Wealth Is Health

In my last post I explored the surprising finding that middle class and affluent African-Americans lead shorter lives on average than white people with similar incomes. Why talk about Blacks who are at the higher end of the socioeconomic spectrum when impoverished African-Americans would seem to face more serious health challenges? Here’s why: because the shorter average lifespan of more financially comfortable African-Americans indicates that racism is so entwined with our society’s past and present that even financially successful Blacks can’t escape its malign influence.

First, some statistics. White men live 4.4 years longer than Black men on average. For women, the gap is smaller but still significant.

Drilling down on the differences between white men’s and Black men’s life expectancies, we see that Black men die at a much higher rate in their 60s and 70s than their white counterparts.

Small health yields on higher incomes

Socioeconomic status is a generally a good predictor of life expectancy but the relationship between the two is weaker in the Black community. We actually see proof at a cellular level that poor and non-poor Blacks age at similar speeds while poor whites age significantly faster than non-poor ones. According to a 2018 article in the academic journal Social Science and Medicine, the data “demonstrate that allostatic load scores [a fancy way of saying wear-and-tear on the body as a result of exposure to chronic stress] and telomere [a structure at the end of chromosomes that get shorter as we age] length are similar for working-age poor and non-poor Blacks but significantly different for their White counterparts.”

And thus we shouldn’t be surprised that a greater percentage of middle-aged, middle-class Blacks report being in poor or fair health than their white counterparts. The widening gap between the two groups’ self-reported health quality as the members of each group move into their 50s leads to 60-79 year-old Blacks dying at a much higher rate than whites in this age group.

Short stays at the top

The authors of the Social Science and Medicine article present a compelling argument for why everyday racism is partly to blame for the smaller health benefits higher earning African-Americans get from their greater incomes. However, I think we should also consider another way that racism damages the health of higher-income Blacks. I’d like to suggest that it’s not just the traumas of the past and the indignities of the present that harm Black health but also financial worries about the future. 

The 1970’s TV show The Jeffersons depicted an African-American couple that moved from a working-class neighborhood in Queens, NY to a wealthy one on the upper east side of Manhattan as a result of the success of George Jefferson’s dry-cleaning business. In the series’ famous (at least to us grey-hairs who grew up in the ‘70s or before) theme song Movin’ On Up, the Jefferson’s proudly declare that they “finally got a piece of the pie.” The data unfortunately shows that for many upwardly mobile African-Americans that piece of the pie can be snatched away at any time as a result of centuries of racism that have stood in the way of Black accumulation of wealth (i.e., assets, such as a house, as opposed to income). 

More affluent whites are often better able to retain their comfortable socioeconomic position because they tend to be much wealthier than Blacks, especially at higher income levels. Wealth is a buffer that prevents families from going into a tailspin when financial or medical calamity – which are often the same thing in the US – strikes. Not surprisingly, African-Americans are bearing the brunt of the economic fallout from the COVID-19 pandemic. When you lack economic resilience, you’re continually on guard for any threat to yours and your family’s economic well-being. Being on high alert 24/7 for decades of life wears on Black minds and bodies, aging many African-Americans prematurely.

This lack of a wealth buffer causes many more middle-class African-Americans to experience downward mobility than middle-class whites (chart below). Not only is wealth a buffer against financial calamity but it also allows white families to buy homes in nicer areas with better schools than Blacks with similar incomes. This also contributes to a discrepancy in wealth because going to an inferior school ultimately results in reduced lifetime earnings and homes in less desirable areas don’t appreciate as much as homes in more desirable ones. The excellent cover story from a recent Sunday New York Times, “What Is Owed“, discusses all the ways in which systemic racism has deprived African-American families of the chance to build wealth throughout our nation’s history.

African-Americans need more than better access to good healthcare and well-paying jobs to achieve health equity with whites. They need a society that enables them to achieve wealth equity by redressing the wrongs of the past and by ending the wrongs of the present.