The Association Between Income and Life Expectancy in the United States, 2001–2014

By Rajendra Chetty, Michael Stepner, S. Abraham, Shelby Lin, Benjamin Scuderi, N. Turner, Augustin Bergeron, D. Cutler. Journal of the American Medical Association (JAMA), 2016

1,034 citations recorded by the source corpus.

Importance The relationship between income and mortality is well established but remains poorly understood. Objectives To measure the level, temporal trend, and geographic variability in the association between income and life expectancy, and identify factors related to small area variation in this association. Design and Setting Income data for the US population were obtained from 1.4 billion de-identified tax records between 1999 and 2014. Mortality data were obtained from Social Security Administration death records. These data were used to estimate race- and ethnicity-adjusted life expectancy at 40 years of age by household income percentile, sex, and geographic area, and to evaluate factors associated with differences in life expectancy. Main Outcomes and Measures Relationship between income and life expectancy; trends in life expectancy by income group; geographic variation in life expectancy levels and trends by income group; and factors associated with differences in life expectancy across areas. Results The sample consisted of 1 408 287 218 person-year observations (mean age at which individuals were analyzed, 53.0 years; median household earnings among working individuals, $61 175 per year [mean, $97 725 per year]). Among those aged 40 to 76 years, there were 4 114 380 deaths among men (mortality rate, 596.3 per 100 000) and 2 694 808 deaths among women (mortality rate, 375.1 per 100 000). The analysis yielded four results. First, higher income was associated with greater longevity throughout the income distribution. The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years (95% CI, 14.4 to 14.8 years) for men and 10.1 years (95% CI, 9.9 to 10.3 years) for women. Second, inequality in life expectancy increased over time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% of the income distribution, but increased by only 0.32 years for men and 0.04 years for women in the bottom 5% (P < .001 for the difference for both sexes). Third, life expectancy varied substantially across local areas. For individuals in the bottom income quartile, life expectancy differed by approximately 4.5 years between areas with the highest and lowest longevity. Changes in life expectancy between 2001 and 2014 ranged from gains of more than 4 years to losses of more than 2 years across areas. Fourth, geographic differences in life expectancy for individuals in the lowest income quartile were significantly correlated with health behaviors such as smoking (r = −0.69, P < .001), but were not significantly correlated with access to medical care, physical environmental factors, income inequality, or labor market conditions. Life expectancy for low income individuals was positively correlated with the local area fraction of immigrants (r = 0.72, P < .001), fraction of college graduates (r = 0.42, P < .001), and local government expenditures (r = 0.57, P < .001). Conclusions and Relevance In the United States between 2001 and 2014, higher income was associated with greater longevity, and differences in life expectancy across income groups increased. However, the association between life expectancy and income varied substantially across areas; differences in longevity across income groups decreased in some areas and increased in others. The differences in life expectancy were correlated with health behaviors and local area characteristics.

Subfields: Demography, General Health Professions, Health

View Paper: https://www.semanticscholar.org/paper/78afff07c5bcee1c1a005706f630048ee49e3495

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In Demography

1. Dacher Keltner
2. Paul K. Piff
3. Facundo Alvaredo
4. Hunt Allcott

In General Health Professions

1. Carol Graham
2. Rebecca Diamond
3. Sergio Pinto
4. Anthony B. Atkinson
5. Michael W. Kraus
6. Dacher Keltner

In Health

1. Carol Graham
2. Sergio Pinto
3. Anthony B. Atkinson
4. Michael W. Kraus
5. Dacher Keltner

Citations in the corpus

• Top wealth shares in the UK over more than a century (2018, background): “Additional evidence on the mortality advantage of US richer classes is contained in the work by Chetty et al. (2016). The discussion so far has taken for granted that a rise in the wealth differential will significantly increase the top shares.”
• The Opportunity Atlas: Mapping the Childhood Roots of Social Mobility (2018, neutral): “…have established that the neighborhood in which a child grows up has substantial causal effects on his or her prospects of upward income mobility (Chetty et al. 2016; Chetty and Hendren 2018a; Chyn 2018; Deutscher 2018; Laliberté 2018).1 The emerging consensus that neighborhoods play a key role…”
• Unequal hopes and lives in the USA: optimism, race, place, and premature mortality (2019, background): “1 Existing studies What explains these surprising trends, which are, at least among wealthy countries, unique to theUSA?Anumber of studies have focusedondifferential trends inmobility (and fear of downward mobility, Cherlin 2016); differential health behaviors (Chetty et al. 2016); inequality of opp”
• Unpacking the inequality paradox: The psychological roots of inequality and social class. (2018, background): “, Pascarella, Pierson, Wolniak, & Terenzini, 2004), health (Barr, 2014), and life expectancy (Chetty et al., 2016).”
• Food Deserts and the Causes of Nutritional Inequality* (2019, background): “A wave of recent studies have drawn increased attention to the causes and consequences of socioeconomic inequality (Aizer and Currie, 2014; Case and Deaton, 2015; Chetty et al., 2014; Chetty et al., 2016; Saez and Piketty, 2003).”