Income & Health Disparities:
Poverty is a Health Issue
The amount of money we make is one of the primary drivers of health. Higher income is associated with better overall health and longer life expectancy. In Colorado, the highest earning men and women in the state live 6 to 10 years longer than those at the bottom of the income spectrum. A recent study concluded that poverty poses a greater societal health burden than any other risk factor.
How is poverty measured?
The official poverty measure, known as the federal poverty level (FPL), was developed in the 1960s. It was based on a low-cost food budget multiplied by three to account for all other costs of living. The thresholds have only been adjusted for inflation since they were first developed. The federal poverty level severely underestimates the cost of modern living. Despite its limitations, it is used widely to calculate eligibility for a variety of poverty and work support programs.
The interactive graph compares the federal poverty level to the Self-Sufficiency Standard basic needs budget by county. The income needed to meet basic needs exceeds the federal poverty level in every county across the state.
Fig. 4. Income required to meet basic needs exceeds federal poverty level
Self-Sufficiency Standard compared to Federal Poverty Level
Physical and Mental Health
Nearly 23 percent of Coloradans living at the federal poverty level (FPL) report experiencing poor or fair physical health. At each progressively higher income level, a declining share of people report poor or fair health. The same trend holds for reports of limited ability to work due to health issues.
People at the lowest end of the income spectrum are also more likely to report a limited ability to work for health reasons. Slightly more than one-third of people making less than the federal poverty level report impaired ability to work. What’s more, nearly 43 percent of private sector workers in Colorado—about 800,000 people across the state—do not have paid sick days.
Fig. 5. Fewer higher income Coloradans report poor/fair health and limited ability to work due to health challenges
Percent Reporting Poor/Fair Health Status and Limited Ability to Work due to Health Issue, by Income, 2015
Source: Colorado Health Access Survey
Living in poverty is taxing and stressful on both adults and children. Research has shown that growing up poor can impair brain function and mental health as an adult. It’s not surprising then that Coloradans living in poverty were three times more likely to report poor mental health compared to people in higher income brackets. Individuals in the lowest income bracket were also twice as likely to skip needed care for mental health compared to people earning two to three times the federal poverty level.
Fig. 6. Fewer higher income Coloradans report poor mental health and skipping needed care
Percent Reporting ≥ 8 Poor Mental Health Days in the Past Month and Skipped Needed Mental Health Care, by Income, 2015
Source: Colorado Health Access Survey
Obesity and Diabetes
Colorado has the lowest obesity rate in the nation. Low statewide obesity, however, masks the disparity in obesity rates by income. People earning less than $15,000 have an obesity rate nearly 10 percentage points higher than people earning $50,000 or more.
Obesity increases the risk of serious health problems, including heart disease, type 2 diabetes, high blood pressure, high cholesterol, stroke and some types of cancer. These conditions increase health care costs and strain the health and wellbeing of families. Diabetes rates are nearly three times higher among people earning less than $15,000 compared to people making $50,000 or more.
Fig. 7. Obesity and diabetes rates decline with income
Rates of Obesity and Diabetes, by Income, 2013-2014
Source: Colorado Behavioral Risk Factor Surveillance System Statistics
Life Expectancy and Income
A direct correlation exists between income and life expectancy. Higher income is unequivocally associated with a longer life span. Recent research found that the wealthiest men in America live 15 years longer than the poorest men. The same is true among women: the wealthiest women in the U.S. live a decade longer than women at the opposite end of the income spectrum.
We see the same trends in life expectancy by income in Colorado.
- Women in the top 25 percent of the income distribution live 6 years longer than women in the bottom 25 percent.
- The gap is even larger among men, where the wealthiest men in the state live over a decade longer than men at the bottom of the income distribution.
- While overall life expectancy has been increasing across the population, these gains have not closed the longevity gap between income groups.
- Men in the bottom quarter of the income distribution in Colorado, in particular, have not seen any improvement in life expectancy in the last 14 years.
- It’s well documented that women tend to live longer than men on average. Yet, that trend is more apparent among low-income people. Low-income women live about 6 years longer than men. At the highest income levels, women live less than year longer than men.
It’s important to note that these findings do not necessarily point to a causal relationship between income and longevity. But the data does suggest a strong association between health and income that likely involves differences in access to opportunity, education and varied health behaviors.
Fig. 8. Wealthier people in Colorado live 6 to 10 years longer than low-income people
Life Expectancy for Women in Colorado, by Income Group, 2001-2014
Life Expectancy for Men in Colorado, by Income Group, 2001-2014
Source: Raj Chetty et al., The Association between Income and Life Expectancy in the United States, 2001 – 2014