The health–wealth gap continues to divide us, a new mega-study finds.
Money can’t buy love or happiness. But it may buy health and a longer life.
In a new mega-review of 26 studies, U.S. Census information, and Social Security records published in The Lancet, Boston University Center for Global Health & Development researchers compared extensive data on Americans’ income disparities and health histories for the years 1980–2015.
They found that the wealth–health gap between the poor and rich is deepening — and that’s translating to a larger difference in how long people live.
“A ‘health–poverty trap’ may be emerging,” explains study lead author Jacob Bor, ScD, SM, assistant professor of global health, “keeping the poor sick, and the sick poor.”
Among the key findings:
- The richest 1 percent of Americans live more than a decade longer than the poorest 1 percent. Among men, the wealthiest 1 percent benefit from an average of 14.6 years greater longevity; women live 10.1 years more.
- Since 2001, the poorest 5 percent of Americans are not living any longer — while middle- and high-income people have gained more than two years in life expectancy.
- Income disparity has “increased dramatically” among Americans in the past four decades: The share of income going into the pockets of the wealthiest 10 percent increased from 33 percent of all earnings in 1978 to 50 percent in 2014 — “a level of inequality not seen since before the Great Depression,” the study authors note. They also found incomes for poor and middle-income Americans have barely changed since the 1970s and, adjusted for inflation, have actually declined since 2000.
- Poverty has long been linked to poorer health outcomes because people in lower-income groups cannot afford as much or the same quality of healthcare as wealthy people. Numerous studies found that poorer people also are statistically more likely to adopt less-healthy habits, such as smoking, substance- and alcohol-abuse, and an unhealthy diet, and have higher incidences of obesity, type 2 diabetes, heart disease, and lung and some other types of cancer.
- Because they die younger, the poor are often “short-changed” by age-related healthcare programs such as Medicare and Social Security retirement benefits.
- This wealth–health gap keeps getting deeper for several reasons, the authors note. Among these is a gulf between the richest and poorest in the adoption of healthcare innovations; access to health-risk and preventive-care information due to cost barriers; and the erosion of public subsidies for health insurance and other health inputs.
The result is a looming health–poverty trap, Bor explains. This is vicious circle “where poverty leads to poor health (because the poor face greater disease risks and have fewer resources to invest in their health), and in turn, poor health leads to deeper poverty (through medical expenses and productivity losses).”
“Low-income Americans are increasingly left behind,” he and his coauthors write in the study. “Without interventions to decouple income and health, or to reduce inequalities in income, we might see the emergence of a 21st century health–poverty trap and the further widening and hardening of socioeconomic inequalities in health.”