Poverty cuts an average of almost 10 years off American men's lives and seven off women's, a new study shows.
Eager to tease out socioeconomic disparities that can hide in state-level data, researchers reclassified all the U.S. counties into 50 new "states" based on household income instead of geography. Then they examined longevity, smoking, obesity, childhood poverty and other health information from the richest and poorest places.
Men in the poorest spots died on average nearly 10 years earlier, at 69 years old, than men in the wealthiest ones, and women in the poorest places died on average seven years sooner, at 76 years old, the research team reports in the American Journal of Public Health.
"The results should be deeply disturbing to all persons in the country," the study authors write. "Life expectancy in the poorest 'state' falls below that of more than half the countries in the world, meaning that, in essence, there are several developing countries hidden within the borders of the United States."
Senior author Dr. Randy Wykoff said in a phone interview that he expected to see differences in smoking and obesity rates - and that's indeed what the study showed. Adults in the poorest places were twice as likely to smoke and 50 percent more likely to be obese.
But the life-expectancy gap surprised him, said Wykoff, who is dean of the College of Public Health at East Tennessee State University in Johnson City.
Also stark were the numbers about race and children living in poverty.
Non-Hispanic African-Americans were 4.5 times more likely to live in the poorest regions than in the richest, the study found. Also, more than 48 percent of children in the poorest spots lived below the federal poverty line, while less than 9 percent of children in the wealthiest did.
"Nearly half of young children grow up in low-income families that cannot provide them with adequate resources to thrive," Dr. Neal Halfon wrote in an email addressing the study.
Halfon directs the Center for Healthier Children, Families and Communities at the University of California, Los Angeles. He was not involved in the research.
"It is not hard to see that individuals born in these low-income and deprived places with few resources are likely to have much lower lifelong health trajectories," he said. "The public sector and civic sector have not been able to put together a comprehensive anti-poverty campaign."
The study authors suggest that public health programs should be targeted more narrowly than by state, focusing instead on the poorest counties.
Researchers found that five states - Georgia, Illinois, Kentucky, Tennessee and Texas - housed both the richest and the poorest people in the nation, suggesting that poverty stems not only from a lack of resources but from their unequal distribution.
Wykoff warned that failure to address economic, educational and health disparities in the poorest spots could lead to a further widening of the gap between the nation's rich and poor.
"We hope this study reinforces the understanding that poverty really is a major factor that impacts health," he said.
Other countries have had some success combating poverty, Halfon said.
"Unfortunately," he said, the U.S. has "not had the political will nor the inclination to take this on in spite of the devastating long- and short-term consequences."