Researchers Daniel Oesch and Nathalie Vigna make the following point about a decline in quality life years for the working class in the United States: “The most tangible sign that the quality of life of the working class has declined comes from mortality rates in the United States, showing that the life expectancy of lowly educated middle-aged whites has been falling since 1999.”⁹⁶

Moreover, research by economists Raj Chetty and David Cutler et al. found “In the United States between 2001 and 2014, higher income was associated with greater longevity, and differences in life expectancy across income groups increased.”⁹⁹

The American Psychological Association Task Force makes the point that race is a determinant of longevity in America: “On average, African-Americans lived eight years less than Hispanic men and six years less than White men.”²⁷⁸

Nobel laureate Angus Deaton explains the health and mortality gap created by income distribution: “Not only does the top 1% of the income distribution live longer than everyone else, but the gap in life expectancy at 40 years of age is widening, and there has been little gain in life expectancy among the lowest income individuals living in the United States. The infamous 1% is not only richer, but much healthier. Conditional on reaching 40 years of age, individuals in the top 1% of income have 10 to 15 more years to enjoy their richly funded lives and to spend time with their children and grandchildren, and they are pulling away from everyone else. Inequality in health reinforces inequality in income, and perhaps even a longer life is for sale.”¹⁰⁰

Nonetheless, while the rich in America live longer, their healthcare outcomes are worse than other high-income countries.

Research published by JAMA in 2018 found the following: “In 2016, the United States spent nearly twice as much as 10 high-income countries on medical care and performed less well on many population health outcomes.”³²⁸

Even more startling is what Ezekiel J. Emanuel, MD, PhD et al. found in 2021.

In an “Original Investigation” published by JAMA Internal Medicine, the authors found: “…White US citizens in the 1% and 5% highest-income counties obtained better health outcomes than average US citizens but had worse outcomes for infant and maternal mortality, colon cancer, childhood acute lymphocytic leukemia, and acute myocardial infarction compared with average citizens of other developed countries.”³³²

They continue: “For 6 health outcomes, the health outcomes of White US citizens living in the 1% and 5% richest counties are better than those of average US citizens but are not consistently better than those of average residents in many other developed countries, suggesting that in the US, even if everyone achieved the health outcomes of White US citizens living in the 1% and 5% richest counties, health indicators would still lag behind those in many other countries.”³³²

Moreover, the OECD also found “The United States spends more on healthcare than any other OECD country, both as a proportion of GDP (16.9%) and per person. Spending is expected to increase with healthcare as a proportion of GDP forecast to reach 20% by 2030.”³³¹