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