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Wealth Inequality Drives Health Inequality

This study reveals that US wealth inequality, at historic highs, creates large health inequality: a lifespan difference of 13 years between the richest and poorest. Rectifying these economic differences would raise overall longevity to levels achieved in other wealthy countries.

February 1, 2024

Wealth Redistribution to Extend Longevity in the US
JAMA Internal Medicine
January 29, 2024
By Kathryn E. W. Himmelstein, Alexander C. Tsai, Atheendar S. Venkataramani

Question:  What is the association between wealth redistribution and longevity in the US?

Findings:  In this cohort study of 35,164 US adults aged 50 yearor older, those with low and high wealth experienced marked differences in longevity. Participants in the highest wealth decile had a hazard ratio of 0.59 for death (95% CI, 0.53-0.66) compared with those in the lowest decile, corresponding to a 13.5-year difference in survival. Simulations suggested that more equitable distributions of wealth might be associated with up to 2.2 years of additional population-level longevity, closing the gap with other OECD countries.


The findings of this cohort study suggest that unequal and racialized distribution of wealth in the US is associated with dramatically reduced longevity across the entire population, with particularly harmful consequences for the survival of individuals with low wealth and Black individuals in the US. Redistributive policies could greatly improve health and longevity of US residents without harming the health of individuals in the US who are currently wealthy.

Comment by: Don McCanne

In the United States, the wealthiest 10% of households hold over 70% of the total wealth, whereas the lower half holds less than 2%. Racial wealth inequalities are even worse. Unfortunately, this plays out in impaired access to medical care and other health risks for poor, Blacks, and Latinos – together substantially lowering life expectancy in these groups.

The good news is that we can fix this. We can redistribute wealth from billionaires and mega-millionaires, using public policies – most of all taxation. We could use much of that revenue to pay for a health care system that takes care of all of us, without the wealthy losing any health care at all. Thus, none of us would have to worry any longer about economic disadvantage reducing our life span.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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