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Income Level & Life Expectancy in the US

JAMA; ePub 2016 Apr 10; Chetty, Stepner, et al

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Life expectancy increases continuously with income in the US; however, the association between life expectancy and income varies substantially across areas. This according to a study and sample consisting of 1,408,287,218 person-year observations for individuals aged 40 to 76 years (median age 53.0 years; median household earnings among working individuals, $61,175 per year) in the US between 2001 and 2014. Researchers found:

• There were 4,114,380 deaths among men and 2,694,808 deaths among women.

• Higher income was associated with greater longevity through the income distribution.

• Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% on the income distribution, but by only 0.32 years for men and 0.04 years for women in the bottom 5%.

• Life expectancy for low-income individuals varied substantially across local areas.

• Geographic differences in life expectancy for individuals in the lowest income quartile were significantly correlated with health behaviors such as smoking, but were not significantly correlated with access to medical care, physical environmental factors, income inequality, or labor market conditions.

Citation: Chetty R, Stepner M, Abraham S, et al. The association between income and life expectancy in the United States, 2001-2014. [Published online ahead of print April 10, 2016]. JAMA. doi:10.1001/jama.2016.4226.

Commentary: This article is a sobering reminder of the relationship between income and health. The effects on health may come from sources as varied as stress, the lack of availability of healthy food choices (food deserts), increased exposure to substances of abuse, high salt diets, as well as other causes. A variety of approaches have been studied to try to offset the effect of income on health. In one study intensive diabetes care management improved A1c levels in low-income populations in California.1 While the causes are varied the response is clear, which is a responsibility to do what we can as a society and as individuals to try to decrease the effect of income on health outcomes. —Neil Skolnik, MD

1. Jovanovic J, et al. Closing the gap: Effect of diabetes case management on glycemic control among low-income ethnic minority populations: The California Medi-Cal Type 2 diabetes study. Diabetes Care. 2004;27(1):95-103. doi:10.2337/diacare.27.1.95.

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