NCPA - National Center for Policy Analysis


September 22, 2004

Individual health is strongly influenced by a person's race and class, according to researchers. Additionally, healthy lifestyle habits may be more critical for lower-income individuals than simply ensuring them adequate medical coverage.

According to Stephen Isaacs' and Steven Schroeder's study published in the New England Journal of Medicine:

  • Between 1972 and 1989, individuals who earned less than $15,000 (1993 dollars) per year were three times as likely to die prematurely than those earning more than $70,000 per year.
  • People without a high school diploma are three times more likely to smoke as college graduates, and are three times less likely to exercise.
  • White American men earning less than $10,000 annually are one and one-half times more likely to die prematurely than those earning $34,000 or more.
  • Black families are more likely to live in poverty than white families, and their life expectancy is seven years less than that of whites; they also have higher rates of cancer, diabetes, infant mortality and cardiovascular disease.

The researchers note that while race and class both impact health, class appears to have more of an effect than race. They also note that low-income individuals have higher death rates from heart attacks than high-income individuals, regardless of race.

The reasons for health disparities between the rich and the poor are likely due to the fact that the poor tend to live in low-quality neighborhoods, are exposed to more environmental hazards and are less likely to purchase higher-priced, wholesome foods. Moreover, the stress levels associated with financial concerns and job security worries lead to a greater chance of becoming ill.

Isaacs and Schroeder conclude that expanding health insurance coverage is a priority, but would likely prevent only 10 to 15 percent of premature deaths. More importantly, they say, adopting healthier lifestyle habits, such as eating right, exercising and smoking cessation, would improve class disparities in health.

Source: Stephen L. Isaacs, J.D. and Steven A. Schroeder, "Class -- The Ignored Determinant of the Nation's Health," New England Journal of Medicine 351, no. 11, September 9, 2004.


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