Life expectancy falling for the poorest Americans

By Patrick Martin
22 September 2012

According to a study conducted for the professional journal Health Affairs, life expectancy is falling for significant sections of the working class in the United States, and in some cases has reverted to levels not seen in half a century.

The figures reported are stark. The gap in life expectancy between the most socially privileged and the most socially disadvantaged groups in American society is more than 10 years for women and more than 14 years for men. The authors write: “These gaps have widened over time and have led to at least two ‘Americas’…”

The authors draw particular attention to the actual decline in life expectancy among the poorest sections of the white working class, those with less than a high school education. Life expectancy for women in that subgroup fell from more than 78 years in 1990 to 74 years in 2008. The figure for men also declined, by three years.

Across all racial groups—white, black and Hispanic—the authors wrote: “We found that in 2008 US adult men and women with fewer than twelve years of education had life expectancies not much better than those of all adults in the 1950s and 1960s.”

Researchers suggested that rising obesity, higher rates of smoking among women, abuse of prescription drugs, and a decline in health insurance coverage—43 percent of the least-educated had no health insurance in 2006—may all have been contributing factors.

Michael Marmot, director of the Institute of Health Equity in London, told the New York Times that the decline in life expectancy for poor white women over the five-year period from 2003 to 2008 brought to mind the seven years of falling life expectancy for Russian men after the collapse of the Soviet Union in 1991.

This comment is all the more striking given that the five years from 2003 to 2008 largely preceded the Wall Street crash of September 2008 and the ensuing plunge of the US and world economy into the deepest slump since the Great Depression of the 1930s. There is no doubt that all the social evils discussed in the Health Affairs report have worsened over the past four years.

The decline for poor white women produced the remarkable result that in 2008 life expectancy for white women without a high school diploma was actually lower than for black women with the same educational level, the first time that such an inversion has been reported in relation to a major indicator of social distress.

This fact alone is a refutation of all the peddlers of identity politics who claim that race, not class, is the fundamental division in American society. What is taking place in America is a class catastrophe, a social counterrevolution directed at the entire working class, of all racial and ethnic backgrounds.

The authors strongly argue that behavioral factors alone, like drug abuse, cannot explain the disparity in health outcomes, which “reflect racial and ethnic differences as well as differences in education and income…”

Instead, they continue, “it has been proposed that social conditions can be ‘fundamental causes’ of health inequalities, which is why interventions based exclusively on modifying biomedical risk factors have not been, and are not likely to be, successful in substantially reducing health disparities.”

In other words, the decline in life expectancy for some sections of the working class is a product of a broader social crisis. The Health Affairs report is an ominous warning of the cumulative impact of social inequality, poverty, unemployment, low wages and general deterioration of social services in America.

Despite being expressed in the technical jargon of the social sciences, with its conclusions very cautiously drawn, the study documents the failure of American capitalism to meet the most basic test of a society: the preservation and extension of human life.

The report provides an insight into the shocking conditions of poverty that are concealed by the corporate-controlled media and the political establishment. The decline in life expectancy for substantial sections of the population is the result not simply of impersonal economic forces. It is the outcome of decades of social and political reaction, presided over by Democratic as well as Republican administrations.

These policies—tax cuts for the rich, deregulation, cuts in social programs—have been carried out with the conscious aim of increasing the wealth of the ruling elite at the direct expense of the vast majority of the people. They have been continued and intensified by the Obama administration.

The New York Times gave the Health Affairs report front-page treatment Friday, a prominence that was certainly warranted by the devastating findings of the study. But the account published by the Times gave one-sided attention to racial and cultural aspects of the study, as suggested by the headline chosen: “Life Span Shrinks for Least-Educated Whites in US.”

The Times article ignores the more fundamental socio-economic dimension of class, a term that does not appear among the more than 1,300 words the newspaper devoted to the report.

The authors of the Health Affairs study are not so shy about considering the impact of economic factors on life expectancy. They argue that “education and its socioeconomic status correlates are associated with lifelong health and survival outcomes that transcend the independent effects of race—a finding that is consistent with a large body of scientific literature dating back more than eighty years.”

The Times report does have the merit of giving the Health Affairs study public attention and placing it in the context of other research into the social crisis in the United States.

The article notes the dramatic decline of the United States in international rankings of life expectancy, especially for women, from 14th place in 1985 to 41st place in 2010, according to the United Nations. “Among developed countries, American women sank from the middle of the pack in 1970 to last place in 2010, according to the Human Mortality Database,” the Times noted.

While social conditions for the working masses deteriorate, America still remains number one in the world in the categories that really matter to the ruling elite: the number of billionaires, the profits amassed by the super-rich, and the number of soldiers, policemen, bombs, missiles, and prison cells available to protect the financial parasites from the working people whose labor is the actual source of all wealth.