Rich in US and UK live nearly ten more healthy years than the poor

By Kate Randall
18 January 2020

Data has proven that the rich have a longer life expectancy than the poor in the US and UK. Now a new study shows that wealthy men and women generally have eight to nine more years of “disability free” life after age 50 than the poorest American and English adults.

The findings were published Wednesday in the Journals of Gerontology: Series A. Researchers sought answers to two main questions: What role do sociological factors play in how long people live healthy lives? And do English adults remain disability-free longer than American adults?

Disability-free life expectancy estimates according to social class and age, men and women in England and the United States (2002–2013). Credit: The Journals of Gerontology: Series A

Researchers from University College London, Harvard University and institutions in three other countries utilized two already existing data sets—one in the US, one in the UK—of more than 25,000 people over age 50. While life expectancy is a useful tool for measuring health, health experts increasingly recognize that the quality of life of later years is equally crucial.

The two sets of data on aging were from the Gateway to Global Aging Data, which included 14,803 men and women aged 50-plus from the US Health and Retirement Study (HRS), and the English Longitudinal Study of Ageing (ELSA), which including 10,754 English individuals aged 50-plus. HRS began in 1991; ELSA began in 2002/2003.

To maximize comparability of the two studies, other data was used from the Gateway to Global Aging Data from 2002/2003 to 2012/2013. Due to the makeup of the data sets, the findings apply only to individuals who identify as white, although the study authors estimate that the outcomes would be similar for non-white ethnicities as a sample that included these groups showed.

The new research divided individuals into three equal groups according to household wealth: poorest, middle and richest—household wealth was defined as the sum of net financial wealth and net housing wealth, less all debts.

They were also assigned one of three levels in the following categories:

* Educational attainment: (low) less than high school; (medium) high school graduate and some college; (high) college degree or more

* Occupational social class: (low) routine, manual, elementary occupations; (intermediate) administrative, secretarial, personal services, sales; (high) managers, professionals, technical

Health expectancy, or quality of life, was measured according to the presence of disability. These disabilities include difficulty in performing daily personal care, preparing a hot meal, shopping for groceries, making phone calls, taking medications, managing money, and other routine tasks.

Research showed that the absolute difference in disability life expectancy—healthy living vs. poor quality of life—was largest for wealth in England and for wealth and education in the United States. In other words, in both countries the most economically advantaged groups could expect to live longer without disability than the most disadvantaged groups (see graphs).

The delivery of health care is different in the United States and England. In England, healthcare is publicly funded through the UK’s National Health Service (NHS), although there have been deep attacks on the health system through privatization. Service through the NHS has been plagued by budget cuts, understaffing and privatization. There have been numerous cases of patients dying while waiting for emergency care.

According to NHS England, the health service recently missed all targets for Accident and Emergency (A&E) care, operations and cancer treatment. Cuts, underfunding and understaffing are reaping a terrible human cost, with many needlessly dying or suffering life-threatening diseases and illnesses that could have been contained if acted upon earlier. The Conservative government of prime minister Boris Johnson threatens even bigger attacks on the NHS, with the ultimate aim of complete privatization. Labour has done nothing to fight this assault.

In the US, health coverage is provided through private health insurance for many working-age adults and their families, and through publicly funded health care for the poor (Medicaid) and for those 65 and older and the disabled (Medicare). Currently an estimated 13.7 percent of the US population is uninsured.

The Affordable Care Act, signed into law by Democratic President Obama in 2010, lowered the uninsured rate somewhat. However, the legislation known as Obamacare was not a public program. It required individuals without insurance to purchase health coverage from private insurers under threat of a tax penalty.

Those buying in were subject to skyrocketing premiums and deductibles. Under the Trump administration, the uninsured rate has begun to rise. It is now clear that Obamacare was part of a deliberate drive by the ruling class to lower the life expectancy of working people.

The “Medicare for All” plans advanced by Democratic presidential candidates Elizabeth Warren and Bernie Sanders are not the solution to this healthcare and quality of life crisis. They constitute a fraud which the two senators know will never be implemented because the private insurance companies and pharmaceutical industry will not allow their own expropriation.

The bottom line is that despite the differences between the US and UK in health care delivery, it is the working class that is subject to inadequate medical care. In many cases this care is either substandard and of poor quality or nonexistent altogether. On the other hand, the rich in both countries are able obtain the finest-quality private medical care that money can buy.

This stark disparity is shown in the current study findings. At the age of 50, men and women in the lowest social class group compared to those in the highest group could expect to live five fewer years free from disability in both the US and England. These disparities between rich and poor lead not only to added years of disability and suffering, but to premature deaths.

Overall life expectancy in the US fell from 2014 to 2017, a streak unprecedented among advanced economies in the modern era. US life expectancy peaked in 2014 at 78.9 years; by 2017, life expectancy had fallen to 78.6 years. In the UK, life expectancy has leveled off during this same period, and stands at about 80.9 years. The drop in life expectancy in the US and the stagnation in the UK are indicative of societies in deep distress.

High-quality, free medical care is a fundamental social right, but genuinely socialized medicine does not currently exist in any country on the planet. The fight for socialized medicine stands at the center of a socialist program, which must be fought for by the international working class armed with an internationalist and socialist perspective.

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