Senior couple running Paul Bradbury/Getty Images

Life-and-Death Inequality

Although people are living longer almost everywhere, life-expectancy figures in the US tell a more complicated story. Rich Americans can expect to live significantly longer than poor Americans, owing to disturbing levels of inequality not only of income and wealth, but also of access to basic health care.

REYKJAVÍK – Just as some of us live longer than others, countries have different average life expectancies. At the bottom of the scale is Swaziland, the only country in the world where a newborn still cannot expect to reach age 50. And at the top is Hong Kong, where a newborn can expect to live to age 84.

The Year Ahead 2018

The world’s leading thinkers and policymakers examine what’s come apart in the past year, and anticipate what will define the year ahead.

Order now

In 1960, the world’s countries could be divided into two groups, based on mortality. Countries in one group had low average life expectancy, from 28 years in Mali to just under 50 years in El Salvador. And countries in the second, much less populous group enjoyed higher average life expectancy – up to 73 years in Norway, Iceland, the Netherlands, and Sweden.

Since then, Hong Kong has surpassed this North European group, as have Japan (84 years), Italy (83), Spain (83), and Switzerland (83). Today, the people of Hong Kong can expect their children to live 17 years longer than in 1960. Japanese newborns can expect to live 16 years longer; and newborn Icelanders can expect to live ten years longer.

Much of this increase in life expectancy around the world is a result of declining child mortality. And the increase has been more marked for women, who tend to live an average of three years longer than men. In Iceland, for example, the average life expectancy for men and women is 81 and 84, respectively.

But life expectancy can also vary significantly within countries, between rich and poor. According to a new study by two MIT researchers, the wealthiest 1% of American men tend to live almost 15 years longer than the poorest 1%; and the wealthiest 1% of American women can expect to live ten years longer than their poorer counterparts.

Moreover, this gap widened over time. In just the last 15 years, the average life expectancy of the wealthiest 5% of Americans has increased by two years for men, and three years for women. Over the same period, the average life expectancy of the poorest 5% Americans has increased by just three months for men, and hardly at all for women.

Like recent reports about many Americans’ deteriorating health, this difference in life expectancy seems to reflect not just income and wealth inequality, but also unequal access to health care. And yet US President Donald Trump and congressional Republicans seem intent on depriving 23 million more Americans of health insurance by repealing and replacing the 2010 Affordable Care Act (“Obamacare”).

If they succeed, life expectancy in the United States would most likely continue to decline, relative to other developed countries. Between 1960 and today, for example, average life expectancy in the US increased from 70 to 79 years, whereas in Italy it increased from 69 to 83 years. While the average American lived one year longer than the average Italian in 1960, the average Italian now lives four years longer than the average American.

Average US life expectancy has increased more slowly than in Europe partly because many white middle-aged Americans have, since 1999, been living shorter lives, owing to lifestyle-related diseases, opioid overdoses, and suicides. In fact, since 1981, opioid overdoses alone have taken almost as many lives as HIV/AIDS.

It is extremely rare for any large cohort in a modern society to suffer such a decline in life expectancy. The only other time it has happened in recent decades was in Russia after the collapse of communism, and in Africa after the outbreak of the HIV/AIDS epidemic.

Rising inequality, then, is not just a question of income, wealth, and power; it is, literally, a matter of life and death. This may explain why inequality has shot to the top of the political agenda in the US and Europe in recent years. In his 2016 Democratic primary campaign, Vermont Senator Bernie Sanders, a self-proclaimed socialist, condemned America’s rising inequality and actually came closer to being elected president than many had expected. And Trump – like the “Leave” campaign in the United Kingdom – was embraced by many voters who feel left behind.

Despite being founded in 1945, the International Monetary Fund only recently began to pay ample attention to the distribution of income and wealth in its member countries. Having now realized that inequality can hinder economic growth, the IMF has begun to discuss the inequality-growth relationship with several of its members.

Some observers have disparaged the IMF for this new approach, and argue that increased inequality simply reflects what people have voted for. But those who claim that inequality is something to be desired are akin to those who argue that unemployment is always voluntary, as some economists still insist.

In fact, when inequality rises, democracy suffers, which is why the demotion of the US in one prominent ranking of the world’s democracies is not particularly surprising. Most people do not want to be unemployed, or be left behind, or have his or her life cut short. It only looks that way to those who frame the choices voters make.

http://prosyn.org/KdeBiHg;

Handpicked to read next

  1. Patrick Kovarik/Getty Images

    The Summit of Climate Hopes

    Presidents, prime ministers, and policymakers gather in Paris today for the One Planet Summit. But with no senior US representative attending, is the 2015 Paris climate agreement still viable?

  2. Trump greets his supporters The Washington Post/Getty Images

    Populist Plutocracy and the Future of America

    • In the first year of his presidency, Donald Trump has consistently sold out the blue-collar, socially conservative whites who brought him to power, while pursuing policies to enrich his fellow plutocrats. 

    • Sooner or later, Trump's core supporters will wake up to this fact, so it is worth asking how far he might go to keep them on his side.
  3. Agents are bidding on at the auction of Leonardo da Vinci's 'Salvator Mundi' Eduardo Munoz Alvarez/Getty Images

    The Man Who Didn’t Save the World

    A Saudi prince has been revealed to be the buyer of Leonardo da Vinci's "Salvator Mundi," for which he spent $450.3 million. Had he given the money to the poor, as the subject of the painting instructed another rich man, he could have restored eyesight to nine million people, or enabled 13 million families to grow 50% more food.

  4.  An inside view of the 'AknRobotics' Anadolu Agency/Getty Images

    Two Myths About Automation

    While many people believe that technological progress and job destruction are accelerating dramatically, there is no evidence of either trend. In reality, total factor productivity, the best summary measure of the pace of technical change, has been stagnating since 2005 in the US and across the advanced-country world.

  5. A student shows a combo pictures of three dictators, Austrian born Hitler, Castro and Stalin with Viktor Orban Attila Kisbenedek/Getty Images

    The Hungarian Government’s Failed Campaign of Lies

    The Hungarian government has released the results of its "national consultation" on what it calls the "Soros Plan" to flood the country with Muslim migrants and refugees. But no such plan exists, only a taxpayer-funded propaganda campaign to help a corrupt administration deflect attention from its failure to fulfill Hungarians’ aspirations.

  6. Project Syndicate

    DEBATE: Should the Eurozone Impose Fiscal Union?

    French President Emmanuel Macron wants European leaders to appoint a eurozone finance minister as a way to ensure the single currency's long-term viability. But would it work, and, more fundamentally, is it necessary?

  7. The Year Ahead 2018

    The world’s leading thinkers and policymakers examine what’s come apart in the past year, and anticipate what will define the year ahead.

    Order now