Fairfax County, Virginia, and McDowell County, West Virginia, are separated by 560km, about a half-day’s drive. Traveling west from Fairfax County, the gated communities and bland architecture of military contractors give way to exurbs, then to farmland and eventually to McDowell’s coal mines and the forested slopes of the Appalachians.
Perhaps the greatest distance between the two counties is this: Fairfax is a place of the haves and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County to US$107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.
One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85 — about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq.
There have long been stark economic differences between Fairfax County and McDowell. However, as their fortunes have diverged even further over the past generation, their life expectancies have diverged, too. In McDowell, women’s life expectancy has actually fallen by two years since 1985; it grew five years in Fairfax.
“Poverty is a thief,” Michael Reisch, a professor of social justice at the University of Maryland, testified before a US Senate panel on the issue.
“Poverty not only diminishes a person’s life chances, it steals years from one’s life,” Reisch said.
That reality is playing out across the country. For the upper half of the income spectrum, men who reach age 65 are living about six years longer than they did in the late 1970s. Men in the lower half are living just 1.3 years longer.
This life-expectancy gap has started to surface in discussions among researchers, public health officials and Washington policymakers. The general trend is for Americans to live longer and as lawmakers contemplate changes to government programs — like nudging up the Social Security retirement age or changing its cost-of-living adjustment — they are confronted with the potential unfairness to those who die considerably earlier.
The link between income and longevity has been clearly established. Poor people are likelier to smoke. They have less access to the health care system. They tend to weigh more. And their bodies suffer the debilitating effects of more intense and more constant stress.
Everywhere, and across time, the poor tend to live shorter lives than the rich, whether researchers compare the Bangladeshis with the Dutch or minimum-wage workers with millionaires.
However, is widening income inequality behind the divergence in longevity over the past three decades? Would an economy with a narrower gap between the haves and the have-nots lead to stronger life-expectancy gains, from the richest to the poorest? Might the expansion of insurance through the Affordable Care Act help close the gap? And might the policies Congress is contemplating to ameliorate poverty — like raising the minimum wage — have a further effect on life spans, too?