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life expectancy
New Report Shows Working-Class Americans Live 7 Years Fewer Than Rich
"The massive income and wealth inequality that exists in America today is not just an economic issue, it is literally a matter of life and death," said Sen. Bernie Sanders of Vermont.
Mar 07, 2025
People living in the top 1% of U.S. counties ranked by median household income live on average seven years longer than their counterparts in the bottom 50% of counties, according to a Friday report from Sen. Bernie Sanders, an Independent representing Vermont and the ranking member of the Senate Committee on Health, Education, Labor, and Pensions.
"The massive income and wealth inequality that exists in America today is not just an economic issue, it is literally a matter of life and death," said Sanders in a Friday statement announcing the report.
What's more, the stress of living paycheck to paycheck "also leads to higher levels of anxiety, depression, cardiovascular disease and poor health," Sanders argued, in a nod to some of the survey responses included in the analysis.
The analysis echoes findings by other researchers that higher income is associated with greater longevity. According to a Congressional Research Service report from 2021, life expectancy has generally increased over time in the United States—with the exception of during Covid-19 pandemic—but "researchers have long documented that it is lower for individuals with lower socioeconomic status compared with individuals with higher socioeconomic status. Recent studies provide evidence that this gap has widened in recent decades."
The findings in Sanders' report relied on county-level data in the United States between 2015 and 2019, the five years prior to the pandemic. For that time period, Sanders' staff matched each U.S. county with both median household income data from the U.S. Census Bureau and average life expectancy data from the Institute for Health Metrics and Evaluation, according to the report.
The life expectancy gap was greater when comparing higher-earning urban and suburban communities with lower-earning rural communities. "Urban and suburban counties with a median household income of $100,000 have an average life expectancy of 81.6 years, while small rural counties with a median household income of $30,000 have an average life expectancy of 71.7 years—a 10-year gap," according to the report.
A boost in earnings also translated into a boost in life expectancy. For example, "among rural counties, a $10,000 increase in median annual household income is associated with an additional 2.6 years of life expectancy," according to the report.
The analysis also includes qualitative data collected by Sanders, who asked working people via social media survey how stress impacts their lives. The outreach generated over 1,000 responses from people around the country.
According to the report, Caitlin from Colorado said: "Stress isn't just an inconvenience for me—it's a direct threat to my heart. Living with a congenital heart defect and multiple mechanical valves means that every surge of anxiety, every sleepless night worrying about bills, isn't just mentally exhausting—it physically wears on my heart."
"Living paycheck to paycheck while supporting a family stresses me out. We are always just one financial emergency from being homeless," said Patrick from Missouri.
One person also reported having to go without preventative healthcare because they are between jobs and can't afford the care without insurance.
The report offers a number of policy solutions to address the key findings of the analysis, including raising the minimum wage to at least $17 an hour, guaranteeing paid family and medical leave, and passing Medicare for All, which would enact a single-payer health insurance program.
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Brutal Murder of Insurance CEO Sparks Wave of Dark Humor, Including Fictionalized Denial of Coverage Letter
"You don't have to sanction murder to see why so many Americans detest health insurance corporations who prioritize profit goals by routinely creating arbitrary reasons to deny patient needs," said one labor movement voice.
Dec 06, 2024
The killing of UnitedHealthcare CEO Brian Thompson outside of a Manhattan hotel Wednesday has sparked a wave of dark humor and fresh fury at the for-profit U.S. healthcare system.
The barbs at UnitedHealthcare—the country's largest private insurer—included a mock denial of coverage letter posted to the subreddit r/nursing in a thread on Thompson's murder.
"We regret to inform you that your request for coverage has been denied," the letter reads. "Our records indicate that you failed to obtain prior authorization before seeking care for the gunshot wound to your chest." The Daily Beast reported a spoof rejection letter was also posted to a since closed thread on r/medicine.
Police are in their third day searching for Thompson's killer, who shot the healthcare executive multiple times in front of a Hilton hotel in Midtown before fleeing the scene. The New York Police Department has released an image that shows a man authorities deem "a person of interest wanted for questioning" in connection to the Wednesday killing, per CNN. The image was captured at a hostel in Manhattan, according to CNN, citing law enforcement.
The words "deny," "defend," and "depose" were found written on the ammunition used by the gunman, three words that partially echo the title of the book Delay, Deny, Defend, which details how the insurance industry avoids paying claims.
In addition to dark humor, reactions to Thompson's assassination have brought to the fore the public's downright rage at the health insurance industry.
In the comment section of Common Dreams' coverage of the murder, one commenter wrote: "I guess if you steal people's labor and deny them healthcare in order to line your own pockets, you might occasionally expect retaliation." Another wrote: "For-profit healthcare is unethical and immoral."
"Thoughts and deductibles to the family," read one comment below a video of the shooting posted by CNN, according to The New York Times. "Unfortunately my condolences are out-of-network."
One woman whose mother with Stage 4 breast cancer was forced to battle insurance to get new treatments approved told New York magazine that she experienced "a little surge of Schadenfreude," when she heard of Thompson's death.
"UnitedHealth CEO Brian Thompson was just 50 years old at the time of his murder, which is a lot more tragic when you know that his life expectancy as a member of the Top 1% was 88, or 15 years longer than the life expectancy of the average American male," wrote journalist and editor Moe Tkacik on X. Later, in a piece for The American Prospect, Tkacik framed the situation like this: "Only about 50 million customers of America's reigning medical monopoly might have a motive to exact revenge upon the UnitedHealthcare CEO."
Others said that the reaction to the murder was an indication that the Democratic Party ought to embrace economic populism and end its close association with corporate power.
"The mass reaction to the healthcare CEO's murder is a reminder that there is a constant deadly class war being waged against working-class Americans. If Dems ditched their billionaires and fully joined the side of the working class in that struggle they would easily win FDR-style majorities," said the political commentator Krystal Ball.
Charles Idelson, former communications strategist for National Nurses United, said that "you don't have to sanction murder to see why so many Americans detest health insurance corporations who prioritize profit goals by routinely creating arbitrary reasons to deny patient needs."
"It's not unique to UnitedHealth," he added.
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What a Study of Oligarchs' Second Acts Heralds for Trump 2.0
They’re usually worse off during their subsequent terms in office. So are the rest of us.
Nov 13, 2024
On November 5, Donald Trump was elected as the 47th U.S. president. Trump is an oligarch—an economic or political actor who secures and reproduces power and wealth, then transforms one into the other. And now he is in the small minority of oligarchs across history who have had second acts—having lost power or wealth, they find a way back. What can we learn from those experiences that might inform our understanding of Trump’s second term?
To answer that question, we looked at the track records of three other business oligarchs like Trump who have served as heads of state or government since World War II. Business oligarchs begin their journey by accumulating wealth, then move to power.
In our book The Oligarch’s Grip: Fusing Wealth and Power, we wrote about Chilean president Sebastian Piñera. He served two non-consecutive terms in office (2010-14 and 2018-22). His second act was decidedly worse than his first. During his first term in office, per capita income in constant dollars grew by 14%, while life expectancy expanded by 0.9 years. Sure, there were controversies, such as the appointment of Pinochet-era figures as cabinet ministers and protests over the end of the school voucher system. But, in general, Chileans felt better off.
While we are hesitant to make any grand predictions for the Trump second term based on these cases, it does seem questionable that it will be any better than the first.
By contrast, Piñera’s second term was disastrous. Per capita income rose by only 2% and life expectancy contracted by 0.8 years. The Covid-19 pandemic played a role in these outcomes, but it wasn’t the only driver. Piñera’s poor handling of a second, larger set of student protests has also led to his relatively low ranking among modern Chilean heads of state. He died in a helicopter accident in 2024.
Trump has been compared to Silvio Berlusconi, Italy’s three-time prime minister (1994-95, 2001-06, and 2008-11). We will focus on his second and third terms, which are longer. Per capita income expanded by 3.5% in that second term, and life expectancy grew by a remarkable 1.4 years. Ambitious goals aimed at constitutional and tax reform were thwarted, but, still, Italians felt better off, even if they narrowly backed a center-left coalition that removed Berlusconi from office.
His third term was dominated by the 2007-08 global financial crisis, the Great Recession of 2008-09, and the 2009-10 eurozone crisis. Italy’s economy was one of the most highly indebted in Europe, and higher interest rates led to a 6.8% GDP decline during 2008-09. Per capita income declined by 3.6% during this term, while life expectancy increased by 0.6 years. Having been ranked by Forbes as the 12th most powerful person in the world in 2009, Berlusconi resigned in 2011 as a deeply unpopular and polarizing figure.
A similar pattern of a poor second act emerges with Rafic Hariri, Lebanon’s prime minister for two terms (1992-98 and 2000-04). Per capita income grew by a substantial 44% during his first term, while life expectancy expanded in the post-civil war period by 2.2 years. But when Hariri returned to office for a second term, results were much less compelling: income up by 16% and life expectancy by 0.6 years. Political tensions led to his assassination in 2005. His son Saad served two terms as well and also left office under a cloud. A third oligarch prime minister, Naguib Mikati, is in his third term and, given the recent Israeli invasion, is unlikely to have a successful ending.
Does history offer any relief from this picture of disappointing second acts? Not really. For example, Marcus Licinius Crassus—one of the Roman Republic’s richest and most powerful men, served as consul twice (70 and 55 BCE), both times with often rival and sometimes ally Pompey. The first consulship led to the Triumvirate Alliance of Caesar, Pompey, and Crassus. The second consulship led to Crassus being named governor of the endlessly wealthy province of Syria, where he was defeated by the Parthians and died in 53 BCE.
These examples suggest some preliminary findings and cautions. First, oligarchs’ second acts generally end badly. Sometimes, external circumstances drive this result. Other times, it seems that oligarchs don’t show much evidence of learning from their first terms.
Second, many oligarchs never serve in decision-making roles as heads of state or government like Piñera, Berlusconi, or Hariri. Some have agenda-setting power through political contributions or media ownership. Others have ideological power, shaping the way we think and act. Based on our dataset at the Center for the Study of Oligarchs, we are unaware of any oligarchs who had and lost those types of power who were able to regain it. We also don’t know of any significant cases of oligarchs losing their wealth and then recovering it.
While we are hesitant to make any grand predictions for the Trump second term based on these cases, it does seem questionable that it will be any better than the first. During that first term, per capita in the U.S. rose by 2.9% and life expectancy fell by a jaw-dropping 1.7 years. That record helped earn Trump a ranking as the worst president in U.S history, according to the American Political Science Association survey.
It is difficult to imagine how Trump will be able to successfully fight the dismal history of oligarchs’ second acts.
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New CDC Data Reveals 'National Embarrassment' of For-Profit Healthcare
"Our leaders must act to kick insurance companies to the curb and enact Medicare for All now," said one advocate.
Mar 21, 2024
Single-payer advocates on Thursday pointed to new federal life expectancy data—which shows Americans live shorter lives than people in any other major most-developed nation—as the latest proof of the need to enact a Medicare for All-type universal healthcare program.
According to the Centers for Disease Control and Prevention (CDC), U.S. life expectancy was 77.5 years in 2022, an increase of 1.1 years from the previous year. The leading U.S. causes of death in 2022 were heart disease, cancer, unintentional injuries, and Covid-19.
The 2022 figures reversed two consecutive years of declining U.S. life expectancy, largely due to Covid-19, which has killed nearly 1.2 million people in the country. However, U.S. life expectancy in 2022 was still below its pre-pandemic high of 78.8 years in 2019.
"Despite spending the most per capita on healthcare, we have a consistently lower life expectancy than our peers in comparably wealthy countries."
"While it is good news that U.S. life expectancy is finally rising again, it is important to remember that despite spending the most per capita on healthcare, we have a consistently lower life expectancy than our peers in comparably wealthy countries with universal healthcare," said Eagan Kemp, the healthcare policy advocate at Public Citizen.
The United States is the only developed nation in the world without guaranteed universal healthcare.
"We must keep making the point that profit-driven healthcare is not only worse for patients—it's a national embarrassment," Kemp added. "Our leaders must act to kick insurance companies to the curb and enact Medicare for All now."
One 2022 study found that more than 338,000 U.S. Covid-19 deaths could have been prevented if the country had a single-payer universal healthcare system like Medicare for All.
While opponents—including U.S. lawmakers who take substantial donations from the for-profit healthcare and insurance industry—often argue that Medicare for All would be too expensive, a 2020 Congressional Budget Office analysis found that such a program would save between $300 billion and $650 billion annually.
The same study found that approximately 68,000 people die each year in the United States because they lack access to healthcare.
Meanwhile, millions of American families face bankruptcy and financial ruin due to healthcare expenses, as the CEOs of 300 major U.S. healthcare companies made $4.5 billion in collective compensation in 2022.
The United States has the lowest life expectancy of any large rich country while spending far more on healthcare than comparable nations. Figures vary by source and year, but according to the 2023 edition of the CIA Factbook, the U.S. ranked 48th in worldwide life expectancy, while 2021 World Bank figures place the U.S. in 59th place globally, between Algeria and Panama.
U.S. Sen. Bernie Sanders (I-Vt.) and Congressional Progressive Caucus Chair Pramila Jayapal (D-Wash.) last year led more than 120 lawmakers in reintroducing bicameral Medicare for All legislation.
"There is a solution to this health crisis—a popular one that guarantees healthcare to every person as a human right and finally puts people over profits and care over corporations," Jayapal said at the time. "That solution is Medicare for All—everyone in, nobody out."
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The US Is Quite Literally in a Neoliberal Death Spiral. We Need Medicare for All
The American left should take note, both for the greater good and for its own political future. You can’t save the marginalized by tinkering around the margins.
Oct 04, 2023
From The Economist, September 28, 2023: "Living to 120 is becoming an imaginable prospect."
From The Washington Post, October 3, 2023: "An epidemic of chronic illness is killing Americans in their prime."
When it comes to social insurance, the Post is hardly a leftist publication. Its editorial page routinely inveighs against Social Security and Medicare “entitlements.” That makes the lede to its October 3rd story even more striking. It begins, “The United States is failing at a fundamental mission — keeping people alive.”
At roughly the same time, The Economist tells us that “after years of false starts, the idea of a genuine elixir of longevity is taking wing. Behind it is a coterie of fascinated and ambitious scientists and enthusiastic and self-interested billionaires.”
The neoliberalist house organ notes that “some people, observing billionaires’ interest in longevity-promoting startups, worry that the benefits will be captured mainly by the rich, leading to a class of long-lived Übermenschen lording it over short-lived ordinary folk.”
Stuff and nonsense, scoffs the British mag. It reassures us that “technologies have a record of spreading, and cheapening as they do so.” That will come as news to poor people of the United States, whose lives are growing shorter and shorter.
Live to 120? There are counties in the United States where you’re beating the odds if you make it past 70. The majorities in these counties may be White, Black, or Native American. But each suffers from poverty, a shortage of healthcare options, and a needlessly complex insurance system. while racism, ageism, and regional animosities compound the mortality crisis.
The system’s complexity is largely an artifact of for-profit insurance, for-profit pharmaceuticals, and, increasingly, for-profit medical offices. The Post tells us of one chronic-disease sufferer:
After he stopped working about seven years ago, he briefly qualified for Medicaid. But then he began collecting Social Security at 62, and his income exceeded the Medicaid eligibility limit. Next, he moved to an Affordable Care Act plan. Bouncing from plan to plan, he negotiated the complexities of being in-network or out-of-network ...
This is neoliberalism in a nutshell.
The Economist assures us that longevity science will be democratically applied: “It is hard to imagine a privilege more likely to spark rebellion than a ruling class that hoards age-treatments to escape the great leveller.” But the age-extending treatments we have today—for cardiovascular disease, for asthma, for cancer—are already being hoarded, albeit in less obvious ways. That’s why the once-small death gap between poor and wealthier regions has grown so dramatically. As the Post writes:
Sickness and death are scarring entire communities in much of the country. The geographical footprint of early death is vast: In a quarter of the nation’s counties, mostly in the South and Midwest, working-age people are dying at a higher rate than 40 years ago.
The rebellion is overdue.
Or is it? Look at the counties that are hardest hit by the mortality crisis:
The purplest counties on the map correspond pretty closely to support for Donald Trump and the far right. That may not have been the rebellion The Economist was talking about, but it’s a rebellion all the same.
The Post writes:
Forty years ago, small towns and rural regions were healthier for adults in the prime of life. The reverse is now true. Urban death rates have declined sharply, while rates outside the country’s largest metro areas flattened and then rose. Just before the pandemic, adults 35 to 64 in the most rural areas were 45 percent more likely to die each year than people in the largest urban centers.
The American left should take note, both for the greater good and for its own political future. The Electoral College and the Senate, both artifacts of slavery, give disproportionate political power to voters in the very areas hit hardest by death inequality. Yes, Democrats took some steps to address the crisis, but the fact remains: it kept getting worse during the Clinton and Obama years.
Bold action is needed to save lives—not “bold” as in “here’s something complicated and incremental that may help you in 2026,” but “bold” as in Medicare for All. It’s not enough to take a victory lap for past accomplishments, because those accomplishments haven’t stopped the dying. You can’t save the marginalized by tinkering around the margins.
What was the line that Ted Sorenson or someone wrote for John F. Kennedy? Oh, right: “Those who make peaceful evolution impossible make violent revolution inevitable.”
We’ve been warned.
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'Policy Murder': Research Shows Poverty Is 4th Leading Cause of Death in US
"Poverty should be considered a major risk factor for death in the U.S.," argues a new analysis.
Apr 19, 2023
Research published this week in the Journal of the American Medical Association estimated that poverty was linked to at least 183,000 deaths in the United States in 2019 among people aged 15 or older, making inadequate income the nation's fourth-leading mortality driver that year behind heart disease, cancer, and smoking.
“Poverty kills as much as dementia, accidents, stroke, Alzheimer's, and diabetes," said David Brady, a professor of public policy at the University of California, Riverside and the lead author of the new analysis.
"Poverty silently killed 10 times as many people as all the homicides in 2019," Brady continued. "And yet, homicide, firearms, and suicide get vastly more attention."
Rev. Dr. William J. Barber II, co-chair of the Poor People's Campaign, wrote Wednesday that the research underlines the importance of connecting "extremists' inaction" on gun violence to "other forms of policy murder."
The new analysis, co-authored by Ulrich Kohler of the University of Potsdam in Germany and Hui Zheng of Ohio State University, stressed that the U.S. "perennially has a far higher poverty rate than peer-rich democracies," which "presents an enormous challenge to population health given that considerable research demonstrates that being in poverty is bad for one's health."
Poverty, which the study defined as less than half the median U.S. income, was "associated with greater mortality than many far more visible causes in 2019—10 times as many deaths as homicide, 4.7 times as many deaths as firearms, 3.9 times as many deaths as suicide, and 2.6 times as many deaths as drug overdose."
"Because the U.S. consistently has high poverty rates, these estimates can contribute to understanding why the U.S. has comparatively lower life expectancy."
The researchers argued their results indicate that "poverty should be considered a major risk factor for death in the U.S.," which has seen life expectancy decline since 2015—and fall sharply amid the coronavirus pandemic.
"Because the U.S. consistently has high poverty rates, these estimates can contribute to understanding why the U.S. has comparatively lower life expectancy," the researchers wrote. "Because certain ethnic and racial minority groups are far more likely to be in poverty, our estimates can improve understanding of ethnic and racial inequalities in life expectancy."
"The mortality associated with poverty is also associated with enormous economic costs," they continued. "Therefore, benefit-cost calculations of poverty-reducing social policies should incorporate the benefits of lower mortality. Moreover, poverty likely aggravated the mortality impact of Covid-19, which occurred after our analyses ended in 2019. Therefore, one limitation of this study is that our estimates may be conservative about the number of deaths associated with poverty."
The onset of the coronavirus pandemic in 2020 brought about a sharp increase in U.S. poverty as millions of people got sick, were thrown out of work, and lost health insurance.
But federal aid initiatives enacted in response to the public health and economic crisis—from stimulus checks to boosted unemployment benefits to enhanced nutrition assistance—ultimately led to a significant drop in poverty, further bolstering the case that "poverty is a policy choice."
However, many of those poverty-reducing aid programs, including the enhanced Child Tax Credit that sharply slashed poverty among kids in the U.S., have since lapsed or been terminated, threatening to reverse any recent progress.
Brady said in a statement that if the U.S. had less poverty, "there'd be a lot better health and well-being, people could work more, and they could be more productive."
"All of those," he added, "are benefits of investing in people through social policies."
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The Deadly Results of Economic Inequality
Inequality is not just an abstract concept or a set of numbers—it's a real-world phenomenon that has tangible effects on the way that ordinary people live (or don’t live) their lives.
Mar 26, 2023
If you grew up in America, then you almost definitely have heard some variation of the refrain: “America is the greatest country in the world.”
It’s an idea that’s so commonplace that it’s more or less taken for granted. We boast of inventions like the airplane, the light bulb, the internet, and even the humble chocolate chip cookie. We are home to some of the best universities in the world and most of the largest corporations.
But when we look more closely at other metrics, America’s position as the top country in the world is called into question. There are many such metrics, but perhaps none more important than life expectancy.
According to a report released last year by the National Center for Health Statistics, the average American can now expect to live 76.4 years. Life expectancy in the US has dropped off in recent years; as life expectancy in other wealthy countries rebounded after the worst of the COVID-19 pandemic, it continued to decline in the US. All in all, the US now ranks 53rd among 200 countries in life expectancy. Citizens of all developed countries suffer from things like heart disease, cancer, and liver disease, but Americans suffer more and, as a result, live shorter lives.
Countries where life expectancy is the highest ( > 82 years) include places like Japan, Australia, Switzerland, South Korea, Norway, Sweden, and Canada. What are these countries doing differently than the US, you may ask? Why are their citizens living longer?
It all comes down to one word: inequality. The US is not poorer than any of these countries – year after year, we have the highest GDP in the world. And on a per-capita basis, we’re consistently in the top 10, far from 53rd in the world. But the difference between the US and other developed countries is that we do a much poorer job sharing wealth (and all the benefits that come with it) among our citizens. Among developed countries, the US has one of the highest rates of inequality, both in terms of wealth and income – and we can, unfortunately, see that disparity in health and life expectancy as well.
Just because the average American life expectancy is 76.4 years doesn’t mean that all Americans can expect to live that long. It’s sad, but in America how long you live has a lot to do with how much money you have. People with high incomes can live 10 to 20 years longer than people with low incomes, even if they live just miles apart in the same metro area. For example, rich residents in Columbus, Ohio can expect to live close to 85 years while poor residents in the very same city typically live just 60 years.
This trend applies to a host of other social outcomes besides life expectancy. Kate Pickett and Richard Wilkinson made this case in their 2009 book, The Spirit Level: Why More Equal Societies Almost Always Do Better. They found that countries with low inequality consistently outperformed those with high inequality not only in life expectancy but in literacy rates, homicides, imprisonment, teenage births, levels of trust, obesity, mental illness, and social mobility. (With high inequality, the US was among the lowest performers in all of these metrics.) It was not GDP or overall levels of wealth that mattered for these social outcomes; it was instead how wealth was distributed that made the difference.
Inequality is not just an abstract concept or a set of numbers – it’s a real-world phenomenon that has tangible effects on the way that ordinary people live (or don’t live) their lives. And we are clearly not doing very well in the US on this front compared to the rest of the world. Americans shouldn’t go around boasting about living in the greatest country on Earth when our citizens are quite literally not living as long as their neighbors.
But all hope is not lost. Our situation in the US is not in any way an inevitability. Inequality is a choice. We certainly can’t bring about change overnight, but, if we keep at it, we can bring about change.
What can be done to turn the tide? It’s simple: follow the example of our neighbors with less inequality and orient our economic policy around reducing the gap between those at the top and everyone else. We can do that by raising taxes on rich people like us, just as President Biden proposed in his latest budget, to limit extreme wealth. We can also lift up the bottom by raising the minimum wage, strengthening unions, and investing in a strong social safety net that keeps all Americans afloat.
The policy possibilities are limitless. Our only limit is a lack of political will. We truly believe that the United States can and should be the greatest country in the world – after all, we’re not called “Patriotic” Millionaires for nothing. But the American Dream that was once a shining light for all is fading. If we want to revive it, we need to start fighting against the inequality that is holding us back.
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