Earlier, I wrote about a NYT article which pointed out that the gap in average lifespan between rich and poor is increasing, while also ignoring that both are living longer. My point there was that the press was deciding to spin what amounts to good news as bad, but the article itself raises an interesting question (which d_taustin raised in the comments), why the poor have such shorter lifespans.

Well, first, let us dismiss the idea that the poor live that much less than the rich. The numbers for 1998-200 say the average for the poorest group is 74.7 years and for the richest group 79.2. That means the poor live 94.3% of the lifespan of the richest on average. This is not a "massive" disparity. One that needs to be explained, perhaps, but not a huge difference.

And now to explain the difference.

Let us start with the obvious. Some part of this is related to medical care. The rich and middle class have better insurance which pays for more thorough care. They also have access to better preventive care. And, for the richest group, they have personal assets which can pay for treatments not covered by insurance. So there is a financial component.

On the other hand, that is much less of a factor than one would think. Thanks to government programs, the difference between insurance held by the middle class and the government coverage of the poor is not that great. Nor are the poor denied emergency care. They may not have quite the access of the rich and middle class, but they are hardly being killed off by influenza or walking around with unset bones, unless it is by choice. The almost Dickensian picture of poor dying in the streets painted by advocates of universal health care is a fiction. The poor may not get the best care, but they definitely get care.

If the availability of medical care is not a major factor (or is at least not as significant a factor as some would suggest), then what does explain the disparity?

One factor which tends to be ignored is in lifestyle choices. Unless they are playing up the Stephen Crane picture of poor driven to a life of crime and prostitution, the left tends to forbid discussion of differing social pressures among the rich and poor. But they are still there.

By and large, the greatest extremes of drug addiction are among the poor. There are certainly wealthy drug addicts, but social pressures tend to frown on such things, and most wealthy drug addicts eventually give in to those pressures. Of course, those who don't tend to lose their wealth and join the poor themselves, so in one way or another, drug addiction tends to be found more often among the poor.

Likewise, wealth and social pressure combine to push the middle and upper classes to greater responsibility about their health. Smoking correlates with income, as do many preventative health measures. Prenatal care and nutritional quality also correlate with income. All of these serve to keep the wealthy living longer. And, for the most part, though they correlate with wealth, not one is caused by poverty itself. For example, there are countless well baby programs for poor women, so the fact that they fail to attend them is a choice, not due to poverty. Meaning, that we cannot really blame wealth here. It is a matter of choice, perhaps reinforced by social pressures found in the various economic classes.

If we look beyond strictly medical questions, we find another factor which reduces the lifespan of the poor, perhaps the single largest influence.

Crime.

The poor feel crime more than any group. They are more often the victims and perpetrators of crime. And both reduce their lifespan. Whether they are murdered or are sentenced to prison for a crime, the results of crime reduce the lifespan of the poor dramatically. Not to say that crime does not touch the rich, they both commit crimes and are victims of crime, just not to the degree the poor are.

Worse for the lifespan of the poor, they also tend to suffer from crime at an earlier age. Rich people tend to be crime victims at any age, while the poor tend to engage in risky behaviors such as drug dealing or theft at very early ages, making them more likely to be killed in their teens or twenties. Averaging in all those very early deaths makes the lifespan of the poor much lower than it would be otherwise.

Of course, there are probably other factors I have overlooked, but I think if we take into account only crime and lifestyle we can see that the reduced lifespan of the poorest is hardly due to limited health care alone. If anything, an improvement in our criminal justice system would likely bring those numbers much closer to parity.

Then again, I doubt anyone in the media will ever say as much. Year after year we will see this gap, and hear the cry for universal health care, but never once will anyone ask "Is there any other reason?" It is just too easy to fall back on the tried and true explanation.

NOTE:  I addressed some similar issues in an earlier post. There I discussed the differences in US and foreign lifespans. There were other issues there, including reliability of government reported numbers from authoritarian regimes, but some of the issues I mentioned above came into play as well.