Why Do the Richest Americans Live a Decade Longer Than the Poorest?

Why Do the Richest Americans Live a Decade Longer Than the Poorest?

Why Do the Richest Americans Live a Decade Longer Than the Poorest?

Falling life expectancy is no accident—it is a direct result, and failure, of policy.


NPR recently reported that in 2021 US life expectancy fell for a second year in a row. The average American lifespan is now 76 years—the lowest it’s been since 1996. This comes after a steady rise since World War II, thanks to improved medical care, education, and scientific breakthroughs.

No doubt Covid-19 played a significant role in this steep drop. But according to the same report, life expectancy in comparable nations slipped only slightly in 2020, and actually rebounded in 2021—not to mention that US life expectancy had already been significantly lagging behind those countries’.

If the pandemic was a test of nations’ health care infrastructure, America failed.

The United States claims to be the leader of the free world. We pride ourselves on democracy, education, and wealth, but these hold very little value if we can’t live long enough to enjoy them. And our falling life expectancy is no accident: It is a direct result, and failure, of policy.

Unsurprisingly, the drop in life expectancy has been disproportionate, reflecting existing socioeconomic inequalities. While life expectancy for white people dropped by 2.4 years, it fell by four years for Black people, and by 4.2 years for Hispanic people. For Indigenous people, it fell by 6.6 years to an average age of 65.2—what the overall US life expectancy was in 1944. Even if America’s overall drop in life expectancy could be attributed entirely to the pandemic, this discrepancy can’t; it’s a reflection of the unequal outcomes that have long defined our health care system.

Aside from Covid-19, the main causes of death in 2021 included drug overdoses, heart and liver disease, and suicide. But at the both the federal and state level, the US government is doing little to mitigate these crises; if anything, by restricting health care, right-wing demagogues are actively making it worse.

Take, for example, maternal mortality, which peaked in 2021 at 1,205 deaths—a 40 percent increase from 2020 and an almost 60 percent increase from 2019. That was before the Supreme Court overturned Roe v. Wade, leading to a massive wave of states’ enacting abortion restrictions—and a Gender Equity Policy Institute report from earlier this year found that in states where abortion is banned, maternal deaths are nearly three times higher than in states that support the right to choose.

Then there are programs like Social Security, Medicare, and Medicaid, which combined provide care and insurance to more than 100 million Americans. Republicans want to gut that, too: Senator Rick Scott wants to require a congressional vote on funding those programs every five years. Senator Ron Johnson wants to do that annually. Senator John Thune supported funding cuts as recently as last November.

Addressing a group of supporters, Senator Mike Lee made his position perfectly clear: “It will be my objective to phase out Social Security. To pull it up by the roots, and get rid of it.”

But for all the hand-wringing about whether we can afford to invest in American health, the United States already spends thousands more per capita on health care than its peer countries do—it’s just that an enormous percentage of that cost is offloaded to American families in the form of insurance premiums and out-of-pocket expenses. Putting even more burden on individuals makes clear that in this country, it’s always wealth before health.

Between 1900 and 2013, American life expectancy shot up by more than 30 years. It’s no mystery why. Medical experts created antibiotics and learned how to treat cardiovascular disease. During World War II, the US Army partnered with scientists to help create the first influenza vaccine, while the War Production Board led a coalition to advance the development of penicillin. And President Lyndon B. Johnson signed Medicare and Medicaid into law, which researchers have credited with increasing life expectancy.

The math is simple: When governments give priority to health and medicine, we live longer. When you look at 10 peer countries—all with higher life expectancies—every one has government-funded health insurance. Why overcomplicate it? The key to improving life expectancy in the United States is to improve the affordability and accessibility of our health care.

That said, there is one group for whom American health care is excellent: the rich and powerful people who can afford it. One Harvard study found that the richest Americans get to live over a decade longer than the poorest Americans. Our politicians are living longer, too: We currently have the second-oldest Senate and third-oldest House of Representatives in history. The two oldest presidents to ever take office could be staging a rematch in 2024 to set a new record high. And our Supreme Court justices are well enough to take billionaire-funded trips around the world well into their 70s.

Our nation’s most privileged people—and the leaders who are living long and well—would be smart to make their quality of care available to all. If they refuse, voters should cut their career expectancy short.

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Katrina vanden Heuvel
Editorial Director and Publisher, The Nation

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