The Public's Health: The Health of the Poorest 50 Percent | Public Health Post

No relationship is more clearly established in population health science than the one between income and health. Those among us who are fortunate enough to have higher income live longer, healthier lives. By way of example, those born in 1960 who are in the lowest income quintile, can expect to live till age 76; those in the highest income quintile can expect to live till age 89. Money buys access to the resources that create a healthier life, from safe neighborhoods to walk in, to clean air to breathe, to time off to care for sick children, to nutritious food to eat. We write about this today, not because it is news, but because, quite simply, the United States is on the brink of creating a class of permanent health have-nots, shaped by entrenched class divides and ever increasing income disparity.
Pre-tax income for the poorest 50% of Americans has remained the sameover the past 40 years, while their after-tax income has dropped as taxes have increased for this same group. Regressive taxation has deepened wealth gaps, virtually assuring a continuing cycle of low income earning. The national share of income owned by the richest 50% of Americans has grown commensurately during this period, and our health indicators have responded accordingly. The slope of the income-health relationship has grown even steeper since 2000; the health advantage that those with higher incomes have over those with lower incomes is greater than it has been in the past four or more decades. Going back to the example we started with, for those born in 1930, the poorest quintile could expect to live till age 77, the richest quintile until 82. The life expectancy gap has widened from 5 to 13 years. The rich have gained years while the poor have not.
Why is this? We as a country continue to invest less in the social resources that can mitigate the challenges that come with a lower income, even as we spend ever more on high-end medicine that is accessed principally by those who can afford it. Social institutions like education that traditionally have led to social mobility and better health have become increasingly the provenance of the well-off. 
That about 1 out of every 2 Americans now have health and survival outcomes no better—and potentially worse—than those born decades earlier, is alarming. Should this not be on the front page of every newspaper every day?
Michael Stein & Sandro Galea