[PEN-L:359] The prosperous live longer

["Frank Durgin" <fdurgin1@xxxxxxxxxxxx>]

               WSWS : News & Analysis : North America

               US Department of Health and Human Services report

               The prosperous live longer

               By Debra Watson
               2 October, 1998

               Income inequality has created a substantial gap between the
               life expectancy of the poor and that of the better off
according
               to a recent US government report. The National Longitudinal
               Mortality Study for 1979-1989 showed white men who were 45
               years of age during any year from 1979 to 1989, and who had
               a family income of at least $25,000, could expect to live
6.6
               years longer than those with family incomes less than
               $10,000 (33.9 years longer compared with 27.3 years). Black
               men lived 6.6 fewer years than white men, but wealthy black
               men lived 7.4 years longer than poor black men. Women
               lived on average 6 years longer than men.

               The cited study makes up part of the health statistics
               compiled by US government researchers into a report entitled
               Health, United States, 1998. The US Department of Health
               and Human Services (HHS) sends a report on the health
               status of the US population annually to the president and
               Congress. It is the first time since such reports were
instituted
               that the HHS has reported the effect of income inequality on
               the health of the US population.

               For the 1998 report, SES (socioeconomic status) was
               determined using household income, education level or
               occupational status to compile data on a broad range of
               health issues. Researchers determined, "Each increase in
               social position, measured either by income or education,
               improves the likelihood of being in good health. For most of
               the health indicators, this SES gradient was observed in
               persons in every race and ethnic group examined."

               The report adds: "Although progress is occurring toward most
               targets, data presented in this chart book demonstrate that,
               for many objectives, only the higher socioeconomic groups
               have achieved or are close to achieving the target, while
lower
               socioeconomic groups lag farther behind."

               Social inequality was found to impact on areas such as
               infant mortality, death rates, and incidence of poor health.
               There were also great differences in the death rate for
               different areas of the United States. For example, the death
               rate was 15 percent higher than the national average in the
               East South Central division, which comprises the acutely
               impoverished areas of America's South.

               Infant mortality in the US declined between 1983 and 1995.
               However, infants born to white mothers with less than 12
               years of education were 2.4 times as likely to die in the
first
               year of life as those whose mothers had at least 16 years of
               education. For minority populations the gap in infant
               mortality has widened, in some cases moving away from the
               target.

               Some environmental risk factors are reported. Children one
to
               five years of age living in poor families were over seven
times
               as likely to have an elevated blood lead level as children
in
               high income families, and one in five poor black children
had
               an elevated blood lead level. There are substantially higher
               blood lead levels in lower income adults, who are often
               exposed to lead in the workplace. Also in 1996, nearly one
in
               five Americans still lived in counties that did not meet the
               Environmental Protection Agency's standards for
               environmental pollutants.

               Other risk factors such as smoking, overweight, and
               sedentary lifestyle were followed. A passage in the
               "Highlights" narrative speculates on the effect wealth has
on
               "having knowledge and time to pursue healthy behaviors,
               having sufficient income to assure access to comfortable
               housing, healthy food, and appropriate health care, access
to
               safe and affordable locations to exercise or relax, and
living
               and working in a safe, healthy environment." In other words,
               the majority of the working population do not have the time,
               financial resources or opportunity to pursue a lifestyle
               advantageous to better health.

               Pronounced inequality exists in access to medical care in
the
               US. In 1993, 41 percent of those over 18 and considered low
               income had seen a dentist in the previous year compared
               with 77 percent of the wealthy. Well-off women over 50 were
               70 percent more likely to have had a mammogram in the past
               two years than low-income women of the same age group.

               The US Census bureau recently released figures showing
               that from January 1993 to January 1996 nearly three out of
               every ten Americans had no health insurance for at least one
               month. Nearly one in six had none for five months or longer,
               and half of those people below the poverty level had no
health
               insurance for at least one month.

               The HHS study also found more people either without
               insurance or paying higher premiums and out-of-pocket
               costs. The burden of the cuts falls disproportionately on
the
               working poor. Between 1989 and 1996 the number of people
               with health care insurance in the US dropped from 76
               percent to 71 percent. The number of people relying on
Health
               Maintenance Organizations to pay for healthcare is steadily
               increasing. In 1997 one-quarter of the insured were enrolled
               in HMOs, double the 1991 enrollment.

               Children living in poverty in 1994-95 were five times more
               likely to be without health insurance. And in the states of
               Arkansas, Louisiana, Texas, New Mexico, Arizona and
               California one in five people had no medical coverage of any
               kind.

               The entire HHS report can be downloaded as a PDF file
               using Adobe Acrobat. Access the web site at
               www.cdc.gov/nchswww/products/pubs/pubd/hus/hus.htm

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