Life expectancy got much higher for most everyone in rich countries over the last several decades. But in the US, the rich are adding years to their life faster than the poor—and probably faster than the rich in other countries.
For example, take a look at the differences between the US and Denmark. A new study looking at life expectancy in both countries shows the lifetimes of high-income Americans grew 140% faster than those of their low-income counterparts from 2001 to 2014. In Denmark, the rich outpaced the poor by less than 20%. The research, conducted by economists at the University of California, San Diego and the University of Copenhagen, also found the situation in Denmark appears to be illustrative of what is happening across many European countries.
Data on incomes and life expectancy is not easy to come by. The US government does not release publicly available data on the finances of people after their death. To estimate the relationship between income and life expectancy, researchers from Opportunity Insights, a policy institute based at Harvard University, gained access to federal income tax and Social Security records. This data, which allows researchers to correlate the historical incomes of Americans to their age at death, is usually kept private to maintain taxpayers privacy. But these researchers were given anonymized data under strict security protocols.
They found men who had reached the age of 40 in 2014 and were in the top 10% in household income could expect to live to 88 years old. For those that were in the bottom 10%, life expectancy was just 76. This means that the richest Americans live 12 years longer than the poorest.
Though both poor and rich people gained years of life since 2001, this 12 year difference was 1.4 years greater than in 2001. The disparities were even greater for women, with those in the top 10% gaining 1.6 more years than those in the bottom 10%.
The researchers attribute the increased variation to differences in smoking and obesity, not access to healthcare. Income inequality also increased over the last several decades, likely exacerbating these differences. Their research was published by the Journal of the American Medical Association in 2016. It is still the most recent data available on the precise relationship between incomes and life expectancy.
Is the extent of US’s life expectancy inequality rise the norm for rich countries? It probably isn’t.
The researchers for the Denmark study used the data from Opportunity Insights for the US, and comparable data on incomes and life expectancy provided by Statistics Denmark. They estimated changes in life expectancy for the bottom, middle, and top third of the income distribution for both countries.
They found that while the differences between the well-off and the poor were large for both men and women in the US, in Denmark both low and high-income women gained about the same amount of years. High-income men did make more gains in Denmark, but inequality only grew half as much as in the US.
Perhaps surprisingly, the economists show that mortality rates, the share of people who die at a given age, have actually fallen about equally for the rich and the poor in the US from ages 40 to 60. This is mostly due to a massive decline in deaths from cardiovascular diseases, such as heart attacks and strokes, that occurred across the income spectrum.
The main reason inequality in life expectancy still grew in both countries is that once people make it to 60, the differences in deaths between the rich and the poor become more stark. This is mostly because poorer people are more likely to die from what the economists call “behavioral” causes past 60, which include deaths related to smoking, drug abuse, and obesity. These behavioral deaths rose so much in the US, that from 2014 to 2017 overall life expectancy actually fell after increasing consistently since the early 1990s.
Though it was not the main purpose of their research, the economists also examine the rise of life expectancy inequality by educational attainment across a number of other European countries—data by income was not available so education levels, which are highly correlated to income, were used instead. None of the countries had such a large increase in life expectancy inequality by education level as the researchers found in the US. In France, they even found that the least educated residents saw much greater gains in life expectancy than the highly educated.
It is not unreasonable to question whether rising life expectancy inequality in the US really even matters. If everybody is living longer, is it really a problem if the rich are getting a bit more life than the poor? Gordon Dahl, one of the economists who worked on the study, says there are two main reasons we still might worry about it.
One, just as for wealth, many people want the gains of society to be equally shared. If one group’s lot is improving more than another, policymakers might want to focus more on the people that are lagging behind. In this case, it might indicate that it would be more equitable to put more healthcare resources into stopping smoking and drug abuse than continuing to fight stroke. The second reason is that if it’s the rich who are living longer, they get a larger share of the benefits from government programs for elderly, such as Social Security and Medicare in the US. These programs generally redistribute wealth from the rich to the poor, but will not have the same progressive impact with increased difference in life expectancy.