Half a century of economic transformations have severely impacted certain Americans, particularly those with limited education, who are not only left behind but also face greater health issues and shorter lifespans, according to fresh research.
The research published in Epidemiology and spearheaded by Arline Geronimus, a professor at the University of Michigan School of Public Health and an inductee of the National Academy of Medicine, investigated local communities and how macroeconomic transformations have fostered escalating educational disparities in health and longevity.
Geronimus and her associates discovered that prolonged economic downturns affected life expectancy, especially among adults with lower educational attainment.
Utilizing data spanning from 1990 to 2017, the research indicated that Americans residing in economically stagnant regions were more prone to experience heightened stress and significantly increased levels of chronic illness, living 1-2 years less between the ages of 25 and 84 when compared to individuals in more affluent regions of the nation.
“These results imply that structural economic shifts over the last fifty years have had significant, enduring consequences on health—particularly for those with less education,” the authors of the study expressed.
Geronimus stated that the investigation “reinforces the overarching idea that macroeconomic restructuring has inequitably influenced life expectancy for less-educated versus more educated adults, affecting both white and Black Americans, leading to increased mortality rates and additional years of life lost for the least educated living in regions where economic opportunities were most negatively impacted by macroeconomic shifts.”
Geronimus and the research team examined the varying impacts of economic transitions across different areas of the U.S. to determine if such changes contributed to the widening disparity in life expectancy based on education—and which life-threatening health issues played a crucial role.
Their findings revealed that job loss, diminished security, and other detrimental effects of the evolving economy, including globalization and technological advancements, exacerbated the stress individuals already experience while striving to succeed.
“The capacity of less-educated workers to make ends meet, prevent food insecurity, or access essential healthcare has been persistently challenged since 1980,” Geronimus noted. “In response to prolonged economic distress and social exclusion, less-educated workers often engage in high-effort adaptive strategies.
“For instance, taking on multiple low-paying roles, which reflects the belief that their economic uncertainty can be exceeded through hard work and perseverance. In the face of strong societal challenges, this persistent coping can cumulatively lead to the wear and tear or deterioration of crucial bodily systems, thus increasing the likelihood of cardiometabolic diseases and cancers.”
Adult life expectancy for this demographic has plateaued over the past fifty years, long before the onset of the COVID-19 pandemic, according to Geronimus. This stagnation coincided with worsening economic opportunities for the least educated adults as positions were lost to globalization and technological innovations.
In contrast to common narratives, the study also discovered that elevated rates of death from suicide or substance abuse were not the primary contributors to the life expectancy disparity. Instead, the divergence was predominantly linked to heightened mortality from cancer, cardiovascular diseases, metabolic disorders, and other internal health issues associated with chronic stress.
“It is essential to acknowledge that these findings do not diminish the significance and devastation of the opioid crisis in 21st century America nor our necessity to confront it,” Geronimus remarked. “Rather, other elements such as targeted marketing and excessive opioid prescriptions during the early years of the epidemic, along with the growing availability and widespread accessibility of fentanyl, a highly lethal synthetic opioid, in more recent years, constitute the main explanations for the opioid crisis and the resultant fatalities.”
The researchers emphasized that mitigating deaths from chronic diseases will necessitate collective actions aimed at ensuring equity for all workers, rather than merely promoting improvements in their individual health behaviors. They urge economic and health policymakers to remain vigilant regarding the adverse health impacts stemming from significant structural changes in the economy for the benefit of less-educated workers.
Co-authors of the research include: Timothy Waidmann and Vincent Pancini from the Urban Institute, John Bound from U-M and the National Bureau of Economic Research, and Meifeng Yang from U-M.