Development & WelfareHealth & Medicine

Poor Income, Lower Social Status Makes You Unhealthy and Die Younger!

Is your health impacted by your wealth?  Does wealth and income impact the longevity and how healthy you are?  Studies now show they do!

East Tennessee State University sorted country’s 3,141 counties by their median household income using the income data from the US Census (averaged over the years 2009 to 2013).  Then they formed “states” by income by grouping the poorest to the richest counties.

The 2% of counties with the lowest median household income composed the poorest “state” in their alternative USA. The next 2% of counties formed the second-poorest “state.” The researchers continued this process until they had 50 new “states,” each with 62 or 63 counties.

So the poorest state had the actual poor counties from states like Alabama, Arkansas, Georgia, Illinois, Kentucky, Louisiana, Mississippi, Oklahoma, South Carolina, South Dakota, Tennessee, Texas and West Virginia; while the richest state also had rich counties from states like Alaska, California, Colorado, Connecticut, Georgia, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Minnesota, Ohio, New Jersey, New Mexico, New York, Pennsylvania, Utah, Tennessee, Texas and Virginia.

 

As is obvious, the same physical states had both richest and the poorest counties – thus showing the highly unequal distribution of wealth within so many states!

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Here are some of the insights from the study:

  • The median household income in the poorest “state” was $24,960. In the richest “state,” it was $89,723.
  • The average number of people per county was about 14,000 in the poorest “state,” compared with about 362,000 in the richest “state.”
  • Although the poorest “state” had a much smaller population, the ratio of people to primary care doctors there was twice that of the richest “state.”
  • Smoking prevalence was twice as high in the poorest “state” as in the richest “state,” and the prevalence of obesity was 50% higher.
  • Life expectancy for women in the poorest “state” was 75.9 years, compared with 83 years in the richest “state.” For men, life expectancy in the poorest “state” was 69.8 years and 79.3 in the richest “state.”
  • The proportion of the population that was African American was 4.5 times higher in the poorest “state” than in the richest one.
  • In the richest “state,” 21% of residents lived in rural areas. In the poorest “state,” 75% of people do.
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What is incredible is that difference in income (which was huge!) contributed to as much as 10 years of life expectancy difference for men between the poorest and the richest states!

Health differences because of Income Disparities

Of course, one of the main reasons for the differences in life expectancy and also health while a person is alive is the access to proper health care.  Part of it may also be general attitudes to life situations and mental health.

In a study by Urban Institute’s Center on Society and Health, the researchers found that the disparities in people’s health statistics based on wealth differences were astonishing!  For example, when people were asked to share the information about their health from different income levels, the study found the following stats which showed that Poor adults are more than three times as likely to have activity limitations due to chronic illness!

Prevalence of disease by Income

Low incomes also impact mental health status.  Those with lower incomes have more mental complications than those with higher incomes.

Mental Health and Income

Is Income the Only Factor?

Interestingly, when studies were done in countries with Universal Health coverage like UK and other European countries, it was found that disparities in health still existed!

As Harvard University’s psychologist Norman Anderson says, it is a still a mystery as to why this is so?

“As you move up the socioeconomic status hierarchy, your health prospects continue to improve,” says psychologist Norman B. Anderson, PhD, a professor of health and social behavior at Harvard University’s School of Public Health and former director of the Office of Behavioral and Social Sciences Research at the National Institutes of Health (NIH). “Why that happens is the $100,000 question.”

Well, it could a whole host of socio-economic factors that could be impacting health because of the income strata that a person comes from.

In a decade long Whitehall study of over 17,000 British civil servants gave an interesting result – Relative Risk of death Increased significantly as the rank decreased!

Maybe folks in the lower income bracket have bad habits like higher drinking or smoking or face more acute life situations (mental health impact), but the researchers are now coming to the realization that there is something more than just access to health and behavioral and environmental differences that is at work!!

“One of the greatest advances of the last few years has been that socio-economic status is now viewed as a determinant of health rather than a mere correlate,” says Anderson.

In order to futher get an insight into this question, Sheldon Cohen, PhD, a professor of psychology at Carnegie Mellon University in Pittsburgh has come up with what is called the Socioeconomic Ladder Concept.  This helps us study the impact of socio-economic status on people’s immune system.

Also read:  Are American Retirees Headed for Poverty?

 

Status in Social Hierarchy and Health

Cohen found a very interesting thing in a study on primates.  In that study it was found that even though stress that the monkeys were subjected to did not have any impact on their susceptibility to virus for upper-respiratory infection, their status in the hierarchy of monkeys had!

Just being in more subordinate position made the monkey more likely to succumb to virus!

Imagine, not stress but that feeling that one was lower in social hierarchy made one succumb to even infections!  When expanded to humans, Cohen found that people who put themselves on a low status rung had a much higher risk of developing infections.

In a very interesting TED talk, Richard Wilkinson, a Public health researcher, shows with hard numbers and charts as to how economic inequality has real impact on health, lifespan and even things like trust in a society!

Bottomline: Poor Income, Lower Social Status Makes You Unhealthy and Die Younger


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When I had looked at the question of differences between health status of people in different economic strata of society, I had thought that it must be due to access to health options – medicines, doctors and hospitals.  But that was ruled out as the only major factor because even people in countries with universal health coverage saw the same dichotomy of health vs income.  And then when one looks at even the situation of how primates get impacted more by something as objective as a viral infection simply because of one’s perceived social status, it becomes even more intriguing.

So those who think that income inequalities and social equality does not matter need to rethink their world-view.  A more egalitarian society is a healthier society!

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Desh Kapoor

The panache of a writer is proven by the creative pen he uses to transform the most mundane topic into a thrilling story. Desh – the author, critic and analyst uses the power of his pen to create thought-provoking pieces from ordinary topics of discussion. He writes on myriad interesting themes. Read the articles to know more about his views and “drishtikone”.

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