The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being.
Experts have long known that rich people generally live longer than poor people. But a growing body of data shows a more disturbing pattern: Despite big advances in medicine, technology and education, the longevity gap between high-income and low-income Americans has been widening sharply.
The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. In the early 1970s, a 60-year-old man in the top half of the earnings ladder could expect to live 1.2 years longer than a man of the same age in the bottom half, according to an analysis by the Social Security Administration. Fast-forward to 2001, and he could expect to live 5.8 years longer than his poorer counterpart.
New research released Friday contains more jarring numbers. Looking at the extreme ends of the income spectrum, economists at the Brookings Institution found that for men born in 1920, there was a six-year difference in life expectancy between the top 10 percent of earners and the bottom 10 percent. For men born in 1950, that difference had more than doubled, to 14 years.
For women, the gap grew to 13 years, from 4.7 years.
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“There has been this huge spreading out,” said Gary Burtless, one of the authors of the study.
The growing chasm is alarming policymakers and has surfaced in the presidential campaign. During the Democratic debate Thursday night, Sen. Bernie Sanders and Hillary Clinton expressed concern over shortening life spans for some Americans.
“This may be the next frontier of the inequality discussion,” said Peter Orszag, a former Obama administration official now at Citigroup, who was among the first to highlight the pattern.
The causes are being investigated, but public-health researchers say that deep declines in smoking among the affluent and educated may partly explain the difference.
Overall, according to the Brookings study, life expectancy for the bottom 10 percent of wage earners improved by just 3 percent for men born in 1950 compared with those born in 1920. For the top 10 percent, though, it jumped by about 28 percent. (The researchers used a common measure: life expectancy at age 50, and included data from 1984 to 2012.)
It is hard to point to one overriding cause, but public-health researchers have a few answers. In recent decades, smoking, the single biggest cause of preventable death, has helped drive the disparity, said Andrew Fenelon, a researcher at the Centers for Disease Control and Prevention (CDC).
As the rich and educated began to drop the habit, its deadly effects fell increasingly on poorer, less educated people. Fenelon has calculated that smoking accounted for a third to a fifth of the gap in life expectancy between men with college degrees and men with only high-school diplomas. For women, it was as much as a quarter.
Obesity, which has been rising since the 1980s, is more ambiguous. The gap between obesity rates for high earners and low earners narrowed from 1990 to 2010, according to an analysis by the National Academy of Sciences.
By 2010, about 37 percent of adults at the lower end of the income ladder were obese, compared with 31 percent of those at the higher end.
More recently, the prescription-drug epidemic has ravaged poor white communities, a problem that experts said would most likely exacerbate the trend of widening disparities.
Limited access to health care accounts for surprisingly few premature deaths in America, researchers have found. So it is an open question whether President Obama’s health-care law — which has reduced the number of Americans without health insurance since 2014 — will help ease the disparity.
At the heart of the disparity, said Elizabeth Bradley, a professor of public health at Yale University, are economic and social inequities, “and those are things that high-tech medicine cannot fix.”
Life expectancy for the bottom 10 percent of male wage earners born in 1920 was 72.9 years, compared with 73.6 for those born in 1950, the Brookings researchers found. For the top 10 percent, life expectancy jumped to 87.2 from 79.1.
Many researchers believe the gap in life spans from lower- to upper-income Americans started widening about 40 years ago, when income inequality began to grow. Earlier in the 20th century, trends in life spans were of declining disparities, some experts say, because improvements in public health, such as better sanitation and creation of the polio vaccine, benefited rich and poor alike.
The broad adoption of medication for high blood pressure in the 1950s led to a major improvement for black men, erasing a big part of the gap with whites, said Dana Goldman, director of the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California. But medical improvements can also drive disparity when they disproportionately benefit affluent Americans; for example, cutting-edge cancer treatments.
“There are large swaths of the population that are not enjoying the pretty impressive gains the rest of us are having in life spans,” said Christopher J.L. Murray, director of the Institute for Health Metrics and Evaluation in Seattle. “Not everybody is sharing in the same prosperity and progress.”