Social mobility may decrease income-based life expectancy gap
Areas with higher social mobility have a smaller life expectancy gap between rich and poor individuals, according to a study published in JAMA Internal Medicine.
“While we cannot prove cause and effect, this study — along with others from our group — suggests that hope for a better future may translate into better health,” Atheendar Venkataramani, MD, PhD, an assistant professor in the department of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania, told Healio Primary Care.
The life expectancy gap between rich and poor individuals is increasing in the United States, according to Venkataramani and colleagues. Evidence suggests that living in areas with low social mobility — the ability of people to make more money than their parents — reduces an individual’s beliefs about their future well-being, “consequently increasing stress or diminishing the motivation to engage in healthy behaviors,” the researchers wrote.
Recently, a study conducted by the Government Accountability Office found that millennials in the U.S. are less likely to make more than their parents.
“If hope for a better economic future is good for health, then these trends suggest that that hope may be declining, which would be detrimental for health,” Venkataramani said.
Venkataramani and colleagues evaluated the link between social mobility and life expectancy at age 40 years in a cross-sectional ecological study. The researchers used information from a database containing life expectancy estimates and tax records from 1,559 counties across the United States. They evaluated the average income from January 2010 to December 2012 of individuals born between January 1980 and December 1982, and their parents’ income between January 1996 and December 2000.
Researchers found that every mean increase of 1 in the social mobility measure was associated with increases in county-level life expectancy in the lowest income quartile of 0.38-years (95% credible interval [CrI], 0.29-0.47) in men and 0.29-year (95% CrI, 0.21-0.38) in women.
The association between social mobility and life expectancy gap in the highest income quartile was smaller and not robust in covariate adjustment, with increases of 0.1 year (95% CrI, –0.02 to 0.22 year) in men and 0.08 (95% CrI, –0.05 to 0.2) in women.
Raising social mobility in all counties to the level of the county with the highest level of social mobility was associated with reductions in the life expectancy gaps between the highest and lower income quartile, which decreased by 1.4 years (95% CrI, 0.7-2.1) in men and 1.1 years (95% CrI, 0.5-1.6) in women. This equates to a 20% decrease in the life expectancy gap between the quartiles.
Although additional research is needed, Venkataramani explained that efforts to improve children’s lives — including increasing their access to better education and health care and reducing poverty and exposure to air pollution — have been shown to lead to better health and economic outcomes.
“We also have to do a better job figuring out how to decouple social mobility from health,” Venkataramani said. “It shouldn’t be the case the diminished economic opportunity should also make us sick.” – by Erin Michael
GAO. Millenial Generation: Information on the Economic Status of Millennial Households Compared to Previous Generations. https://www.gao.gov/products/GAO-20-194. Accessed on Jan. 1, 2020.
Disclosures: Venkataramani reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.