INCOME AND HEALTH: Poor Are Left Behind In Health Gains
A comprehensive study of health in America has found a strong link between socioeconomic status and health, with the wealthy faring far better than the poor in almost every category, from infant mortality to obesity to life expectancy. The study, conducted by the National Center for Health Statistics, found that although health is improving in many areas, with average life expectancy at a record 76.1 years and the infant death rate down to 7.3 deaths per thousand live births, the link between income and life span is "pervasive" across all races and genders (Sternberg, USA Today, 7/30). Study co-author Elsie Pamuk of the NCHS said, "We were all somewhat surprised by the strength and persistency of the findings" (AP/Baltimore Sun, 7/30).
The NCHS report found that low birthweight and infant mortality rates were higher among the children of less-educated mothers than among children of more-educated mothers. Infants born to mothers who did not finish high school were about 50% more likely to be of low birthweight than infants whose mothers finished college. In addition, children in higher income families were less likely than poor children to be without a regular source of health care. Among all poor children under 6 years of age, 21% of those without health insurance had no usual source of care compared with 4% of poor children covered by insurance (HHS release, 7/30). The report also found that a "45-year-old white man who makes at least $25,000 can expect to live 6.6 years longer than a white man of the same age making less than $10,000." The study also found that the "1995 chronic-disease death rate for men with less than a high school education was 2.5 times that for men with more eduction," and for "infectious diseases other than HIV, the death rate for the least educated men was three times that of the most-educated" (Schulte, Philadelphia Inquirer, 7/30).
The Problems Of Poverty
Merely expanding health insurance coverage may not solve the problem: "the poorest Americans have Medicaid insurance yet they also have the worst health," AP/CNN reports. According to Judith Jones of Columbia University's School of Public Health, "The widespread dissemination of information about diet, exercise and smoking has reached richer, better educated people first, improving their health but widening the gap" between income groups. Furthermore, for those who cannot afford nutritious food or regular checkups -- people just "trying to survive on a daily basis" -- it can be difficult to "focus on issues of healthy lifestyles" (7/30). Dr. George Kaplan of the University of Michigan's School of Public Health said, "We need to start thinking that economic policy is the most powerful form of health policy. As we increase people's economic well-being, we increase the health of all" (Inquirer, 7/30).
Now For The Good News
The report holds more than just doom and gloom. Said Pamuk: "We don't want to get too negative, because overall, the report shows we're making tremendous progress and we're clearly on the right track." The Washington Times reports that some positive highlights include:
- Deaths from heart-disease -- the #1 killer of Americans -- dropped 12% between 1990 and 1996.
- Deaths from cancer -- the #2 killer -- fell 5% in the same period after a steady 20-year upswing.
- The number of teenagers giving birth has dropped 12% from 1991 to 1996.
- The life-expectancy gap between genders and races closed slightly; women now live an average of six years longer than men, and whites live an average of 6.6 years longer than blacks.
- Cigarette smoking among people 25 years and older declined from 37.1% to 24.6% between 1970 and 1995, although the less-educated continue to smoke and die of lung cancer at an above-average rate (Larson, 7/30).
Health and Human Services Secretary Donna Shalala said of the findings, "Health is improving in America along many fronts, and our challenge is to share that progress as widely as possible" ( Cox News/San Jose Mercury News, 7/30). email subscription.