COVERAGE: Rich, Poor Gaps Show Up in Life Expectancy

Joanne Kenen — Mon, 24 Mar 2008 17:17:00 -0400

The rich don't just live differently than you and I. They live longer.

Despite a growing push to close the minority health gaps, new data shows that the life expectancy between rich and poor has widened. In 1980, wealthy people's life expectancy was on average 2.8 years longer than poor people's. Twenty years later, it had increased to 4.5 years. One of the experts who found these disturbing trends, Dr. Gopal Singh, told the New York Times that "life expectancy was higher for the most affluent in 1980 than for the most deprived group in 2000."

The reasons for the gap are many and complex, but one screams out to us: lower income people are less likely to have health insurance. Without it, they are less likely to receive checkups, screenings, diagnostic tests, prescription drugs and other types of care. They are less likely to get timely access to detection, and treatment, of cancer and heart disease.

Don't fall into the trap that the life expectancy gap is inevitable, or that the right social policies can't change it. Nancy Krieger, a professor at the Harvard School of Public Health, has studied deaths before the age of 65 and infant mortality from 1960 to 2002. The socioeconomic gaps decreased from 1966 to 1980. Then they widened.

Krieger says that the progress in the earlier period occurred when Medicaid and Medicare, community health centers, the "war on poverty" and the Civil Rights Act of 1964 all probably contributed to the earlier narrowing of health disparities.

PBS next month airs a four-part series looking at various aspects of the health gaps: Unnatural Causes: Is Inequality Making Us Sick. Here's a preview:

COVERAGE: Everything You Hope You Never Have to Know about Buying Your Own Insurance

Joanne Kenen — Mon, 17 Mar 2008 18:25:00 -0400

Right alongside karaoke industry trends and arcane market-beating tools, the Washington Post devoted much of its Sunday business section to a nice clear explanation of just how tough it is to shop for health insurance - and the sad dollars and cents facts about what living in a society with 47 million uninsured people means for the rest of us. We've written about this topic too - check out our paper on our web site.

The Post had three pieces on purchasing insurance in the individual market - where people go when they don't have insurance on the job - or through COBRA, which is how people can
pay the full tab for job-related insurance after they leave a job for 18 months. Both options are pricey, and the individual market is a tough place to navigate if you've been sick. The paper identifies useful websites from the Georgetown University Health Policy Institute, and Consumers Union.

The Color of Money column this week (we linked in our first paragraph) didn't give us the usual tips about how to spend our money wisely. Instead it told us about the people - particularly minorities - for whom health care is an unaffordable luxury. They don't get the care they need at the time they need it - and the rest of us pay when they end up in the emergency room. "If you have insurance, you know how the costs hit your wallet," Michelle Singletary wrote, citing estimates that the yearly hidden tax passed onto the insured could exceed $1500 by 2010.

Disparities

COVERAGE: Rich, Poor Gaps Show Up in Life Expectancy

COVERAGE: Everything You Hope You Never Have to Know about Buying Your Own Insurance