Life expectancy of less-educated Americans decreasing

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), is a freelance journalist based in Denver and former topic leader on aging for AHCJ. She haswritten for the New York Times, Kaiser Health News, the Washington Post, the Journal of the American Medical Association, STAT News, the Chicago Tribune, and other publications.

Call it the life expectancy gap.

While Americans with higher education degrees are living longer, white men and women without high school diplomas are seeing their life expectancies shrink – by four years since 1990.

Public health professor S. Jay Olshansky, based at the University of Illinois at Chicago, wrote about this remarkable trend in Health Affairs recently (AHCJ members have free access) and Sabrina Tavernise picked up the story for The New York Times.

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

Of most interest to Tavernise is what’s underlying this development, which is not affecting either blacks or Hispanics with similarly low education levels. (That observation is worthy of further investigation. Why would whites be affected but not others in similar circumstances?)

Could it be higher levels of obesity, smoking and prescription drug use among poor educated white women? The trend toward single parenting, with all the stress that this implies? Low wage jobs that don’t offer much flexibility, another potential source of stress? The lack of health insurance?

Tavernise writes:

“There’s this enormous issue of why,” said David Cutler, an economics professor at Harvard who was an author of a 2008 paper that found modest declines in life expectancy for less educated white women from 1981 to 2000. “It’s very puzzling and we don’t have a great explanation.”

“Something is going on in the lives of disadvantaged white women that is leading to some really alarming trends,” Jennifer Karas Montez of Harvard told the New York Times.

Here are the numbers from the Health Affairs study, sponsored by the MacArthur Foundation Research Network on an Aging Society, which will be participating in an AHCJ webcast on aging trends:

White women without high school diplomas have a life expectancy of 73.5 years, compared with one of 83.9 years for women with college degrees, according to the latest estimates available. Between 1990 and 2008, life expectancies for poorly educated white women fell by five years.

White men without have school diplomas have a life expectancy of 67.5 years, compared with one of 80.4 years for men with a college degrees. Betwteen 1990 and 2008, life expectancies for poorly educated white men fell by three years.

To me, this is one of the most graphic, vivid illustrations of the growing gap between “haves” and “have nots” in America that I’ve yet seen.

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For reporters, it’s an occasion to probe further.

What do white adults at the bottom of the educational ladder say about their lives? What are the challenges they face day in and out? What do they think of their futures? What vision do they have of growing old? What examples do they look to? What circumstances confront their elderly moms and dads, aunts and uncles, friends and neighbors?

The data in the Health Affairs piece provides a news hook that can anchor this kind of investigation. It allows reporters to observe that what is at stake is not just sour grapes, the sense of a group of Americans falling on hard times and having been left behind. What’s at stake is people’s lives, and how they live beyond middle age.

It’s important to note that other data sources are available for reporters. An important one is Institute for Health Metrics and Evaluation, which published new information about life expectancies in every U.S. county in April, including historical comparisons, and presented results from the research at the AHCJ annual meeting in Atlanta. Several other studies worth knowing about are also mentioned in the Health Affairs piece and The New York Times story.

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