Income has a significant impact on life expectancy. People of lower income generally have poorer health outcomes and a higher risk of premature death compared to those of average income. Specifically, people of lower income have a higher risk of dying from diabetes, motor vehicle accident (MVA), fall, septicaemia and coronary heart diseases. The reason why the poor die more frequently from these conditions include lower access to health care, higher exposure to occupational and environmental hazard, chronic stress, lower access to healthy food and lower education. Below are more details regarding the correlation between income and life expectancy.
Access to healthcare
People of lower income have more difficulty accessing healthcare. They generally experience higher delays in diagnosis and treatment. In addition to sheer cost, barriers preventing access to healthcare for people of low income include lack of education, complications with health insurance and a distrust of healthcare providers.1 As result, people of low income are at a higher risk to die from conditions that must be diagnosed early to prevent deterioration and that require ongoing monitoring by health professionals. For example, people of lower income have more than twice the risk of dying from diabetes2 because diabetes is expensive to treat and requires close monitoring by health professionals. As such, diabetics with limited access to healthcare lack the support they need to manage their diabetes and co-morbidities which inadvertently leads to premature death. Limited access to healthcare is also the reason why people of lower income bear a disproportionate share of the coronary heart diseases (CHD)3.
People of lower income may be more likely to work in jobs with high levels of occupational hazards like exposure to dangerous machinery or toxic chemicals. This increases their risk of workplace accidents and injuries as well as long-term health problems which lower life expectancy. Specifically, people of lower income are more likely to die from motor vehicle accidents (MVA)4 and falls, amongst other type of accidents. Moreover, People who work in these types of jobs for extended periods of time generally face discrimination in the job market and have limited opportunities for career advancement into jobs that are less hazardous.
People of lower income are more likely to live in neighbourhoods with poor air quality, higher levels of pollution, inadequate housing and limited access to safe recreational areas. These environmental factors increase the risk of premature death and lower life expectancy amongst the poor. People of lower income are also more likely to dies from septicemia5 as they are more likely to live in overcrowded or unsanitary conditions and be malnourished.
People of lower income tend to experience higher levels of stress than those of average income. One important type of stress is financial stress. That is low-income individuals may struggle to make ends meet, pay bills and cover basic needs like housing and food. This constant financial strain leads to chronic stress, which has significant impacts on physical and mental health. Low-wage workers also have jobs that are insecure, meaning they may not have stable employment or access to benefits like paid time off or healthcare for themselves and their loved-ones. This uncertainty can lead to chronic stress and anxiety that leads to unhealthy behaviours and lower life expectancy.
Individuals of lower income generally live in areas where healthy food options are limited or too expensive. Indeed, healthy foods like fresh fruits, vegetables, lean proteins, and whole grains are generally more expensive than processed foods. Processed foods are typically high in sugar and fat and contain additives that are potentially detrimental to health. Consequently, people of lower income are more likely to have an unhealthy diet which is a major risk factor for a range of chronic diseases, including cardiovascular diseases, cancer and diabetes.
People of lower income tend to have limited access to training and education programs. Lower levels of education and health literacy is generally associated with a poorer understanding of health needs and consequences of unhealthy behaviours. As such, people of lower income are less likely to know what is good for them. A lower level of education also makes it harder to qualify for jobs with low levels of occupational hazards. Unfortunately, people with less education typically have lower income which exposes them to more health risks by default.
People of lower income face a vicious circle. Namely, without sufficient financial resources, one does not get healthcare. Without healthcare, one does not get the care needed for oneself and one’s loved-ones. Without the care needed, one experiences chronic stress, adopts unhealthy behaviours and gets marginalized, which further reduces one’s career advancement opportunities and financial resources.
Predicting life expectancy is complex and needs to take many factors into consideration. Youlldie allows to visualize how income interacts with other factors like gender, race, world region, education, alcohol, tobacco, physical activity, sleep, blood pressure, body mass index and family history to statistically predict life expectancy.
- Lazar M, Davenport L. Barriers to Health Care Access for Low Income Families: A Review of Literature. J Community Health Nurs. 2018 Jan-Mar;35(1):28-37. doi: 10.1080/07370016.2018.1404832. PMID: 29323941. https://pubmed.ncbi.nlm.nih.gov/29323941/
- Saydah S, Lochner K. Socioeconomic status and risk of diabetes-related mortality in the U.S. Public Health Rep. 2010 May-Jun;125(3):377-88. doi: 10.1177/003335491012500306. PMID: 20433032; PMCID: PMC2848262. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848262/
- Hamad R, Penko J, Kazi DS, et al. Association of low socioeconomic status with premature coronary heart disease in US adults. JAMA Cardiol. Published online May 27, 2020. doi:10.1001/jamacardio.2020.1458. https://pubmed.ncbi.nlm.nih.gov/32459344/
- Sam Harper and others, Trends in Socioeconomic Inequalities in Motor Vehicle Accident Deaths in the United States, 1995–2010, American Journal of Epidemiology, Volume 182, Issue 7, 1 October 2015, Pages 606–614, https://doi.org/10.1093/aje/kwv099
- Kempker JA, Kramer MR, Waller LA, Martin GS. Risk Factors for Septicemia Deaths and Disparities in a Longitudinal US Cohort. Open Forum Infect Dis. 2018 Nov 15;5(12):ofy305. doi: 10.1093/ofid/ofy305. PMID: 30568980; PMCID: PMC6290783. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290783/