Unequal Until the End

I read about this in the print edition of the New York Times, Tues. Oct. 13, 2015

I suggest reading the whole article at the following link:

http://www.theatlantic.com/business/archive/2015/04/unequal-until-the-end/389910/

Corey Abramson Apr 20, 2015

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in accordance with institutional review board requirements all the names in this article are pseudonyms.

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First, consider the sobering fact that many of the most disadvantaged simply die before they are eligible for their first Social Security check—a process demographers euphemistically call “selective mortality.” A recent review by public health experts puts this in perspective: "In 2008 white U.S. men and women with 16 years or more of schooling had life expectancies far greater than black Americans with fewer than 12 years of education—14.2 years more for white men than black men, and 10.3 years more for white women than black women. These gaps have widened over time."

[Looking at the graph provided, Hispanics have a longer life expectancy than Caucasians, maybe because it's the healthier people who can immigrate.]

Social circumstances affect not only how long we live, but how healthy we are when we become seniors. An overwhelming body of evidence suggests that differential exposure to toxic environments, the stresses of poverty and discrimination, and unequal access to medical institutions are contributing factors to the gap between rich and poor elders. New research suggests that the influence of social factors can even be seen on the genetic level. Jeremy Freese and Karen Lutfey, sociologists at Northwestern University and University of Colorado, summarize the empirical relationship between inequality, health, and aging in unambiguous terms when they note, “The lower status people are, the sooner they die, and the worse health they have while alive.”

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While Social Security and Medicare help, they don’t level the playing field. Disparate resources—monetary, social, and spatial—continue to shape the lives of elders. Some of the elderly I encountered in my study aged with immense wealth, social support, and education. Others did so in poverty and isolation. The wealthiest people in my study had aged in or retired to communities with voluminous senior programs, while many of the poor became increasingly isolated as they struggled with piecemeal social services.

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Growing wealth inequality, and its racial components, continue to have profound ramifications for seniors’ lives. In addition to larger Social Security checks, the affluent seniors I encountered often owned homes, received pensions, had relatives who could hire health aides, and could afford supplemental health insurance. In contrast, seniors from poor and working-class backgrounds, who were also disproportionately people of color, often had little choice but to engage with public services even when they would prefer not to.

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Unfortunately, but perhaps not surprisingly, those who needed public resources the most—people like Dave and Bernard—lived in neighborhoods that provided fewer services.

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So what can be done? First, it is hard to overstate how vital government services and volunteer programs are to older Americans across the social spectrum. Issues that may seem minor to those in the Capitol, such as the disruptions to Meals on Wheels services during budget freezes, have a profound impact on the lives of seniors. Cutting the already thin safety net, which is anchored by Social Security and Medicare, would be catastrophic. Second, it is important to examine how political and economic structures funnel resources into some neighborhoods and starve others. Seniors in impoverished areas would also benefit immensely from the services that eased Jessica’s trials in later life.

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