Being poor is a major leading cause of death in America, new research suggests. The study’s authors estimate that there were roughly 180,000 poverty-related deaths among people over the age of 15 in 2019—a total only surpassed by deaths from heart disease, cancer, and smoking that year.
Poverty has long been known to be an important risk factor for poor health and early death. Those struggling to make ends meet are more likely to live in places with unclean air and water and will have higher rates of chronic illness, along with reduced access to good healthcare. Studies have found that people living in the poorest neighborhoods of America can have a life expectancy 10 to 20 years lower than those living in the richest ones. But scientists from the University of California, Riverside and elsewhere say there hasn’t been much research looking at the annual strain of poverty on U.S. mortality.
In this new study, published Monday in JAMA Internal Medicine, the authors analyzed sources of nationally representative income and death data collected regularly in the U.S. Then, based on earlier estimates of how much poverty contributes to mortality, they calculated how many poverty-related deaths likely occurred in 2019.
All told, they estimated that 183,000 deaths of Americans over 15 were associated with poverty that year. It’s a figure above many other major causes of death, including drug overdoses, homicides, suicides, and the seasonal flu, though there might be some overlap between these causes. According to the same analysis, only deaths linked to heart disease, cancer, and smoking clearly outpaced poverty in 2019. The mortality impact of poverty also appears to be strongest after age 40, which was when the gap in deaths began to increase substantially between poorer and richer Americans.
“Poverty is a major risk factor for death, and results in a huge quantity of death in the U.S.,” lead author David Brady, a professor of public policy at UC Riverside, told Gizmodo in an email.
The poverty rate in the U.S. is worse than in many wealthy peer countries (estimates vary depending on the methodology, but the national rate was 12.8% in 2021, according to the Census Bureau). And the toll of poverty in America may have only gotten worse since, the study authors note. While there were initially sweeping policies that helped Americans stay on their feet and reduced poverty during the covid-19 pandemic, these policies have largely ended, and the current poverty rate appears to have once again reached or risen slightly above pre-pandemic levels. Covid-19 has also directly killed more than a million Americans over the past three years, and poorer people are more likely to die from covid-19 than those well-off.
“My expectation is that poverty-associated death got MUCH worse since 2019,” Brady wrote. “Poverty was likely a major exacerbating factor for covid, and covid caused an enormous increase in death.”
Unfortunately, things aren’t looking to get better on the poverty front anytime soon. Last week, President Biden agreed to sign a resolution that officially ended the country’s declaration of a national emergency concerning the pandemic, though it was only about a month ahead of schedule from the administration’s stated plan to do so. Among the many consequences of this decision will be the end of pandemic-era federal rules that increased Medicaid enrollment in many states, a crucial source of health coverage for the poor. Without major reforms, poverty in America looks to be stuck in the status quo—a status quo that’s harmful to the country as a whole, the team notes.
“Poverty costs our society enormous resources and suffering,” Brady said. “Reducing poverty would likely reduce mortality substantially. And, the benefits of poverty-reducing policies should include the lives saved.”