancy between the top 10 percent of earners and the bottom 10 percent. For men born in 1950, that difference had more than doubled, to 14 years… For women, the gap grew to 13 years, from 4.7 years…

“‘This may be the next frontier of the inequality discussion,’ said Peter Orszag, a former Obama administration official now at Citigroup, who was among the first to highlight the pattern… The causes are still being investigated, but public health researchers say that deep declines in smoking among the affluent and educated may partly explain the difference.

“Overall, according to the Brookings study, life expectancy for the bottom 10 percent of wage earners improved by just 3 percent for men born in 1950 compared with those born in 1920. For the top 10 percent, though, it jumped by about 28 percent. (The researchers used a common measure — life expectancy at age 50 — and included data from 1984 to 2012.). ” New York Times, February 12^th.

Why? Just awareness of health issues as noted above? Access to healthcare? Stress from constantly dwindling real-value earning power/standard of living for the vast majority of Americans (for decades) in the middle and bottom economic tiers? “It is hard to point to one overriding cause, but public health researchers have a few answers. In recent decades, smoking, the single biggest cause of preventable death, has helped drive the disparity, said Andrew Fenelon, a researcher at the Centers for Disease Control and Prevention. As the rich and educated began to drop the habit, its deadly effects fell increasingly on poorer, uneducated people. Mr. Fenelon has calculated that smokingaccounted for a third to a fifth of the gap in life expectancy between men with college degrees and men with only high school degrees. For women it was as much as a quarter.

“Obesity, which has been sharply rising since the 1980s, is more ambiguous. The gap between obesity rates for high earners and low earners actually narrowed from 1990 to 2010, according to an analysis by the National Academy of Sciences. By 2010, about 37 percent of adults at the lower end of the income ladder were obese, compared with 31 percent at the higher end.

“More recently, the prescription drug epidemic has ravaged poor white communities, a problem that experts said would most likely exacerbate the trend of widening disparities… Limited access to health care accounts for surprisingly few premature deaths in America, researchers have found. So it is an open question whether President Obama’s health care law — which has sharply reduced the number of Americans without health insurance since 2014 — will help ease the disparity.

“At the heart of the disparity, said Elizabeth H. Bradley, a professor of public health at Yale, are economic and social inequities, ‘and those are things that high-tech medicine cannot fix.’… Life expectancy for the bottom 10 percent of male wage earners born in 1920 was 72.9, compared with 73.6 for those born in 1950, the Brookings researchers found. For the top 10 percent, life expectancy jumped to 87.2 from 79.1.

“The growing longevity gap means that benefits like Social Security are paid out even more disproportionately to the better-off because they are around for more years to collect them. Last summer, the National Academy of Sciences convened a panel of experts to study the implications. It concluded that disparate life expectancies are making the country’s biggest entitlement programs, like Social Security and Medicare, increasingly unfair to the poor and suggested officials consider policy changes to address the problem.

“Poor health outcomes for low-income Americans have dragged the United States down to some of the lowest rankings of life expectancy among rich countries. The Social Security Administration found, for example, that life expectancy for the wealthiest American men at age 60 was just below the rates in Iceland and Japan, two countries where people live the longest. Americans in the bottom quarter of the wage scale, however, ranked much further down — one notch above Poland and the Czech Republic.” NY Times.

Income inequality seems to be a bigger issue than most of us, and most of our politicians, have assumed. Notwithstanding blanket statements from candidates to the contrary, cutting taxes and regulatory controls on the rich – the trickle-down “job creation” theory – is a practice that has failed miserably since it became a basic GOP assumption since Ronald Reagan. The government can help narrow this embarrassing gap. The rich have gotten richer even with Congress firmly in Republican control, the rest are earning less in real buying power and not remotely living as long as the wealthy in our nation. Compared to other wealthy nations, we have failed most of our population.

I’m Peter Dekom, and indeed, income inequality has become a matter of life and death for most of us.