If you are a poor person in the United States, I have some bad news: Where you live will shape when you die. A new study by the Health Inequality Project has found that while rich people enjoy long lives no matter where they live, poor people die significantly sooner in certain areas of the United States. What is this and why is it happening?
Geography plays the biggest part in a poor person’s life expectancy, more than any other factor. That is some very bad news for those living in the belt of red running from Texas to Michigan in the infographic above.
In these red parts of the country, adults with the lowest incomes die on average as young as people in much poorer nations like Rwanda. Worse, their life spans are getting shorter. Meanwhile, poor people living in cities, especially those near the coast, live almost as well as the middle class in worse areas.
Notice below how the cities in the middle of the country (Detroit and Dallas) versus cities on the coasts (New York City and San Francisco) have huge differences in the life expectancy of their city’s poorest people (bottom five percent) while their richest (top five percent) are all relatively the same.
Why are the poor dying so young in certain areas? Research shows that it is largely internal factors like obesity, heart disease, and diabetes. External factors, like murder, play much less of a role than previously thought.
The most important correlations to lifespan has to do with behaviors. In some cities, negative behaviors like smoking and obesity are way more prevalent, while positive behaviors like exercise are low.
It turns out that behaviors are infectious. They spread like viruses in our social groups, because people tend to act like the people around them.
Research shows that if your friend is obese, your risk of obesity increases. Nicholas Christakis, a Yale University professor who is one of the country’s leading researchers on socially contagious behaviors, says,
“If your friend’s friends are obese, your risk of obesity is 25 percent higher. If your friend’s friend’s friend, someone you probably don’t even know, is obese, your risk of obesity is 10 percent higher.”
Behaviors in friend groups can hint at behaviors in the larger community, so this information makes sense. If people in your social circle are obese, it is likely your community has a higher concentration of obesity.
Smoking is a contagious habit as well. The large decline in smoking in the United States mostly occurred in middle to high income families. Smoking only declined nine percent in the poorest families. Americans with only a GED certificate are eight times more likely to smoke than those with a graduate degree.
Having social supports to eat healthy foods, stop smoking, and exercise are huge factors in making healthy habits stick. These supports simply do not exist in communities in which unhealthy behaviors are normal.
It is not difficult to see how unhealthy behaviors are fostered by institutional neglect of lawmakers who do not support our poor. Junk food is cheap and convenient, and convenience stores are much easier to find than produce in poor neighborhoods.
Poor people often live in dangerous neighborhoods and have long commutes to areas with a wealth of jobs, which leaves little time or space for exercise. Poor neighborhoods have routinely underfunded and overcrowded public school systems. These schools may not do an adequate job of teaching children safe or healthy behaviors. With so many Republican lawmakers blocking the poor from access to affordable healthcare, poor people are dying from preventable illnesses.
By creating concentrations of poverty in specific regions, lawmakers have concentrated deadly habits and increased the likelihood that young people in poor families will grow up in neighborhoods where bad health behaviors are normal.
Usually when the government seeks to promote healthy behaviors, it seeks to restrict unhealthy behaviors. The government taxes cigarettes, forbids smoking in specific areas, and bans certain sugary and fatty foods in schools.
With the viral behavior model in mind, policymakers will have to be more proactive in building infrastructure for healthier living so that new social norms can be created. Much to the dismay of fiscal conservatives, ignoring the problem means that it’ll only get worse. When the government is inactive, as Republicans want, poor people die young. It is no surprise that the most unhealthy cities have Republican lawmakers.
When a new park is built, it creates an environment where outside play is normal. When gym, recess, and health education are all funded in schools, social norms around health and exercise can be created. If we create low income housing in rich, healthier cities, the poorest Americans can be assimilated into communities where healthy behaviors are common and infectious.
It will take effort to create new social norms in our communities. But it is possible, if only we vote in lawmakers that are committed to that change.
Featured photo: John Moore/Getty Images