Life expectancies have gone up significantly in the last 50 years, and it’s natural to think that they’re just going to continue to go up. Globally, though, much of that gain has come in developing countries, thanks to very basic improvements like better sanitation, better nutrition, and in the last few decades, less war (the gains in developed countries are leveling off somewhat, since there’s only so much you can do to reverse the effects of old age). But alarmingly, recently we’ve seen some signs that some of those gains are starting to reverse in America, and it’s exacerbated by inequality. As gaps in income grow, so too do gaps in life span between America’s most and least affluent.
This got a lot of attention back in November, with a study by Angus Deaton (a Nobel laureate in economics) showing that mortality for U.S. whites age 45 to 54 was going up, and had been since 1998. Some experts argued that this was mostly a statistical accident (in other words, it reflected the fact that the median age within the 45-54 bin was going up in that period, because of the large number of Baby Boomers passing through that group, being replaced by the less numerous Gen Xers).
However, whether that was the explanation for the overall increase or not, the increase was limited to people with a high school degree or less. The death rate for the college-educated kept going down. Also, it matched results found in earlier studies, such as one in 2012 which found the trend especially present among white working-class women. While these studies didn’t point directly to causes, they suggested that higher rates of smoking, drug overdoses, and obesity among poorer whites was at the root of it.
And now another study, this time from the Brookings Institution, has confirmed that there's something going on with life expectancies, and it's increasingly related to inequality.
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.
Here’s another way of looking at the same problem, examining actual expected age:
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.
Or, as the Brookings study describes it: “The average life expectancy of man born in 1920 in the top 10 percent of the mid-career income distribution is 79.3 years. The same man in the bottom 10 percent of the distribution has an average life expectancy 5 years lower…. For men born 20 years later in 1940, the difference in average life expectancy is 12 years.”
The first inclination might be to think "that's because the poor have limited access to health care," and that that will improve in the future thanks to the Affordable Care Act, and more so if we continue to build on the ACA and add more improvements. However, limited access to health care doesn't account for many of the nation's premature deaths. More than anything, the gap, again, seems to be behavioral, starting with smoking.
As the rich and educated began to drop the habit, its deadly effects fell increasingly on poorer, uneducated people. Jessica Ho, of Duke University, and Mr. Fenelon calculate that smoking accounted 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.
Two other factors are the rise in deaths related to drug overdoses (including prescription drugs), and the rise in obesity. However, obesity may not be the main driver of the income disparity, if only because obesity is something that's increasing on all sides of the income divide: In 2010, the number had risen to the point where 37 percent of adults at the lower end of the income ladder were obese, compared with 31 percent at the higher end.
In related news, another interesting study came out last week that doesn’t focus on life expectancy and inequality, but does focus more specifically on one important component in that relationship: Obesity and poverty. People who grow up poor tend to have trouble regulating their food intake—in other words, to stop eating when one is full. Part of that may be learned behavior: To eat as much as possible when food is available, to essentially save up calories for when food may, in fact, not be available later. If food then continues to be available, obesity is what results when someone continues to eat as if food is going to be cut off at some point.
One other implication that Brookings focuses on, compounding the simple moral problem of shorter life expectancies for people with less money, is the impact that has on the Social Security system. Social Security usually starts paying at 65 (though you can get smaller payments for life if you take it earlier, or larger payments for life if you wait to begin). In this way, you can see how Social Security is less of an advantage for the poor than it is for the middle-class. If you start drawing Social Security at 65 and live to be 70 or 75, you get a lot less out of the system than someone who draws it until 85.
Compounding that is the way that someone with a comfortable desk job can hold out until, say, age 67 to start drawing Social Security, in exchange for larger payments later. In a way, the increasing disparity in life expectancy means that the poor who pay into the Social Security pool are helping to subsidize the longer life spans of people more affluent than them—without getting much of anything in return.