The Health of the Poorest 50%
This chapter focuses on the health of the poorest 50% of Americans. Pretax income for the poorest 50% of Americans has remained the same over the past 40 years, while their after-tax income has dropped as taxes have increased for this same group. Regressive taxation has deepened wealth gaps, virtually assuring a continuing cycle of low income earning. The national share of income owned by the richest 50% of Americans has grown commensurately during this period, and the health indicators have responded accordingly. The slope of the income–health relationship has grown even steeper since 2000; the health advantage that those with higher incomes have over those with lower incomes is greater than it has been in the past four or more decades. Why is this? Americans continue to invest less in the social resources that can mitigate the challenges that come with a lower income, even as they spend ever more on high-end medicine that is accessed principally by those who can afford it. Social institutions like education that traditionally have led to social mobility and better health have become increasingly the provenance of the well-off.