A recent report I released as ranking member of the Senate Health, Education, Labor, and Pensions Committee found that the bottom 50 percent of Americans can expect to live seven fewer years than those in the top 1 percent.
Bernie Sanders: Why Do Working People Die Younger Than the Wealthy? | Opinion
- When comparing extreme limits, this is true.
- But he’s comparing one extreme group- the top 1% to the bottom 50%. In fact, many studies compare the top 1% to the bottom 1% – in these small groups, the difference is up to 14 years at the extremes. But this is not representative of the overall population.
- A more representative sample would compare those in the bottom half of the 25th percentile to the top half up to 75th percentile.
- The difference between these groups is about 1-3 years, not as high as the numbers cited by Sanders.
In the extreme groups, what accounts for the difference?
I asked an AI to look up some of the data on this topic.
Overall Breakdown
- Childhood Mortality: ~1-2 years (small but persistent due to socioeconomic disparities in infant and child health).
- Adult Mortality from Accidents: ~2-4 years (significant due to road accidents and overdoses, especially in younger adults).
- Adult Mortality from Crime: ~0.5-1 year (notable in high-risk areas but less impactful overall).
- Other Factors: The remaining 3-6 years of the gap are largely driven by chronic diseases (e.g., heart disease, cancer, diabetes), which are exacerbated by socioeconomic factors like stress, poor diet, smoking, and limited healthcare access. These factors disproportionately affect the poorest 10% and dominate adult mortality differences.
Notes
- The exact contributions vary by region, sex, and specific causes. For instance, men in the poorest 10% face a larger gap (10-12 years) than women (8-10 years) due to higher exposure to accidents and homicides.
- Data on the top and bottom 10% specifically is less granular than for the 1% extremes, so estimates rely on broader income quartile trends and county-level disparities.
- Chronic diseases and systemic issues (e.g., healthcare access, stress) are the largest drivers of the gap, with accidents and crime playing secondary but notable roles.
Comparison to Extreme Outliers
The top and bottom 1% are extreme outliers which, by definition, involve few people in the population. Sanders compares the top 1% outlier group the bottom 50% of the US population, which does not tell us much other than to create a large number (7 years).
The extreme outliers (top and bottom 1% or 10%) show larger gaps due to amplified socioeconomic disparities:
- Top 1% vs. Bottom 1%: As noted, the gap is 14.6 years for men and 10.1 years for women, driven by vast differences in wealth, elite healthcare, and low exposure to risks like crime or occupational hazards for the rich, versus severe deprivation for the poorest.
- Top 10% vs. Bottom 10%: The gap shrinks to 10–12 years for men and 8–10 years for women, as the bottom 10% includes less extreme poverty, and the top 10% has less extreme wealth.
- Middle 30%–70%: The 1–3-year gap is much smaller because the middle range excludes the extreme advantages of the ultra-wealthy (e.g., concierge medicine, stress-free lifestyles) and the extreme disadvantages of the poorest (e.g., homelessness, no healthcare). The middle group’s more similar living conditions—decent housing, some healthcare access, and moderate job stability—reduce the impact of socioeconomic factors.
Implications for the Overall Population
Focusing on the middle 30%–70% gives a better sense of life expectancy trends for the “typical” population, as it excludes the extremes that skew overall averages. The small 1–3-year gap suggests that for most people, socioeconomic differences have a modest but measurable impact on longevity. This contrasts with the dramatic gaps at the extremes, where wealth or poverty amplifies health disparities. For the overall population:
I asked about the 30th to 70th percentile – and the values provided by the AI are likely interpolated. Turns out there are studies that look at the 25th to 75th percentile groups which represents household incomes from about $36k to $130k. The income level does not take into account the differences in cost of living – such that, say, a person earning $50k at one place might have a lifestyle equivalent to someone earning $75k in a more expensive area.
For most people, the difference in life expectancy is likely 1-3 years – versus 7 in Sander’s comments, or up to 14 years when comparing the top 1% to the bottom 1% (which is commonly used in many advocacy stories).
The differences are not due solely to income but, as shown above, also due to accidents, overdoses and crime, and one’s sex (male or female).
Then there is this: Why do wealthy Americans only live as long as poor people in western Europe?
(This assumes the populations between the areas are otherwise identical characteristics. For example, the study did not take into account race and ethnicity and many other possible factors.)
