Michael Stepner

The Association between Income and Life Expectancy in the United States, 2001 - 2014

The Journal of the American Medical Association (2016), Vol 315, No. 14

with Raj Chetty, Sarah Abraham, Shelby Lin, Benjamin Scuderi, Nicholas Turner, Augustin Bergeron, and David Cutler

Website: healthinequality.org

We examine inequality in life expectancy using 1.4 billion anonymous earnings and mortality records covering the U.S. population from 1999-2014. We present four main findings:
  1. Higher income is associated with greater longevity throughout the income distribution. The richest 1% of American men live 15 years longer than the poorest 1%, while the richest 1% of American women live 10 years longer than the poorest 1%.
  2. Inequality in life expectancy has increased in recent years at the national level. From 2001-2014, the richest 5% of Americans gained approximately 3 years in longevity, but the poorest 5% experienced no gains.
  3. Life expectancy varies substantially across areas, especially for low-income individuals. Life expectancy varies by approximately 5 years between the areas with the highest and lowest longevity. Trends in life expectancy varied substantially across areas as well, ranging from gains of more than 4 years between 2001 and 2014, to losses of more than 2 years.
  4. Differences in life expectancy across areas for low-income individuals are highly correlated with differences in health behaviors such as smoking, obesity and exercise. In contrast, life expectancy for low-income Americans is not significantly correlated with measures of the quantity and quality of medical care, local income inequality, residential segregation, and labor market conditions. Low-income individuals tend to live the longest (and have the most healthful behaviors) in affluent cities with highly educated populations and high levels of government expenditures.