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Saturday, February 13, 2016

They Die Early in Fishtown

At The New York Times, Sabrina Tavernise reports on the longevity gap:
The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. In the early 1970s, a 60-year-old man in the top half of the earnings ladder could expect to live 1.2 years longer than a man of the same age in the bottom half, according to an analysis by the Social Security Administration. Fast-forward to 2001, and he could expect to live 5.8 years longer than his poorer counterpart.
New research released on Friday contains even more jarring numbers. Looking at the extreme ends of the income spectrum, economists at the Brookings Institution found that for men born in 1920, there was a six-year difference in life expectancy between the top 10 percent of earners and the bottom 10 percent. For men born in 1950, that difference had more than doubled, to 14 years.
For women, the gap grew to 13 years, from 4.7 years.
What account for the gap?  The poor have higher rates of smoking, obesity, and prescription drug abuse.
Limited access to health care accounts for surprisingly few premature deaths in America, researchers have found. So it is an open question whether President Obama’s health care law — which has sharply reduced the number of Americans without health insurance since 2014 — will help ease the disparity.
At the heart of the disparity, said Elizabeth H. Bradley, a professor of public health at Yale, are economic and social inequities, “and those are things that high-tech medicine cannot fix.”
There are consequences for entitlements:
The growing longevity gap means that benefits like Social Security are paid out even more disproportionately to the better-off because they are around for more years to collect them. Last summer, the National Academy of Sciences convened a panel of experts to study the implications. It concluded that disparate life expectancies are making the country’s biggest entitlement programs, like Social Security and Medicare, increasingly unfair to the poor and suggested officials consider policy changes to address the problem.
At The Atlantic, Victor Tan Chen writes:
For the last several months, social scientists have been debating the striking findings of a study by the economists Anne Case and Angus Deaton.* Between 1998 and 2013, Case and Deaton argue, white Americans across multiple age groups experienced large spikes in suicide and fatalities related to alcohol and drug abuse—spikes that were so large that, for whites aged 45 to 54, they overwhelmed the dependable modern trend of steadily improving life expectancy. While critics have challenged the magnitude and timing of the rise in middle-age deaths (particularly for men), they and the study’s authors alike seem to agree on some basic points: Problems of mental health and addiction have taken a terrible toll on whites in America—though seemingly not in other wealthy nations—and the least educated among them have fared the worst.
At The New York Times, Gina Kolata and Sarah Cohen write:
The Times analyzed nearly 60 million death certificates collected by the Centers for Disease Control and Prevention from 1990 to 2014. It found death rates for non-Hispanic whites either rising or flattening for all the adult age groups under 65 — a trend that was particularly pronounced in women — even as medical advances sharply reduce deaths from traditional killers like heart disease. Death rates for blacks and most Hispanic groups continued to fall.
The analysis shows that the rise in white mortality extends well beyond the 45- to 54-year-old age group documented by a pair of Princeton economists in a research paper that startled policy makers and politicians two months ago.
While the death rate among young whites rose for every age group over the five years before 2014, it rose faster by any measure for the less educated, by 23 percent for those without a high school education, compared with only 4 percent for those with a college degree or more.
The drug overdose numbers were stark. In 2014, the overdose death rate for whites ages 25 to 34 was five times its level in 1999, and the rate for 35- to 44-year-old whites tripled during that period. The numbers cover both illegal and prescription drugs.