What the dip in US life expectancy is really about: inequality

////What the dip in US life expectancy is really about: inequality

What the dip in US life expectancy is really about: inequality

Living in the US increasingly looks like a health risk. Average life expectancy here dropped for the second year in a row, according to recent data from the Centers for Disease Control and Prevention. The grim trend stems from a toxic mixture of more drug- and alcohol-related deaths and more heart disease and obesity in many parts of the country. And it puts Americans at a higher risk of early death compared to their counterparts in other wealthy countries.

But what’s often lost in the conversation about the uptick in mortality here is that this trend isn’t affecting all Americans. In fact, there’s one group in the US that’s actually doing better than ever: the rich. While poor and middle-class Americans are dying earlier these days, the wealthiest among us are enjoying unprecedented longevity.

So when we talk about life expectancy slipping, what we should also talk about is the growing problem of health inequality in America. And it’s an increasingly urgent discussion, health researchers are warning, because of policy changes on the horizon that are poised to make the mortality gap even wider.

Some of these policies will hamper access to medical care (such as failing to fund CHIP, the health insurance program for low-income children) but others that aren’t even directly related to health care — like tax cuts — may have even more insidious effects on the American mortality gap.

The rich have long-enjoyed more longevity than the poor, but the gap in life expectancy has been widening in the US over the last few decades, along with other types of social and income inequality here.

The CDC’s Division of Vital Statistics, which tracks mortality in the US, uses death certificates as the data source, and doesn’t collect family income data. But we do have good data on the mortality gap and income from a study published in JAMA in 2016. A group of researchers, led by Stanford University economist Raj Chetty, analyzed income data for the US population from 1.4 billion tax records between 1999 and 2014. They then compared it with mortality data from Social Security Administration death records. They found that, from 2001 to 2014, the richest Americans gained about five years of longevity, while life expectancy for the poor didn’t budge.

Read more: https://www.vox.com/science-and-health/2018/1/9/16860994/life-expectancy-us-income-inequality