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Member Research & Reports

Member Research & Reports

Harvard: For Life Expectancy, Money Matters

Being poor in the United States is so hazardous to your health, a new study shows, that the average life expectancy of the lowest-income classes in America is now equal to that in Sudan or Pakistan.

A Harvard analysis of 1.4 billion Internal Revenue Service records on income and life expectancy that showed staggering differences in life expectancy between the richest and poorest also found evidence that low-income residents in wealthy areas, such as New York City and San Francisco, have life expectancies significantly longer than those in poorer regions.

While those differences can be chalked up, in part, to healthy behaviors — low-income residents in New York City smoke and drink less, exercise more, and have lower rates of obesity than the poor in other cities — it is unclear what other factors might contribute to the difference, said Dr. David Cutler, the Otto Eckstein Professor of Applied Economics at Harvard and professor at Harvard T.H. Chan School of Public Health and the Harvard Kennedy School.

“It’s not an overwhelming correlation with medical care or insurance coverage,” he said. “It’s not that the labor market is getting better — it’s not correlated with unemployment, or the expansion or contraction of the labor force, or how socially connected people feel. The only thing it seems to be correlated with is how educated and affluent the area is, so low-income people live longer in New York or San Francisco, and they live shorter in the industrial Midwest.”

Among men, that gap is 15 years, roughly equivalent to the life expectancy difference between the United States and Sudan. For women, the 10-year difference between richest and poorest is equivalent to the health effects from a lifetime of smoking. The study is described in a paper published in the Journal of the American Medical Association online on April 11.

“This paper really has two missions,” said Dr. Cutler. “One is to present this data, but the other is to create this data set so it can then be used by policymakers and researchers everywhere. This data has never been looked at with this level of granularity before.

Read a Harvard Gazette story about the study and view charts: