The Deadly Consequences of Inequality

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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