The New York Times reported on an alarming new study: researchers have documented that the least educated white Americans are experiencing sharp declines in life expectancy. Between 1990 and 2008, white women without a high school diploma lost a full five years of their lives, while their male counterparts lost three years. Experts say that declines in life expectancy in developed countries are exceedingly rare, and that in the U.S., decreases on this scale “have not been seen in the U.S. since the Spanish influenza epidemic of 1918.”
Undoubtedly, the increasing numbers of low-income Americans without health insurance is a major contributor factor. Researchers also say that lifestyle factors such as smoking, which has increased among low-income white women, play a role; poor folks tend to engage in more risky health behaviors than their more affluent counterparts.
Moreover, there is a compelling body of research that suggests that inequality itself - quite apart from low incomes, or lack of health insurance - is associated with more negative health outcomes for those at the bottom of the heap. One of the most famous series of studies of the social determinants of health, Britain’s Whitehall Studies, had as their subjects British civil servants, all of whom health insurance and (presumably) decent enough jobs. Intriguingly, these studies "found a strong association between grade levels of civil servant employment and mortality rates from a range of causes. Men in the lowest grade (messengers, doorkeepers, etc.) had a mortality rate three times higher than that of men in the highest grade (administrators)." So what was behind such disparate health incomes among high-status and low-status workers? Researchers pointed the finger at inequality, hypothesizing that various psycho-social factors associated with inequality - such as the higher levels of stress at work and at home experienced by the lower tier workers, as well as their lower levels of self-esteem - were behind the dramatic differences in mortality rates.
Undoubtedly, the increasing numbers of low-income Americans without health insurance is a major contributor factor. Researchers also say that lifestyle factors such as smoking, which has increased among low-income white women, play a role; poor folks tend to engage in more risky health behaviors than their more affluent counterparts.
Moreover, there is a compelling body of research that suggests that inequality itself - quite apart from low incomes, or lack of health insurance - is associated with more negative health outcomes for those at the bottom of the heap. One of the most famous series of studies of the social determinants of health, Britain’s Whitehall Studies, had as their subjects British civil servants, all of whom health insurance and (presumably) decent enough jobs. Intriguingly, these studies "found a strong association between grade levels of civil servant employment and mortality rates from a range of causes. Men in the lowest grade (messengers, doorkeepers, etc.) had a mortality rate three times higher than that of men in the highest grade (administrators)." So what was behind such disparate health incomes among high-status and low-status workers? Researchers pointed the finger at inequality, hypothesizing that various psycho-social factors associated with inequality - such as the higher levels of stress at work and at home experienced by the lower tier workers, as well as their lower levels of self-esteem - were behind the dramatic differences in mortality rates.
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