For a poor woman born in the Roaring Twenties, getting to age 50 was something of an accomplishment. She had to contend with diphtheria and tuberculosis, hookworm and polio, not to mention childbirth, which killed about 800 women for every 100,000 births at the beginning of the decade. Widespread use of penicillin to treat infections was still 20 years away; Medicaid, four decades. If she did make it to 50, on average she would live to be 80 years old. That sounds pretty good, until you consider that the richest women born at the same time lived about four years longer.
Americans have become much healthier since then, generally speaking, thanks to scientific advances, higher living standards, better education, and social programs. Life expectancy hit a record high in 2012. But as with economic prosperity, gains in physical health haven’t been spread equally. Instead, they’ve been increasingly skewed towards the wealthy—and a new analysis from the Brookings Institution indicates gaps in lifespan between the rich and the poor are getting worse, not better.
Using data from the Social Security Administration and other government records, the report compares the lifespan of people born in 1920 and in 1940 who were in either the top or bottom ten percent of wage earners. It turns out that rich men born in 1940 can expect to live 12 years longer than the poorest, compared to a six-year gap between rich and poor men born in 1920. The disparity in life expectancy between women at the top and bottom more than doubled, growing from four to ten years. In fact, women at the bottom saw no increase at all in their life expectancy. The difference continued to grow between rich and poor people born in 1950.
The Brookings analysis “adds to a growing body of evidence that there is a widening gap in health between the haves and have-nots in the country,” said Steven Woolf, director of the Center on Society and Health at Virginia Commonwealth University. It’s been clear for some time that how long Americans live depends on how much money they have, even their zip codes. What the Brookings study adds is evidence of the problem getting steadily worse.
As for how socioeconomic inequalities translate into inequities in life span, “It’s rather mysterious,” said Lisa Berkman, the director of the Center for Population and Development Studies at Harvard University. One answer is that low-income people tend to be sicker in the first place, because the neighborhoods they can afford to live in are more polluted; because they can’t afford to adopt and maintain healthy behaviors; because they can’t afford health insurance premiums, copayments, and prescription drugs.