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

By Julia Belluz@juliaoftorontojulia.belluz@voxmedia.com Updated Nov 30, 2018, 9:13am EST

Living in the US increasingly looks like a health risk. Average life expectancy in the country dropped for the third year in a row, according to recent data from the Centers for Disease Control and Prevention. That’s the longest downturn since the Spanish flu wiped out more than 50 million people a century ago.

The grim trend stems from a toxic mixture of more drug- and alcohol-related deaths and more suicide 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 in the US 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, 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 rescinding funding for 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.

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They also found that men who were among the top 1 percent of income earners lived 15 years longer than men at the bottom 1 percent. For women at the extremes of the income distribution, life expectancy differed by 10 years.

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Right now, there are several policies that are not only expected to hamper health care access but also exacerbate income inequality — and widen the life expectancy disparity, David Blumenthal, president of the Commonwealth Fund, says. Blumenthal has written about the potential effects of the tax bill President Donald Trump signed into law last December, on low- and middle-income Americans in particular, and how it’ll disproportionately ding them while rich Americans and corporations will enjoy tax breaks:

Americans earning less than $75,000 would face higher taxes on average by 2027, according to the Joint Commission on Taxation’s estimates of the bill’s distributional effects. The bill has varying effects on different income groups in different years, but consistently cuts taxes for the richest Americans. For example, individuals earning less than $10,000 would see their federal taxes go up on average by $182 each year until 2027. People earning a million dollars or more would, on average, see their taxes fall by $6,800 annually over the next decade.

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