Evan Horowitz | Quick Study

Death — the ultimate form of inequality

It no longer makes sense to think of death as the great leveler. Sure, it catches up with everyone eventually, but it generally comes for the poor first. And every year, wealthy Americans seem to get a bigger headstart.

Just since 2001, folks in the top 5 percent have seen their life expectancy grow by about 2.5 years. Among the bottom 5 percent, the change rounds to zero.

This may count as the most basic, and most visceral, manifestation of rising inequality, where not only do high earners get ever more income, they also get more time, more experiences, and more breaths.


And if the unequal distribution of years wasn’t enough, this widening gap in life expectancy has some surprising spillover effects. Among other things, it means richer households are pocketing more and more Social Security income — since every additional month of life brings another check.

More money, more life

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Estimating life expectancy is tricky businesses. If you wait for people to die, you’ll always be stuck calculating details on your grandparents’ generation. To study the present, you need a model that can predict life expectancy using current information and evolving trends.

Such models now abound, and despite their differing assumptions, they all tell the same basic story. Life expectancy is rising faster for high-income Americans than for their lower-income neighbors. And over time, this difference has really added up.

Take the following example, from a recent paper by a team of leading economists and demographers. The group compared silent generation men born in 1930 with late baby boomers born in 1960 — and to guard against the differential impact of wars and accidents, they looked exclusively at the future life expectancy for those who survive at least to age 50.

In the 1930 cohort they found a modest gap between rich and poor, with the top 20 percent of earners living roughly five years longer than the bottom 20 percent. Turn to the next generation, however, and the change is remarkable. Upper-income men born in 1960 could expect to live 13 years longer than those at the bottom, an increase of 160 percent.


Thriving communities, longer lives


As to why the Fates seem to reach for their scissors more quickly when dealing with lower-income Americans, that’s still very much under debate. Perhaps the fullest account comes from a study led by Stanford University professor Raj Chetty.

He found smoking is a big factor, and obesity as well — two public health scourges that are concentrated among lower-income Americans and that continue to suck away years of life.

Access to health insurance, by contrast, didn’t seem to play a key role — nor did health care spending. That may surprise, but it could reflect the fact that rich and poor get the same basic health plan once they reach 65, namely Medicare.

Less directly, the life expectancy of poor Americans seems intricately connected to the vibrancy of their communities. Merely living in a dense population seems to extend lives. Better still if the people around you are college grads — or immigrants. In fact that was one of the tightest correlations: The larger the immigrant population, the longer lower-income residents could expect to live.

Government spending, too, is a good predictor of longevity among the poor. As are high housing prices, presumably as a proxy for economic health.

Massachusetts, a partial exception


Run through that list again and you can see why Massachusetts might be a good home for lower-income folks looking for long lives. After all, we’ve got low smoking rates, low obesity rates, high housing prices, lots of college grads, and a sizeable immigrant population.

Sure enough, lower-income residents live longer here than in 44 other states, by Chetty’s numbers. In fact, Massachusetts is one of just a handful of places bucking the life-inequality trend. Since 2001, life expectancy for men and women has actually grown faster among the poorest 25 percent than among the top 25. So that today, any Bay Stater who reaches 40 has a projected life span of at least 80, wherever they stand on the income ladder.

Rural America is where things are really going badly. In states like North Dakota, Wyoming, Iowa, and Maine, life expectancy is barely inching ahead for lower-income residents — or sometimes moving backward — even as wealthier residents extend their lives.

A perverse consequence, more government support

The unequal distribution of life is creating a new divide: not between the haves and have-nots but instead the heres and the not-heres.

And while that may be the most fundamental issue, it’s not the only one. Perversely, the rise in life inequality means that high-income Americans are getting a growing share of Social Security and Medicare benefits.

Why is that? Because both these programs have a built-in bias toward the long-lived. So long as you’re around to cash checks and visit doctors, they’ll keep paying.

For folks born in 1930, this didn’t matter much. Social Security and Medicare provided a pretty consistent set of lifetime benefits; the top 20 percent of earners got about as much as the bottom 20 percent.

Not so for those born in 1960. Richer families in that cohort are expected to collect $130,000 more than poor families, simply because they’ll be around longer to claim benefits.

There’s a fairness question embedded here, as with so many questions about rising inequality. Does it really make sense for Social Security to provide greater lifetime benefits to those with already substantial incomes? Maybe yes. After all, those richer, longer-living folks don’t just get more benefits, they also have more lifetime costs, since dead men pay no rent.

But that only points back to the deeper problem, which isn’t about money but about something even more basic. These days, inequality isn’t just about paychecks or income. Increasingly, it’s a matter of life and death.

Evan Horowitz digs through data to find information that illuminates the policy issues facing Massachusetts and the United States. He can be reached at Follow him on Twitter @GlobeHorowitz.